Onset Of Hearing Loss Research Articles

PB1958 SUDDEN ONSET HEARING AND VISUAL LOSS: AN UNUSUAL PRESENTATION OF CHRONIC PHASE CHRONIC MYELOID LEUKEMIA

Background:Hearing loss and blindness are seldom encountered as primary manifestations in patients with chronic myeloid leukemia. Chronic myeloid leukemia (CML) commonly presents with weakness, dysphagia, abdominal distension and pain and rarely constitutional symptoms. Chronic myeloid leukemia rarely presents with auditory or visual manifestations. Hyperleukocytosis at presentation can lead to obstruction of the small vessels of mainly brain, lungs and kidneys leading to organ dysfunctions. Headache, convulsions, stroke, papilledema, hearing loss, tinnitus and vertigo constitute the rare neurological spectrum of CML.Aims:We present a case series of four patients who presented with bilateral sudden onset of hearing and visual loss. This report highlights the unusual presentation of chronic phase CML with visual and sensorineural hearing loss.Methods:A detailed evauation of hisory, clinical examination, ENT & Eye examination was done in each patients. Related radiological evaluation was done as needed.Results:Chronic myeloid leukemia rarely presents with visual or hearing loss and till date, only 29 cases of CML with deafness have been reported. Neurological involvement including deafness, blindness and tinnitus was reported as 15.5% in a series of 33 adults with CML. Otological findings, for instance, sudden hearing loss, vertigo, tinnitus, facial weakness, and infection, were found in 16–40% of patients. However, deafness as an initial sign of this disease is very rare. Bilateral sudden sensorineural hearing loss, vertigo, and nausea were the presenting manifestations of CML in our patients. CML associated deafness presents itself as sensorineural, unilateral, bilateral or starting unilaterally and developing into bilateral. The pathogenesis of this clinical symptom in leukemia is very complex, and may include multiple mechanisms such as leukemic infiltration, hyperviscosity syndrome, inner ear hemorrhage, and infection. A relationship between leukemic infiltration of the cochlea and impairment of hearing in CML has also been mentioned in literature. Cochlear and retinal blastic infiltration may also cause sensorioneural deficit other than leukostasis in CML. Inner ear hemorrhage has been shown as a cause of sudden hearing loss in leukemia by some authors. Hyperleukocytosis is considered to be the foremost pathogenesis of CML with hearing loss, as suggested by recovery of hearing upon leukapheresis in some cases.Summary/Conclusion:CML should be considered as one of the rare diagnostic possibilities in patients presenting with sudden onset of hearing and visual impairment and managed on an emergent basis as delay can result in permanent impairment.image

Prelingual Deaf Children Treated With Cochlear Implant: Monitoring Performance With Percentiles.

To develop a percentile ranking system driven by speech recognition data obtained from different groups of patients treated with a cochlear implant to serve as a tool to monitor the progress of these patients. Prospective study. Tertiary referral center. Diagnosed with a bilateral, profound sensorineural hearing loss treated with a unilateral cochlear implant. Diagnostic. Six different percentiles (p) were classified taking into account the correlation between speech recognition outcome scores and age at implantation, with reference to the onset of hearing loss. Four hundred sixteen prelingual patients were included. These subjects were divided into subgroups depending on age at implantation.Prelingual group, from the fifth year after implantation, p50 centered on the following percentages of correct words in each subgroup: 100, 94.6, 91.4, 91.0, 79.2, and 63.1% in children implanted under 12 months, 1, 2, 3, 4 to 6, 7 to 10 years, respectively. After a 12-year follow-up, a significant negative correlation between age at implantation and speech recognition was observed in both prelinguals (Rhos=-0.578, p<0.001). A percentile system was developed to monitor the postimplant progress of prelingual deaf implanted patients, with potential applications in patient follow-up and handling circumstances that may deteriorate results.

