Feasibility analysis and surgical highlight of cochlear implantation in infants under 12 months of age

Abstract

To explore feasibility and surgical highlight of cochlear implantation in infants under 12 months of age. A retrospective review was performed in 14 infants under 12 months of age and 63 cases from 13 to 24 months of age with bilateral profound sensorineural hearing loss, who underwent unilateral cochlear implantation surgery. The operative parameters, including operation duration, amount of intraoperative bleeding, length of hospital stay, surgical complications and auditory outcomes, including warble tone average aided in free field, category of auditory performance (CAP), language behavior development quotient, babbling onset or spurt were recorded. There was no significant difference between infants younger than 12 months and older in operation duration, amount of intraoperative bleeding, except for the length of hospital stay. Otherwise, less complication occurred in younger group (7.1% and 11.1%, respectively, χ(2) = 0.19, P > 0.05). The surgical highlights and experience, strictly restricted operation duration, intimate cooperation among the treatment team members and reduction of intraoperative bleeding are key points to ensure safety and success of the operation. The warble tone average aided in free field and language behavior developmental quotient of younger infants were both improved during follow-up and showed no significant difference compared with older group (t = 4.6 and 3.8, P > 0.05). 80% of infants who finished 24 months follow-up had a CAP score of 6 or 7. The babbling onset in younger group occurred at (14.1 ± 0.9) months of life, which was better than that in older group [(22.6 ± 3.0) months of life]. It is feasible to put cochlear implantation in infants under 12 months of age. And the earlier cochlear implantation could shorten auditory deprivation for children with bilateral congenital profound sensorineural hearing loss. Considering the high requirement of surgical highlights and experience, the suggest was that only experienced otologists challenge this domain cautiously.