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The pediatric postoperative outcomes of the cochlear implant systems
Saidia A. , Bouchair A. , Djerad N.
Hopital Dr. Dorban, ENT Department, Annaba, Algeria
Cochlear implants (CI) have considerably improved quality of life in children with bilateral profound hearing loss,
by offering them significantly greater access to sound, which has promoted an increase in communication
abilities. Some of those children develop oral language and speech production skills. CI outcome in children with
profound deafness is highly variable. The purpose of this study is to present the postoperative auditory
performance, the speech intelligibility scores and the integration into mainstream school system of children
implanted with CI.
Between May 5 , 2007 and April 29 , 2013, 44 patients with a bilateral profound deafness have been implanted
unilaterally with a NUCLEUS™ FREEDOM™ system (Cochlear Corp. Australia) and included to a retrospective
cohort study. A postoperative evaluation of the auditory performance (CAP, APCEI) and the speech intelligibility
(SIR, IT-MAIS) was assessed. The integration to into mainstream school system was followed.
44 children were included in the analysis, 23 males and 19 females. The mean age at implantation was 4±1.6
years old (yo) (2 yo - 10 yo). The duration of the follow-up (FU) was from 9 months to 6 years (Y). 98% of
children were prelingually deaf. The cohort was divided into two groups. Group 1 (G1) (n=9) with less than 2Y
after the CI implantation and group 2 (G2) (n=23) with more than 2Y after the implantation.
The auditory performance (APCEI, CAP) of G1 was scored as follow: APCEI: 10, CAP: 4 (3-5) whereas the G2:
APCEI: 18, CAP 5 (4-6). Moreover, the speech intelligibility (SIR, IT-MAIS) of G1 was scored as follow: SIR: 1
(0-3), IT-MAIS < 2 while the G2: SIR: 3 (2-4) and IT-MAIS between 3 and 4 for all questions. Likewise, All
children of G2 are integrated into school system whose 78% into mainstream school.
The results showed the ability of children of G1 of discrimination of sounds (CAP: 4) and their primary ability to
discriminate words (APCEI: 10) with an absence of speech intelligibility (SIR: 1). Immediately after 2Y after
implantation, The CAP scores were gradually increased, all the children understood phrases (CAP: 5) with very
good speech intelligibility (SIR: 3) and IT-MAIS between 3 and 4 for all questions. 2Y after CI, and despite the
lack of motivation of the parents (67%), all children were able to integrate the school system whose 78% into
mainstream school system.
These data suggest that implanting children with CI allows the best opportunity for them to acquire
communication skills. A rigorous FU of speech and language therapy is critical to acquire the best auditory
performance and speech intelligibility. Thanks to a strict speech therapy FU of at least 2Y, the cochlear
implanted patient is able to integrate a school system.
All children with congenital deafness who underwent CI before age of 6Y appeared to benefit from the implant.
However, the data add the evidence of the importance of a strict long term speech and language therapy FU.