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Franchella S, Concheri S, Di Pasquale Fiasca VM, Brotto D, Sorrentino F, Ortolani C, Agostinelli A, Montino S, Gregori D, Lorenzoni G, Borghini C, Trevisi P, Marioni G, Zanoletti E. Bilateral simultaneous cochlear implants in children: Best timing of surgery and long-term auditory outcomes. Am J Otolaryngol 2024; 45:104124. [PMID: 38035465 DOI: 10.1016/j.amjoto.2023.104124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE Evaluate the hearing outcomes of bilateral deaf children implanted simultaneously and define the most appropriate timing for surgery. MATERIALS AND METHODS Audiological CI results were retrieved in both the short-term and long-term period and compared by stratifying the patients into different subcohorts according to their age at surgery. Additional data collected were age at implant activation, etiology and timing of onset of deafness, presence of psychomotor delay. RESULTS fifty-six bilaterally implanted children were included. The short-term outcomes differed significantly when comparing groups of different ages at implantation: younger patients achieved better aided pure tone audiometry results. Considering long-term follow-up, a significant correlation was identified between an early age at implantation and the hearing outcome at ages 2 to 5 years. Perceptive levels were better at 4 years of age in the younger group. No significant differences were found between children implanted at before 12 months and between 12 and 16 months of age. CONCLUSIONS The results of the analyzed follow-up data support the hypothesis that children implanted at before 24 months are expected to have better hearing performances. Nevertheless, these results are referred to a widely heterogeneous group of patients and the duration of auditory deprivation should be considered.
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Affiliation(s)
- Sebastiano Franchella
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Concheri
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | | | - Davide Brotto
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Flavia Sorrentino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Caterina Ortolani
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Anna Agostinelli
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Silvia Montino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Carlotta Borghini
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, Treviso, Italy.
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
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Chen Y, Li Y, Jia H, Gu W, Wang Z, Zhang Z, Xue M, Li J, Shi W, Jiang L, Yang L, Sterkers O, Wu H. Simultaneous Bilateral Cochlear Implantation in Very Young Children Improves Adaptability and Social Skills: A Prospective Cohort Study. Ear Hear 2023; 44:254-263. [PMID: 36126187 DOI: 10.1097/aud.0000000000001276] [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: 11/27/2022]
Abstract
OBJECTIVES To investigate the value of using the Gesell Development Diagnosis Scale (GDDS) to predict developmental outcomes in very young children who undergo simultaneous bilateral cochlear implantation. DESIGN In this prospective cohort study, a repeated-measures investigation was conducted in a tertiary referral hospital. A total of 62 children receiving simultaneous bilateral cochlear implantations were enrolled from April 2017 to August 2018. They were divided into 2 groups depending on the operative age: "Infants" group (6 to 12 months, N = 38) or "Children" group (12 to 36 months, N = 24). Data on the surgical outcomes, auditory development, speech production, and developmental indicators were collected until 2 years after the initial fitting. The primary outcome measure was the GDDS, a neuropsychological development examination. Secondary outcomes included the following: complication rate, aided pure-tone average, Infant-Toddler Meaningful Auditory Integration Scale, Categories of Auditory Performance-II, Meaningful Use of Speech Scale, Speech Intelligibility Rating, and the LittlEARS Auditory Questionnaire. RESULTS The mean ages at implantation in infants and children groups were 9.2 ± 1.17 and 16.6 ± 3.60 months, respectively. Significant differences were found in the social skills ( p = 0.001) and adaptability ( p = 0.031) domains of GDDS. The younger the age of bilateral cochlear implants surgery, the higher developmental quotient of language, social skills, and adaptability the child could achieve after 2 years. The complication rates in the infants and children groups were 0% versus 2.1% ( p = 0.57). There was no surgical complication in the infants group. In the children group, 1 case with enlarged vestibular aqueduct and Mondini malformation had a receiver-implant misplacement on the right side (2%, 1/48). In the two groups, auditory performance and speech production had improved similarly. In the infants group, social skills developmental quotient at baseline had a significant positive relationship with Meaningful Use of Speech Scale after 2 years. CONCLUSIONS Simultaneous bilateral cochlear implantation in younger children improves adaptability and social skills. GDDS is a sensitive tool of evaluating short-term effect of bilateral cochlear implants in neuropsychological development and constitutes a reliable predictor of speech production for the very younger pediatric cochlear implant users.
