Hearing-impaired Children and Adults in Need of Cochlear Implant- A Hospital Based Cross-sectional Study

Abstract

Introduction: Hearing is essential to learn language and speech and to develop cognitive skills. According to World Health Organisation (WHO), world-wide approximately 350 million people have hearing disorder. The performance of some moderately severe hearing-impaired adults and children using hearing aids is poorer than that of even profoundly hearing-impaired individuals using cochlear implants with advanced speech processing strategies. Aim: To find out the appropriate candidates in need of cochlear implantation in Prayagraj district of Uttar Pradesh, India. Materials and Methods: This cross-sectional study was conducted on hearing impaired patients attending Ear Nose Throat (ENT) Out Patient Department (OPD) of tertiary health care center in Prayagraj Uttar Pradesh from August 2011 to July 2012. The study population consisted of 95 patients categorised into four groups (pre-lingual children and adults, post-lingual children and adults) who presented with the chief complaints of impaired hearing and delayed speech. A detailed history, clinical and other relevant systemic examination and investigations were done. Patients were subjected to free field audiometry, pure tone audiometry and Brainstem-Evoked Response Audiometry (BERA) for assessment of hearing threshold level. Patients used hearing aid for six months and after hearing aid use, their hearing threshold and speech discrimination scores were estimated. Patients, whose aided score on open-set sentence test was less than 50%, were selected as candidate for cochlear implants, as they were not significantly benefited by hearing aids. Results: Out of the 95 cases, 48 were found to be suitable for cochlear implantation, which formed 50.5% of the study group. Pre-lingual hearing impaired adults had the highest percentage i.e., 86.7%, fulfilling the criteria for cochlear implantation followed by pre-lingual children, in whom 46.7% fell in this category. A 26.7% of postlingual children and 20% of postlingual adults were found suitable for cochlear implantation. Conclusion: The pre-lingual hearing impaired children and adults are more in need for cochlear implantation than the postlingual hearing-impaired children and adults. Approximately, 134,501 cases were estimated to be, in need of cochlear implantation in Prayagraj district based on the census estimate of 2011.