Communication participation in older adults with dual sensory loss

ABSTRACT Purpose: Living with a dual sensory loss (DSL), the impairment of both vision and hearing, has a significant impact on the daily life for many older adults, particularly limiting an individual’s ability to access information from their surroundings and to communicate effectively. Method: This study investigated the communication modes (n = 513; spoken, manual), communication systems use (n = 513; e.g., oral, signed, tactile), and communication participation (n = 302; participation in conversation, groups, social activities, loneliness) of adults aged 50 years and older who had been diagnosed with a DSL. Results: The majority of older adults with DSL used oral communication, with a small number using manual forms of communication, and few people using both oral and manual communication. Those who used oral communication tended to be older and had later onset of vision loss, hearing loss, and dual sensory loss. Severity of DSL and vision loss were not associated with communication participation. Severity of hearing loss was associated only with ability to participate in group conversations and withdrawal from conversation. Regardless of the communication mode used, older adults with DSL reported difficulties with communication participation, especially in terms of participating in group conversations, and reported frequently withdrawing from conversation, being alone when they would rather not be, and limited participation in social activities outside of the home. Conclusions: Communication participation is a frequent difficulty for older adults with DSL. Research is required to gain a richer understanding of the communication participation of older adults with DSL and how they and their communication partners can best be supported.

Phonological development in Portuguese deaf children with cochlear implants: Preliminary study

IntroductionChildren with severe to profound sensorineural hearing loss and prelingual onset of deafness exhibit less linguistic skills and poorer academic achievements when compared with their hearing peers. Recent studies show that cochlear implants may promote language development in this paediatric population, although phonological development does not always follow the patterns attested for typically developing children. Aim and methodThe present study aims at describing the phonetic properties of segments and the phonological processes produced by 18 deaf Portuguese children with more than 2.0 years of implant use, divided into two groups according of their hearing age (A=2.10-4.04 and B=5.04-7.03) For this purpose, we used a formal articulation test validated for the Portuguese population. ResultsResults show that Group B, with a higher hearing age, exhibit a consonant repertoire more complete than Group A, whose hearing age was lower. Syllable and segmental difficulties tend to persist over a long period of time, even after 4 years of implant experience (i.e. hearing age). DiscussionThe children's consonant repertoire of plosives and fricatives seems to take longer to establish in deaf children with cochlear implants than in their Portuguese hearing peer; other phonological patterns found in the data show an immature phonological development (e.g. syllable omission and onset deletion); these results match the ones reported for other languages in other studies on cochlear implanted children.

Cortical Visual Impairment in Congenital Cytomegalovirus Infection.

To describe the presentation, evolution, and long-term outcome of cortical visual impairment (CVI) in patients with symptomatic congenital cytomegalovirus (CMV) infection, and to identify risk factors for the development of CVI in patients with symptomatic congenital CMV. Retrospective subanalysis of a long-term prospective cohort study with data gathered from 1982 to 2013. Eleven of 77 (14.3%) patients with symptomatic CMV, 0 of 109 with asymptomatic CMV, and 51 control patients had CVI. Overall, patients with symptomatic CMV had worse vision than patients with asymptomatic CMV, who in turn had worse vision than control patients. Microcephaly, intracranial calcification, dilatation of ventricles, encephalomalacia, seizure at birth, optic atrophy, chorioretinitis/retinal scars, strabismus, and neonatal onset of sensorineural hearing loss were risk factors associated with CVI. CVI may result from symptomatic congenital CMV infection. The relationship of CVI and its risk factors in patients with CMV suggests the potential to predict the development of CVI through predictive modeling in future research. Early screening of CVI in children born with symptomatic congenital CMV can facilitate educational, social, and developmental interventions. [J Pediatr Ophthalmol Strabismus. 2019;56(3):194-202.].

Time From Hearing Aid Candidacy to Hearing Aid Adoption: A Longitudinal Cohort Study.

