Efficacy of cochlear implants in children with borderline hearing who have already achieved significant language development with hearing aids

• Published in: PloS one Vol. 17; no. 6; p. e0267898
• Main Authors: Kim, Young Seok, Kim, Yehree, Lee, Seung Jae, Han, Jin Hee, Yi, Nayoung, Yoo, Hyo Soon, Carandang, Marge, Lee, Sang-Yeon, Kim, Bong Jik, Choi, Byung Yoon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-06-2022; Public Library of Science (PLoS)
• Subjects: Accuracy; Auditory perception; Biology and Life Sciences; Care and treatment; Children; Cochlea; Cochlear implants; Cytomegalovirus; Deafness; Ears & hearing; Etiology; Hearing aids; Hearing disorders in children; Hearing loss; Implantation; Keywords; Language; Language acquisition; Language skills; Magnetic resonance imaging; Medicine and Health Sciences; Pediatric research; Pediatrics; Perception; Phonation; Psychological aspects; Social Sciences; Speech; Speech perception; Speeches; Statistical analysis; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0267898

There are still debates about timing and effectiveness of cochlear implants (CI) in pediatric subjects with significant residual hearing who do not belong to traditional indication of CI. In this study, we aimed to investigate the outcomes of CI, specifically on improvement of pronunciation, among hearing-impaired children already with a substantial degree of language skills as evaluated by Categories of Auditory Perception (CAP) scores or sentence score. Our cohort comprised pediatric CI recipients from July 2018 through October 2020. Among them, cases with CAP scores of 5 or 6 preoperatively were defined as "borderline cases". We investigated prevalence and etiologies, and compared speech evaluation data preoperatively and postoperatively at three time points (3, 6 and 9-12 months after implantation). Among 86 pediatric CI recipients, 13 subjects (15.12%) had language development that reached CAP scores of 5 or 6 before implantation. Postoperative speech evaluation data 6 months after implantation revealed significant improvement of pronunciation (Urimal Test of Articulation and Phonation scores: UTAP), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and word perception scores, but not of CAP and sentence perception scores. Notably, the significant improvement of pronunciation based on UTAP scores outstripped that of other speech parameters and this continued steadily up to one-year postoperatively. The result of the study serves as evidence for what to expect from cochlear implantation in hearing-impaired children who have already achieved a substantial degree of language development in terms of CAP scores or sentence perception scores, preoperatively.