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Yu C, Luo J, Zhong M, Wang R, Chao X, Qiu J, Xu L, Graham PL, Psarros C. Factors impacting outcomes of cochlear implantation in children at two University centres in China: Multi-year analysis from the Paediatric Implanted Recipient Observational Study (P-IROS). Cochlear Implants Int 2024:1-14. [PMID: 39106152 DOI: 10.1080/14670100.2024.2382579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVES To identify factors affecting functional hearing performance and quality of life (QoL) outcomes in paediatric cochlear implantation (CI) recipients at two University centres in mainland China. METHODS Two university centres in mainland China, part of the prospective longitudinal Paediatric Implanted Recipient Observational Study (P-IROS), contributed participant data. Participants were aged under 10 years at time of CI. Functional hearing performance and QoL measures were collected prior to device activation, and at 6-monthly intervals for 2 years post-implantation. Functional hearing endpoints including Categories of Auditory Performance-II (CAP-II) and QoL were evaluated and analysed using ordinal mixed-effects regression models. RESULTS Data were from 288 children with a mean age at implant of 2.74 years. Overall follow-up at 1 year was 59% and 51% at 2 years. Younger age at implantation (p<0.001) and hearing aid use preimplantation (p=0.026) were associated with significant benefit. Bilateral device users (both CI and bimodal) achieved significantly better functional hearing performance on the CAP-II than unilateral CI users (p<0.001). Slower functional hearing improvements were observed in those with lower parental expectations compared to higher expectations (p<0.001). QoL improved over time but followed a different initial trajectory between centres. CONCLUSION All participants demonstrated significant improvements in auditory performance and QoL over time. Younger age at CI, and bilateral/bimodal device fitting contributed to earlier improvements. Other potential factors that could help inform families, professionals, and health authorities about choice of hearing device and educational supports required included aetiology of hearing loss and level of maternal education.
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Affiliation(s)
- Chongxian Yu
- Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Jianfen Luo
- Department of Otolaryngology and Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, People's Republic of China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, People's Republic of China
| | - Mei Zhong
- Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Ruijie Wang
- Department of Otolaryngology and Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, People's Republic of China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, People's Republic of China
| | - Xiuhua Chao
- Department of Otolaryngology and Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, People's Republic of China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, People's Republic of China
| | - Jianxin Qiu
- Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Lei Xu
- Department of Otolaryngology and Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, People's Republic of China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, People's Republic of China
| | - Petra L Graham
- School of Mathematical and Physical Sciences, Macquarie University, Sydney, Australia
| | - Colleen Psarros
- Cochlear Limited (Asia Pacific), Macquarie University, Sydney, Australia
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Micaletti F, Boullaud L, Amelot A, Schleich M, Pondaven-Letourmy S, Lescanne E. Day-case otology: Special attention to the pediatric cochlear implantation procedure. Int J Pediatr Otorhinolaryngol 2024; 179:111932. [PMID: 38537448 DOI: 10.1016/j.ijporl.2024.111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Assess the feasibility of cochlear implantation as day-surgery in children and identify variables influencing admission, readmission, and unplanned postoperative consultation. METHODS This retrospective observational monocentric study was conducted according to the STROBE recommendations. Between January 2017 and July 2022, all medical records of children who underwent cochlear implantation were analyzed. Eligible children were admitted for the first time to the pediatric day-surgery unit. Exclusion criteria were children planned for inpatient procedure, bilateralization or explantation-reimplantation. Sex assigned at birth, analgesic medication, anesthesia and complications were related to categorical variables. Age, duration of anesthesia, length of stay and ASA score were related to continuous variables. RESULTS We included 66 children from a total of 106. Mean age was 53 months [SD: 46 months, range 8-184 months]. Successful day-surgery management was observed in 86% of cases. In 14% of cases, children were admitted to the pediatric ENT unit for the following reasons: late awakening in 6%, non-controlled pain in 4.5%, postoperative nausea and vomiting in 3.5% of cases. Univariate analysis did not observe any factor promoting success of day-surgery regarding anesthetic agents. Age was not statistically significant as a factor of ambulatory failure. Time spent in the operating room was not a determining factor (p = 0.559). None of the children were rehospitalized. Early unplanned consultations were observed in 3% of cases for vertex edema in 1 case and uncomplicated otorrhea in 1 case. CONCLUSION This study adds to the knowledge on pediatric cochlear implantation and suggests that this procedure is suitable for day-surgery at any age.