Although many individuals with hearing loss could benefit from intervention with hearing aids, many do not seek or delay seeking timely treatment after the onset of hearing loss. There is limited data-based evidence estimating the delay in adoption of hearing aids with anecdotal estimates ranging from 5 to 20 years. The present longitudinal study is the first to assess time from hearing aid candidacy to adoption in a 28-year ongoing prospective cohort of older adults, with the additional goal of determining factors influencing delays in hearing aid adoption, and self-reported successful use of hearing aids. As part of a longitudinal study of age-related hearing loss, a wide range of demographic, biologic, and auditory measures are obtained yearly or every 2 to 3 years from a large sample of adults, along with family, medical, hearing, noise exposure, and hearing aid use histories. From all eligible participants (age ≥18; N = 1530), 857 were identified as hearing aid candidates either at baseline or during their participation, using audiometric criteria. Longitudinal data were used to track transition to hearing aid candidacy and hearing aid adoption. Demographic and hearing-related characteristics were compared between hearing aid adopters and nonadopters. Unadjusted estimated overall time (in years) to hearing aid adoption and estimated delay times were stratified by demographic and hearing-related factors and were determined using a time-to-event analysis (survival analysis). Factors influencing rate of adoption in any given time period were examined along with factors influencing successful hearing aid adoption. Age, number of chronic health conditions, sex, retirement status, and education level did not differ significantly between hearing aid adopters and nonadopters. In contrast, adopters were more likely than nonadopters to be married, of white race, have higher socioeconomic status, have significantly poorer higher frequency (2.0, 3.0, 4.0, 6.0, and 8.0 kHz) pure-tone averages, poorer word recognition in quiet and competing multi-talker babble, and reported more hearing handicap on the Hearing Handicap Inventory for the Elderly/Adults emotional and social subscales. Unadjusted estimation of time from hearing aid candidacy to adoption in the full participant cohort was 8.9 years (SE ± 0.37; interquartile range = 3.2-14.9 years) with statistically significant stratification for race, hearing as measured by low- and high-frequency pure-tone averages, keyword recognition in low-context sentences in babble, and the Hearing Handicap Inventory for the Elderly/Adults social score. In a subgroup analysis of the 213 individuals who adopted hearing aids and were assigned a success classification, 78.4% were successful. No significant predictors of success were found. The average delay in adopting hearing aids after hearing aid candidacy was 8.9 years. Nonwhite race and better speech recognition (in a more difficult task) significantly increased the delay to treatment. Poorer hearing and more self-assessed hearing handicap in social situations significantly decreased the delay to treatment. These results confirm the assumption that adults with hearing loss significantly delay seeking treatment with hearing aids.

Pediatric Ototoxicity: Current Trends and Management.

Medical interventions to combat serious infection or malignancies carry significant morbidities, including ototoxicity. While these lifesaving drugs are often necessary to preserve life, the impact on quality of life for survivors is increasingly concerning for families and healthcare providers. Of primary importance for medical prescribers are appropriately sensitive ototoxicity grading scales and audiological monitoring protocols for surveillance for hearing loss. The intent of grading scales is to help communicate complicated audiological information to non-audiologist healthcare providers (such as oncologists) to help them make good decisions with regards to chemotherapy dosing. Appropriate audiological monitoring helps reduce the time delay between the adventitious onset of hearing loss and the diagnosis and intervention. Finally, pediatric ototoxicity grading and monitoring protocols help ensure timely access to adequate hearing habilitation, verification and validation of the management of permanent medication-induced hearing loss and tinnitus in children.

Feasibility of magnetic resonance imaging in the differential diagnosis of isolated acute audiovestibular loss.

Isolated acute audiovestibular loss is characterized by the sudden onset of unilateral hearing loss and prolonged vertigo. The purpose of this study is aimed to identify the value of magnetic resonance imaging (MRI) for the evaluation of isolated acute audiovestibular loss. We retrospectively enrolled 31 patients with isolated acute audiovestibular loss from March 2007 to December 2017. Specific medical records including initial and final pure tone audiometry (PTA), and canal paresis value were reviewed. Abbreviated MRI was performed in all patients. Fifteen patients showed increased signal of labyrinth on FLAIR images and eleven revealed negative findings on MRI. Two patients showed an infarction in the anterior inferior cerebellar artery (AICA) territory and three exhibited vestibular schwannoma in the internal auditory canal. There were no significant differences in initial, final PTA, and hearing recovery between negative and labyrinthine abnormality groups on MRI. Our results show that isolated acute audiovestibular loss due to labyrinthitis is more common than other secondary causes including vestibular schwannoma or AICA infarction. However, MRI with a tailored, abbreviated protocol is strongly recommended in patients with isolated acute audiovestibular loss to identify the exact etiologies.

Risks of Ear Complaints of Passengers and Drivers While Trains Are Passing Through Tunnels at High Speed: A Numerical Simulation and Experimental Study.

