Advantages of cochlear implantation in prelingual deaf children before 2 years of age when compared with later implantation

OBJECTIVES
To compare the auditory abilities and speech performance of children with a profound prelingual bilateral hearing-impairment when subjected to a cochlear implant (CI) before or after 2 years of age. To analyze the complications that arose during, or as a result of, the implantation process in these groups.

DESIGN
Prospective cohort single-subject, repeated-measures study of children with profound bilateral hearing impairment subjected to CI.

SETTING
Tertiary referral center with a program of pediatric CI from 1991.

PATIENTS
This study analyzed 130 children subjected to multichannel CI for profound prelingual bilateral hearing-impairment in two age groups: 0 to 2 (n = 36) and 2 to 6 years of age (n = 94).

INTERVENTIONS
The children were evaluated before, and each year after, the intervention (for up to 5 years) with both closed-set and open-set auditory and speech perception tests. Their speech ability was evaluated according to the Peabody Picture Vocabulary and Reynell general oral expression scales.

RESULTS
Auditory and speech perception tests improved significantly in all children after CI, regardless of the follow-up time. The infant's performance was better the earlier the implant was performed. Speech tests showed that the development of children treated before 2 years of age was similar to normal children, and no additional complications were observed when compared with CI in older children.

CONCLUSIONS
When performed before 2 years of age, CI offers a quicker and better improvement of performance without augmenting the complications associated with such an intervention.

CITA DEL ARTÍCULO Laryngoscope. 2004 Aug;114(8):1462-9