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Affiliation(s)
- Fabrice Micaletti
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France.
| | - Luc Boullaud
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France
| | - Aymeric Amelot
- Neurosurgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; INSERM U1253, IBrain, University of Tours, Tours, France
| | - Marianne Schleich
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France
| | - Soizick Pondaven-Letourmy
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; Pediatric Head and Neck Surgery Department, University Hospital Center of Tours, 49 Boulevard Béranger, 37000, Tours, France
| | - Emmanuel Lescanne
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; Pediatric Head and Neck Surgery Department, University Hospital Center of Tours, 49 Boulevard Béranger, 37000, Tours, France; Faculty of Medicine, Université de Tours, 10 Boulevard Tonnellé, 37044, Tours, France
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Cottrell J, Spitzer E, Friedmann D, Jethanamest D, McMenomey S, Thomas Roland J, Waltzman S. Cochlear Implantation in Children Under 9 Months of Age: Safety and Efficacy. Otol Neurotol 2024; 45:121-127. [PMID: 38082466 DOI: 10.1097/mao.0000000000004071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To assess the safety of cochlear implants (CIs) in children under 9 months of age to better understand expected postoperative complication rates, and to provide a preliminary look at efficacy. STUDY DESIGN Single-center retrospective review. SETTING Tertiary referral center. PATIENTS Children 5 to 8 months of age who received a CI between 2011 and 2021. INTERVENTIONS Therapeutic-CI. MAIN OUTCOME MEASURES The primary outcome was 6-month postoperative complication rate. Secondary outcomes included length of stay, device explantation/reimplantation, rehabilitation supports, and hearing and language outcomes. Complications of children implanted under than 9 months of age was compared with a cohort of children implanted 9 to 18 months of age between the years 2011 and 2016 using a chi-squared test ( p < 0.05). RESULTS One hundred six children under 9 months of age were implanted (204 CIs) at a mean age of 6.6 months (range: 5-8). Postoperative complications occurred in 28 patients (26%) and were often minor. There were no mortalities. There was no statistically significant difference in complications, including reimplantation rates, between patients implanted under 9 months of age and those implanted 9 to 18 months of age. Speech discrimination outcomes were excellent, and mean spoken language outcomes were near normative for typically developing children. CONCLUSIONS Cochlear implantation can be a safe and effective treatment option for children 5 to 8 months of age. Early hearing screening and referral for infants to receive appropriate intervention will continue to play a critical role in optimizing speech and language outcomes.
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Affiliation(s)
- Justin Cottrell
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone, New York, NY
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Cuzzuol BR, Apolonio JS, da Silva Júnior RT, de Carvalho LS, Santos LKDS, Malheiro LH, Silva Luz M, Calmon MS, Crivellaro HDL, Lemos FFB, Freire de Melo F. Usher syndrome: Genetic diagnosis and current therapeutic approaches. World J Otorhinolaryngol 2024; 11:1-17. [DOI: 10.5319/wjo.v11.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
Usher Syndrome (USH) is the most common deaf-blind syndrome, affecting approximately 1 in 6000 people in the deaf population. This genetic condition is characterized by a combination of hearing loss (HL), retinitis pigmentosa, and, in some cases, vestibular areflexia. Among the subtypes of USH, USH type 1 is considered the most severe form, presenting profound bilateral congenital deafness, vestibular areflexia, and early onset RP. USH type 2 is the most common form, exhibiting congenital moderate to severe HL for low frequencies and severe to profound HL for high frequencies. Conversely, type 3 is the rarest, initially manifesting mild symptoms during childhood that become more prominent in the first decades of life. The dual impact of USH on both visual and auditory senses significantly impairs patients’ quality of life, restricting their daily activities and interactions with society. To date, 9 genes have been confirmed so far for USH: MYO7A, USH1C, CDH23, PCDH15, USH1G, USH2A, ADGRV1, WHRN and CLRN1. These genes are inherited in an autosomal recessive manner and encode proteins expressed in the inner ear and retina, leading to functional loss. Although non-genetic methods can assist in patient triage and disease extension evaluation, genetic and molecular tests play a pivotal role in providing genetic counseling, enabling appropriate gene therapy, and facilitating timely cochlear implantation (CI). The CRISPR/Cas9 system and viral-based gene replacement therapy have recently emerged as highly promising techniques for treating USH. Regarding drug therapy, PTC-124 and Nb54 have been identified as promising drug interventions for genetic HL in USH. Simultaneously, CI has proven to be critical in the restoration of hearing. This review aims to summarize the genetic and molecular diagnosis of USH and highlight the importance of early diagnosis in guiding appropriate treatment strategies and improving patient prognosis.