Ear complaints induced by interior pressure transients are common experiences for passengers and crew members when high-speed trains are passing through tunnels. However, approaches to assessing the risks of the pressure-related aural discomfort have not been reported until recently. The objective of this study was to evaluate the hazards of interior pressure transients of high-speed train on human ears combining the effects of operation speed and seal index. Moving model tests were conducted to obtain the pressure transients when the model train runs in the tunnel. The recorded data were transformed into the interior pressures by empirical formula. Furthermore, the aural sensations were divided into four levels hierarchically and the range for each level was derived by logistic regression analysis method and represented by three biomechanical metrics. Furthermore, a human middle ear finite element (FE) model was used to simulate its dynamics under the interior pressures. The results indicate that lifting operation speed from 250 km/h to 350 km/h in tunnel will prolong the duration of ear complaints by more than two times whereas improving the seal index from 4 s to 12 s will reduce the incidences of the onset of tinnitus and hearing loss by more than ten times. In addition, the duration of aural comfort shortens from the head car to the tail car against the running direction. It is desirable that enhancing the seal index improve the aural sensations of the passengers and crew members considering the lifting operation speed of high-speed train.

Consequences of auditory experience and cochlear implant stimulation on tuning and other measures obtained in pre-lingually deaf children and postlingually deaf adults

Children and adults with moderate to severe hearing loss may obtain cochlear implants (CIs) to restore auditory perception, but auditory development differs among them. We have compared various peripheral measures across CI listeners differing in etiology, age of onset and duration of hearing loss, and duration of CI use. Several measures assess the efficacy with which CI electrodes activate their target auditory neurons in individuals with varying hearing demographics. In addition to peripheral contributions to auditory perception, central reorganization might occur when the auditory nerve is stimulated with coarse, electrical input from CIs. Evidence from neurophysiological studies in cats suggest that the central representation of spectral/spatial resolution is altered by chronic CI stimulation. In humans, psychophysical tuning curves might reflect both the spread of electrical current in the cochlea and the central representation of electrical stimuli. Understanding how chronic, electrical stimulation during auditory system development affects spectral resolution may be useful for optimizing CI programming in children and adults.

Is tinnitus a major concern in individuals with auditory neuropathy spectrum disorder? - Questionnaire based study.

ObjectiveOur study attempted to determine if tinnitus is a major concern in individuals with auditory neuropathy spectrum disorder (ANSD). The study also attempted to determine if pure tone average (PTA), speech identification scores (SIS), or reported duration of hearing loss could predict the tinnitus severity and functional handicap in adults with ANSD.MethodsTinnitus functional index (TFI) and tinnitus severity index (TSI) were administered on all the 40 participants diagnosed with ANSD.ResultsThe mean TFI score was 44.3, which suggested moderate degree of tinnitus related functional impairment. The mean TSI score was found to be 33.3, which suggested moderate degree of severity in individuals with ANSD. The study also showed that tinnitus causes functional impairment that leading to sleep disturbances, emotional problems, and affecting the quality of life. There was no significant correlation (P > 0.05) between PTA, SIS, reported onset of hearing loss and scores of TFI or TSI.ConclusionTinnitus in individuals with ANSD should also be given priority during assessment and provide appropriate tinnitus management.

Cellular Differences in the Cochlea of CBA and B6 Mice May Underlie Their Difference in Susceptibility to Hearing Loss.

Hearing is an extremely delicate sense that is particularly vulnerable to insults from environment, including drugs and noise. Unsurprisingly, mice of different genetic backgrounds show different susceptibility to hearing loss. In particular, CBA/CaJ (CBA) mice maintain relatively stable hearing over age while C57BL/6J (B6) mice show a steady decline of hearing, making them a popular model for early onset hearing loss. To reveal possible underlying mechanisms, we examined cellular differences in the cochlea of these two mouse strains. Although the ABR threshold and Wave I latency are comparable between them, B6 mice have a smaller Wave I amplitude. This difference is probably due to fewer spiral ganglion neurons found in B6 mice, as the number of ribbon synapses per inner hair cell (IHC) is comparable between the two mouse strains. Next, we compared the outer hair cell (OHC) function and we found OHCs from B6 mice are larger in size but the prestin density is similar among them, consistent with the finding that they share similar hearing thresholds. Lastly, we examined the IHC function and we found IHCs from B6 mice have a larger Ca2+ current, release more synaptic vesicles and recycle synaptic vesicles more quickly. Taken together, our results suggest that excessive exocytosis from IHCs in B6 mice may raise the probability of glutamate toxicity in ribbon synapses, which could accumulate over time and eventually lead to early onset hearing loss.