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Affiliation(s)
- Ying Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Yun Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Huan Jia
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Wenxi Gu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Zhaoyan Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Zhihua Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Minbo Xue
- Child Healthcare Department, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjie Li
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wentao Shi
- Clinical Research Center, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linlin Jiang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Lu Yang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Olivier Sterkers
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
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Orzan E, Pizzamiglio G, Magadle J, Bubbico L, Cutler JM, Consolino P, Burdo S, Zamagni G, Magni E, Mariottini C, Gambacorta V, Ricci G, Brotto D. Early cochlear implantation in prelingual profound hearing loss in Italy, analyzed by means of a social media survey. Front Pediatr 2023; 11:1031341. [PMID: 36816372 PMCID: PMC9935678 DOI: 10.3389/fped.2023.1031341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To assess newborn hearing screening (NHS) impact on timing of cochlear implant (CI) surgery of patients with prelingual bilateral profound hearing impairment (BPHI), in order to evaluate whether the NHS ultimately serves the needs of the target population in Italy. METHODS An online questionnaire was created to survey subjects affected by prelingual BPHL born between 1990 and 2018. Questions focused on age at BPHI diagnosis, first and second CI surgery (if performed), and the region in which the surgery was performed. The survey was distributed to potential participants via social media communities used by hearing impaired people or their family members for sharing advice and offering support. Responses were analyzed using descriptive statistics. RESULTS Among the 318 respondents who completed the questionnaire, 276 (87%) reported having chosen CI surgery, 2/3 of them bilaterally. In the vast majority (97%) of cases the CI is used on a daily basis. Most of the people residing in the center (65%) and southern Italy (71%) had to move from their region of residence to perform the surgery. Late CI surgery was associated with failure to perform NHS (p = 0.007), birth before 2011 (p = 0.009), definitive diagnosis of BPHI after 6 months of life (p = 0.002), and progressive hearing impairment (p < 0.001). CONCLUSION The worldwide scientific approval of the NHS as the current best opportunity for early diagnosis and CI treatment for prelingual BPHI is confirmed by what patients and families reported via the online questionnaire used for this study. In recent years, early bilateral cochlear implantation has become increasingly available in Italy, but late diagnosis, progressive hearing loss, failure to perform the NHS and lack of follow-up are still open questions. A large proportion of families had to move from the region of residence to have their child undergo CI surgery, revealing inequalities in terms of geographical disparities. Social media has proved to be a valuable, fast and inexpensive tool for gathering information on the effectiveness of health prevention programs, involving a large sample of individuals in a short amount of time.
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Affiliation(s)
- Eva Orzan
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Jad Magadle
- Neurology Department, Hadassah University Hospital (Ein Kerem), The Hebrew University, Jerusalem, Israel
| | - Luciano Bubbico
- Department of Sensorineural Disabilities, INAPP/Italian Institute of Social Medicine, Rome, Italy
| | - Jodi M Cutler
- NPO Associazione ASI Affrontiamo la Sordità Insieme, Carpi, Italy
| | | | - Sandro Burdo
- NPO Associazione Italiana Liberi di Sentire, Varese, Italy
| | - Giulia Zamagni
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elena Magni
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Claudio Mariottini
- NPO Famiglie Associate per la Difesa dei Diritti Degli Audiolesi Dell'Umbria (FIADDA Umbria), Castiglione del Lago (Perugia), Italy
| | - Valeria Gambacorta
- Department of Surgery and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Giampietro Ricci
- Department of Surgery and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Davide Brotto
- Otorhinolaryngology Section, Neurosciences Department, Università di Padova, Padova, Italy
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Chweya CM, Smith AJ, May MM, Lohse CM, Neff BA, Driscoll CLW, Carlson ML. Prevalence of Surgical, Anesthetic, and Device-related Complications Among Infants Implanted Before 9 and 12 Months of Age Versus Older Children: Evidence for the Continued Expansion of Pediatric Cochlear Implant Candidacy Criteria. Otol Neurotol 2021; 42:e666-e674. [PMID: 33710142 DOI: 10.1097/mao.0000000000003060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the prevalence of surgical, anesthetic, and device-related complications among infants and older children receiving cochlear implantation (CI). STUDY DESIGN Retrospective chart review. SETTING Tertiary academic referral center. PATIENTS Pediatric patients who underwent CI from November 1990 to January 2020. INTERVENTION CI. MAIN OUTCOME MEASURES Surgical, anesthetic, and device-related complication rates were compared by age group (<12 versus 12-23 versus 24+ months with subset analysis of <9 versus 9-11 months). RESULTS A total of 406 primary pediatric CI surgeries encompassing 482 ears were analyzed, including 45 ears in 23 patients implanted less than 9 months and 89 ears in 49 patients less than 12 months. No anesthetic complications occurred. Postoperative surgical and device-related complication rates were not significantly different among the less than 12, 12 to 23, and 24+ month groups (16% versus 16% versus 12%; p = 0.23) or between the less than 9 and 9 to 11 month groups (22% versus 9%; p = 0.09). Thirty-day readmission was significantly higher for patients less than 12 months compared with patients 24+ months (6% versus <1%; p = 0.011), but was not significantly higher compared with patients 12 to 23 months (6% versus 3%; p = 0.65). Reoperation rates did not differ significantly among the less than 12, 12 to 23, and 24+ month groups (10% versus 7% versus 6%; p = 0.31). CONCLUSIONS The prevalence of surgical, anesthetic, and device related complications was not significantly different among infants implanted less than 9 or less than 12 months of age when compared with older children. These data provide evidence for the continued expansion of pediatric cochlear implant candidacy criteria to include appropriately selected infants less than 9 months of age.
