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The challenge of a mature final diagnosis of hearing loss severity and early cochlear implantation

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Abstract

Purpose

Despite the recent trend of cochlear implantation (CI) at the age of six or even four months is prevalent in many centers around the world, clinicians should be cautious because perinatal risk factors of auditory neuropathy and/or delayed maturation carry the possibility of reversible hearing loss, yielding better auditory performance at the age of one year. The purpose of this study is to raise awareness that early CI may not be universal for all patients. In addition, we specify the factors to be considered in the pre-operative evaluation of CI in infants younger than one year.

Methods and results

This study describes four cases provisionally diagnosed with severe to profound sensorineural hearing loss that were presented to the CI clinic to determine candidacy for implantation. Two cases had histories of prematurity, one had Down syndrome, and one had a family history of hearing loss. None of the study cases were candidates for CI, as they had varying degrees of hearing improvement.

Conclusion

Although early CI may yield better auditory performance, the final diagnosis should be made only after repeated subjective and objective measurements as well as family feedback on the child's auditory performance, especially in preterm children. Early auditory brainstem response (ABR) prior to the age of one year in children with cognitive, neurologic, or developmental comorbidities should be interpreted with caution, as ABR "alone" could not accurately represent the child's true hearing ability in this patient population.

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Data availability

The figures and table contain all the data necessary to support the findings. No additional data is available.

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Funding

This study was not funded by any governmental or private sponsor.

Author information

Authors and Affiliations

  1. Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Mahmoud M. Mahrous

  2. Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

    Mahmoud M. Mahrous

  3. Physiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Yomna A. El-Khattib

Authors
  1. Mahmoud M. Mahrous
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  2. Yomna A. El-Khattib
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Contributions

MMM, YAEl-K: contributed in study design, data collection and analysis in addition to manuscript writing and revision of the manuscript.

Corresponding author

Correspondence to Mahmoud M. Mahrous.

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Conflict of interest

The authors declare no conflicts of interest or any commercial relation with the contents of the manuscript.

Ethical approval

A retrospective study where parents of the children have given their written informed consent. The Otolaryngology Department Board ethically approved the study.

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Mahrous, M.M., El-Khattib, Y.A. The challenge of a mature final diagnosis of hearing loss severity and early cochlear implantation. Eur Arch Otorhinolaryngol 281, 2011–2022 (2024). https://doi.org/10.1007/s00405-023-08439-2

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  • DOI: https://doi.org/10.1007/s00405-023-08439-2

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