Fever-related ataxia: a case report of CAPOS syndrome

BackgroundCAPOS (Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy and Sensorineural hearing loss) syndrome is caused by the heterozygous mutation, c.2452G > A, in the ATP1A3 gene. Other mutations in this gene can cause a spectrum of overlapping phenotypes including alternating hemiplegia of childhood, rapid onset dystonia parkinsonism, early infantile epileptic encephalopathy and fever induced paroxysmal weakness and encephalopathy. The phenotype is still mistaken for mitochondrial/metabolic disorders and follow up studies are scare.Case presentationWe report a 20 year old Norwegian male with ataxia, sensorineural deafness and visual loss. Before the age of five he experienced three fever related episodes of acute neurological deterioration when he temporarily lost his acquired motor skills and developed persistent gait and limb ataxia. In childhood, he developed bilateral optic atrophy and bilateral sensorineural hearing loss. Motor skills improved and at age 20 the patient showed a mild ataxia, hearing loss and reduced vision. A c.2452G > A mutation in the ATP1A3 gene was identified and CAPOS syndrome was confirmed.ConclusionsThis is the first Norwegian patient reported with CAPOS syndrome. Our patient had a de novo, previously identified ATP1A3 mutation. The combination of recurrent episodes of fever related ataxia, loss of motor skills in early childhood, and early onset hearing and vision loss is typical of CAPOS syndrome. Previous reports suggest a gradual progression of the disease after the initial episodes, while this patient showed a good outcome with improvement of motor skills from adolescence long after the last deterioration episode.

Early Intratympanic Methylprednisolone in Sudden SNHL: A Frequency-wise Analysis.

Sudden sensorineural hearing loss is a dire medical emergency which must be treated at the earliest to get better long term hearing results. Our study aims to determine the efficacy of intratympanic steroid (Methylprednisolone) on auditory outcomes in patients of sudden sensorineural hearing loss and study the relation between time of onset of hearing loss to start of therapy and frequency-wise recovery of hearing loss. A prospective cohort clinical study with 33 patients with sudden hearing loss of 30dB or more were treated with the intratympanic injection of methylprednisolone and the effect of the drug was observed. In this study, 33 patients with sudden onset (unilateral or bilateral) of hearing loss were treated with intratympanic methylprednisolone. The duration at which the drug was administered and the age of the participants was taken into consideration. Main outcome measures included audiometry results at low, medium and high hearing loss frequencies. The specific frequency at which the hearing improvement took place was tabulated. It was observed that hearing improved significantly if the steroid is injected within the first 4days of onset (p < 0.05) at all the frequencies. A gain of 15dB or more was achieved in more than 78% patients after injecting methylprednisolone intratympanically. A statistically significant association was found between recovery rate and frequency of hearing loss with patients showing greater improvement at low hearing loss frequency in comparison to mid and high frequencies (p < 0.05). The drug efficacy does not change with the age of the patient.

Delays in care of sudden sensorineural hearing loss, an unrecognized emergency

Sudden sensorineural hearing loss (SSNHL) is an acute loss of hearing due to poorly understood insults to the inner ear. SSNHL is a medical emergency warranting urgent referral to an otolaryngology specialist because hearing outcomes are improved with steroid treatment that must be administered soon after the onset of hearing loss to be effective, making early diagnosis and triage essential to salvaging hearing. This prospective study catalogued the timeline of the onset of hearing loss, diagnosis, treatment, and settings where care was administered for patients with SSNHL. We diagnosed 21 patients with SSNHL in the otolaryngology specialty clinics of West Virginia University over a 6 month time period. Nine of those patients (42.9%) were diagnosed outside of the window for treatment. The most common cause of delayed diagnosis was inappropriate treatment and triage in the primary care setting, As the quality of life burden of hearing loss is quite significant, improving recognition and triage in the primary care setting would allow for more patients with SSNHL to undergo treatment, improving hearing outcomes and quality of life.

Hearing disorders - findings on computed tomography and magnetic resonance imaging: pictorial essay.

Hearing disorders are usually unilateral and are more common in women. They can be congenital or acquired, and hearing loss is categorized as sensorineural, conductive, or mixed. The onset of hearing loss can be progressive or sudden, and it is a common reason for seeking medical attention. In this context, computed tomography and magnetic resonance imaging have assumed critical roles in the search for an etiological diagnosis and in guiding the therapeutic approach. In this pictorial essay, we illustrate the common causes of hearing loss, discussing the possible differential diagnoses and highlighting the most relevant imaging findings.

Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection—A Case Series with Literature Review

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures, but the occurrence of delayed sudden sensorineural hearing loss (SNHL) after pituitary adenoma resection is extremely rare. In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented, and the possible causes of SNHL were discussed. Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed. The past medical history, onset of sudden hearing loss, accompanying symptoms such as headache, tinnitus, dizziness and aural fullness, and the post-operative MRI images, therapy, and hearing results were reported. Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day, all accompanied by prior headache, tinnitus and dizziness. One patient developed episodic vertigo, ear fullness accompanying with fluctuating hearing loss in the first post-operative month. Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction. Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day. Under treatment with prednisone orally, dexamethasone intratympanic injection, neurotrophic and vasodilatation drugs for 3 to 8 months, hearing of all three improved partially. Obstructive hydrocephalus and ischemia might be responsible for the hearing loss. Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

Possible involvement of cochlear macrophage in the onset of sensorineural hearing loss

Possible involvement of cochlear macrophage in the onset of sensorineural hearing loss

Interplay between Nutrition and Hearing Loss: State of Art.

Hearing loss has been recently ranked as the fifth leading cause of years lived with disability, ahead of many other chronic diseases such as diabetes, dementia, or chronic obstructive pulmonary disease. Moreover, according to the World Health Organization, moderate-to-profound hearing loss affects about 466 million people worldwide. Its incidence varies in each population segment, affecting approximately 10% of children and increasing to 30% of the population over 65 years. However, hearing loss receives still very limited research funding and public awareness. This sensory impairment is caused by genetic and environmental factors, and among the latter, the nutritional status has acquired relevance due its association to hearing loss detected in recent epidemiological studies. Several experimental models have proved that the onset and progression of hearing loss are closely linked to the availability of nutrients and their metabolism. Here, we have reviewed studies focused on nutrient effects on auditory function. These studies support the potential of nutritional therapy for the protection against hearing loss progression, which is especially relevant to the aging process and related quality of life.

Eficacia del implante coclear en la Clínica Visual y Auditiva del Instituto para Niños Ciegos y Sordos del Valle del Cauca

&#x0D; Introducción: La hipoacusia neurosensorial es un problema de especial importancia para el desarrollo intelectual y social de los niños. De su detección temprana y tratamiento oportuno depende un mejor resultado en términos de la ganancia auditiva y logros en el desarrollo del lenguaje y por tanto, en la comunicación. Se estima una incidencia de hipoacusia entre uno a tres por mil nacidos vivos. Cuando se presenta en etapas tardías o en adultos jóvenes produce grandes trastornos en la vida familiar, académica o laboral de las personas. Los implantes cocleares son ahora una alternativa terapéutica de elección en personas que no se benefician de otras ayudas auditiva o con perdida profunda de su audición. Material y métodos: se realizó un estudio cuasi experimental tipo antes y después en 69 pacientes sometidos a implante coclear en el periodo 2013 a 2015 en el Instituto para niños ciegos y sordos del Valle. Todos los pacientes tenían un diagnóstico de hipoacusia de origen neurosensorial bilateral profunda. Se evaluaron, además de las variables socio demográficas, las relacionadas con audimetrías y valoraciones de lenguaje y habla realizadas por personal experto antes y después de la realización del implante. Resultados: El 51% de los pacientes recibieron el implante en etapa prelingual con una mediana de edad de tres años (rango 2 a 12) y 35 pacientes lo recibieron en etapa poslingual (mediana de edad 43 años, rango de 3 a 76). La ganancia en audición fue mayor en pacientes poslinguales pues el 88% alcanzaron un nivel cuatro que corresponde a comprensión del lenguaje hablado. En pacientes prelinguales se observó una mayor variabilidad en los resultados. Todas las diferencias en cuando a la ganancia en audición o niveles de habla fueron estadísticamente significativas. Conclusión: El implante coclear mejoró sustancialmente los niveles de audición y desarrollo del lenguaje en ambos grupos de pacientes. Los factores de mayor importancia pronostica fueron: duración de la hipoacusia, el momento de la aparición de la pérdida auditiva, el apoyo social y familiar y el tipo de rehabilitación realizado luego de la implantación. &#x0D;