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Affiliation(s)
| | | | | | - Christine M Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Brian A Neff
- Department of Otolaryngology-Head and Neck Surgery
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Brotto D, Sorrentino F, Favaretto N, Bovo R, Trevisi P, Martini A. Pediatric Hearing Loss Management in the COVID-19 Era: Possible Consequences and Resources for the Next Future. Otolaryngol Head Neck Surg 2021; 166:217-218. [PMID: 33940979 DOI: 10.1177/01945998211012677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pediatric hearing loss early diagnosis and treatment have been limited by the current restrictions due to the coronavirus disease 2019 pandemic. The difficulty in accessing the multiple facilities required for the rehabilitative process is influencing the timing of each step of the process. Auditory hearing screening programs, etiological characterization, surgical timing, and speech therapies have all been limited in the past year. The current conditions have forced us to adopt different strategies to overcome the necessary social distancing prescriptions. Although their efficacy should be proved over time, some of these resources will be probably useful even in a nonpandemic future.
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Affiliation(s)
- Davide Brotto
- Otorhinolaryngology Section-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Flavia Sorrentino
- Otorhinolaryngology Section-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Niccolò Favaretto
- Otorhinolaryngology Section-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Roberto Bovo
- Otorhinolaryngology Section-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Patrizia Trevisi
- Otorhinolaryngology Section-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Alessandro Martini
- Centro di Ricerca Interdipartimentale "I-APPROVE," University of Padova, Padova-Venezia, Italy
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Gao Z, Wang S, Yang H, Feng G, Shang Y, Wang B, Tian X, Li Y, Wei X, Shu Z. Simultaneous bilateral cochlear implantation in children aged 12‒18 months is safe and can be performed using standard cochlear implant surgical techniques. Eur Arch Otorhinolaryngol 2020; 277:2193-2197. [DOI: 10.1007/s00405-020-05928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/16/2020] [Indexed: 10/24/2022]
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Sorrentino F, Gheller F, Lunardi G, Brotto D, Trevisi P, Martini A, Marioni G, Bovo R. Cochlear implantation in adults with auditory deprivation: What do we know about it? Am J Otolaryngol 2020; 41:102366. [PMID: 31837837 DOI: 10.1016/j.amjoto.2019.102366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION In the ENT community, auditory deprivation is frequently considered as a negative prognostic factor for a good hearing outcome of cochlear implantation (CI), even if a growing literature suggests that this is not completely true. The purpose of this study is to evaluate the results of CI in patients with hearing deprivation, to compare them to results from non-deprived patients and then estimate how time of deprivation impacts on CI outcome and how a bilateral deprivation can affect the outcome compared to a unilateral deprivation. METHODS Seventy-eight adults with severe to profound post-verbal hearing loss, with and without auditory deprivation history, received CI; audiological results obtained at 3-6-12-24 months follow up post CI were analyzed. RESULTS No differences were founded between patients with unilateral deprivation and patients with no deprivation. Patients with bilateral deprivation seem to have a worse hearing outcome compared to that of those patients with unilateral deprivation or no deprivation at all. Long time deprivation (>15 years) seems to have a negative influence on the hearing outcome but results with CI remain excellent. CONCLUSIONS Auditory deprivation should not be considered a contraindication to CI. The duration of auditory deprivation in the implanted ear seems to be a negative prognostic factor only for ears deprived from more of 15 years.
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Affiliation(s)
- Flavia Sorrentino
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy.
| | - Flavia Gheller
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Giuseppe Lunardi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Davide Brotto
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Patrizia Trevisi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Alessandro Martini
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
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