Cochlear Implantation in Children Under 9 Months of Age: Safety and Efficacy

• Published in: Otology & neurotology Vol. 45; no. 2; pp. 121 - 127
• Main Authors: Cottrell, Justin, Spitzer, Emily, Friedmann, David, Jethanamest, Daniel, McMenomey, Sean, Thomas Roland, Jr, J, Waltzman, Susan
• Format: Journal Article
• Language: English
• Published: United States 01-02-2024
• Subjects: Child; Cochlear Implantation - adverse effects; Cochlear Implants - adverse effects; Deafness - surgery; Hearing; Humans; Infant; Postoperative Complications - surgery; Speech; Speech Perception; Treatment Outcome
• ISSN: 1531-7129; 1537-4505
• DOI: 10.1097/MAO.0000000000004071

To assess the safety of cochlear implants (CIs) in children under 9 months of age to better understand expected postoperative complication rates, and to provide a preliminary look at efficacy.
Single-center retrospective review.
Tertiary referral center.
Children 5 to 8 months of age who received a CI between 2011 and 2021.
Therapeutic-CI.
The primary outcome was 6-month postoperative complication rate. Secondary outcomes included length of stay, device explantation/reimplantation, rehabilitation supports, and hearing and language outcomes. Complications of children implanted under than 9 months of age was compared with a cohort of children implanted 9 to 18 months of age between the years 2011 and 2016 using a chi-squared test ( p < 0.05).
One hundred six children under 9 months of age were implanted (204 CIs) at a mean age of 6.6 months (range: 5-8). Postoperative complications occurred in 28 patients (26%) and were often minor. There were no mortalities. There was no statistically significant difference in complications, including reimplantation rates, between patients implanted under 9 months of age and those implanted 9 to 18 months of age. Speech discrimination outcomes were excellent, and mean spoken language outcomes were near normative for typically developing children.
Cochlear implantation can be a safe and effective treatment option for children 5 to 8 months of age. Early hearing screening and referral for infants to receive appropriate intervention will continue to play a critical role in optimizing speech and language outcomes.