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Affiliation(s)
- Beatriz Rocha Cuzzuol
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Jonathan Santos Apolonio
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Lorena Sousa de Carvalho
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luana Kauany de Sá Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luciano Hasimoto Malheiro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Marcel Silva Luz
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Mariana Santos Calmon
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Henrique de Lima Crivellaro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabian Fellipe Bueno Lemos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
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Honigman T, Cushing SL, Papsin BC, Waltzman S, Woodard J, Neumann S, Fitzgerald MB, Gordon KA. Safety and Early Outcomes of Cochlear Implantation of Nucleus Devices in Infants: A Multi-Centre Study. Trends Hear 2024; 28:23312165241261480. [PMID: 38887094 PMCID: PMC11185016 DOI: 10.1177/23312165241261480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024] Open
Abstract
This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9-11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012-December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.
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Affiliation(s)
- Tal Honigman
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sharon L. Cushing
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Susan Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Jennifer Woodard
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Matthew B. Fitzgerald
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Karen A. Gordon
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Department of Communication Disorders, The Hospital for Sick Children, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
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Di Stadio A, De Luca P, Ippolito V, Vedova P, Garofalo S, Turchetta R, Ferlito S, della Volpe A. Comparative Analysis of Intellectual Quotient in Developmental Population with Severe Hearing Loss: Hearing Aids vs. Cochlear Implant Users. Life (Basel) 2023; 14:12. [PMID: 38276261 PMCID: PMC10820146 DOI: 10.3390/life14010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
The development of language, memory and intellectual functions is linked to normal hearing and correct sounds interpretation. Hearing loss (HL), especially in its severe form, negatively affects the development of these functions. This prospective study aimed at comparing the Intelligent Quotients (IQ) of children with cochlear implants (CI) with the ones of people wearing hearing aids (HA) after one year of hearing rehabilitation. 21 subjects with severe/profound bilateral hearing loss (deafness) were included in this study. Eleven children with congenital profound HL underwent CI and ten children with moderate to severe HL (congenital and acquired) were rehabilitated by HA. Children's IQs were assessed at enrolment (T0) and 12 months after hearing aids/CI use plus speech therapy. Statistical analyses were performed to analyze the data within and between groups. Comparison of IQs showed no statistically significant differences between CI and HA none at T0 and T1. The subtests showed lower scores in verbal comprehension and process speed index in patients treated with HA when compared to CI. This study showed that auditory rehabilitation can support the normal development of cognitive function in children between six and eight years of age. The use of the correct hearing aids based on the patient's hearing thresholds is important to maximize the rehabilitation outcomes. Due to the small sample size, although stratified for age, our results must be considered preliminary and further analyses on larger samples are needed to confirm our data.
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Affiliation(s)
- Arianna Di Stadio
- GF Ingrassia Department, University of Catania, 95121 Catania, Italy;
| | - Pietro De Luca
- Otolaryngology Department, Isola Tiberina—Gemelli Isola Hospital, 00186 Rome, Italy; (P.D.L.); (A.d.V.)
| | - Valentina Ippolito
- ENT Department, Pediatric CI Regional Referral Centre, Santobono-Pausilipon Children’s Hospital of Naples, 80129 Naples, Italy; (V.I.); (S.G.)
| | - Paola Vedova
- Neuropsychiatric Department, Santobono-Pausillipon Hospital, 80129 Naples, Italy;
| | - Sabina Garofalo
- ENT Department, Pediatric CI Regional Referral Centre, Santobono-Pausilipon Children’s Hospital of Naples, 80129 Naples, Italy; (V.I.); (S.G.)
| | - Rosaria Turchetta
- Pediatric Audiology Unit, Organ of Sense Department, University La Sapienza of Rome, 00185 Rome, Italy;
| | - Salvatore Ferlito
- GF Ingrassia Department, University of Catania, 95121 Catania, Italy;
| | - Antonio della Volpe
- Otolaryngology Department, Isola Tiberina—Gemelli Isola Hospital, 00186 Rome, Italy; (P.D.L.); (A.d.V.)
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