Long-Term Auditory and Speech Outcomes of Cochlear Implantation in Children With Cochlear Nerve Aplasia.
Xiuhua Chao, Jianfen Luo, Ruijie Wang and 4 others
PMID 36476611WHAT IT FOUND
Children with absent cochlear nerves improved after cochlear implantation and rehabilitation, but hearing and speech scores remained lower than children with normal nerves.
At last follow-up, 27 of 55 could recognize words without choices.
Key findings
01Children with cochlear nerve aplasia who received cochlear implants and rehabilitation had higher aided hearing thresholds and lower auditory, speech, and word recognition scores than children with normal-sized cochlear nerves.
02After cochlear implantation and rehabilitation, children with cochlear nerve aplasia improved over time, but open-set speech performance remained limited.
03At last follow-up, 27 participants had some open-set speech perception, 10 passed closed-set testing, and 18 could not pass or cooperate with closed-set testing.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Retrospective single-center case-control study, so it cannot prove that cochlear implantation and rehabilitation caused the gains. Controls were matched but not randomly assigned, and groups had different cochlear implant programming settings. Some children used hearing aids in the other ear, and the study did not analyze how much that affected auditory and speech progress. CAP and SIR scores only partially assess hearing and speech, so pronunciation and other spoken-language skills were not answered. Many children could not complete speech tests early, and one child stopped wearing the device, so the group changed over follow-up. Individual outcomes varied widely, and the study did not show a preoperative scan measure that predicts which child will benefit most.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that cochlear implantation and rehabilitation restore typical hearing and speech in children with absent cochlear nerves. These children improved, but their aided hearing thresholds, auditory and speech scores, and word recognition remained lower than matched children with normal nerves, and many still had limited open-set speech.