Indications and counterindications for cochlear implantation in children
Manrique, M.; Huarte, A.; Cervera-Paz, F.J.; Espinosa, J.M.; Molina, M.; Garcia-Tapia, R.
American Journal of Otology 19(3): 332-336
1998
ISSN/ISBN: 0192-9763 PMID: 9596184 Document Number: 490089
Objective: This study is aimed to analyze the current indications and counterindications of cochlear implantation (CI) in children. Study Design: This study reviews the children implanted in our institution looking specifically at the following aspects: 1) auditory criteria for candidate selection; 2) age at implantation; 3) educational environment; and 4) associated handicapping conditions. Setting: Tertiary referral center with experience in CI since 1989 with inpatient and outpatient care. Intervention: All children received a Mini Nucleus 22 CI device (Cochlear Limited, Australia) in a standard surgical procedure. Results: Regarding auditory criteria, children with average hearing level of 100-105 dB HL are more likely to obtain benefit from a CI than from a hearing aid. The minimum age for CI should be as soon as there is a reliable diagnosis of bilateral profound hearing loss, while the maximum age for CI depends on strict selection criteria of candidates. The educational environment is of a great importance in the rehabilitation process, permitting a progressive change to oral communication. Our experience in CI of children with multiple handicapping conditions is limited to a case of a deafblind child who was implanted with a good performance. In the selection of these children it is mandatory to have extensive multidisciplinary evaluation. Conclusions: An experienced team is needed in the selection of children for CI. Candidates should meet anatomic criteria, have a reliable diagnosis of bilateral profound hearing loss, an evaluation of communication skills, and extensive neuropediatric and socioeducational evaluation.