Outcome of cochlear implantation at different ages from 0 to 6 years.

OBJECTIVE To evaluate the outcome of cochlear implantation in young children in relation to the age at implantation. STUDY DESIGN A retrospective longitudinal and cross-sectional analysis of pediatric cochlear implant patients. PATIENTS All children with congenital deafness who underwent implantation before the age of 6 years (n = 48 for the longitudinal analysis and n = 70 for the cross-sectional analysis) INTERVENTIONS All children received a multichannel cochlear implant. MAIN OUTCOME MEASURES Categories of Auditory Performance (CAP) score and integration into the mainstream school system. RESULTS For all children, the CAP score increased after implantation. Implantation beyond the age of 4 years hardly ever resulted in normal CAP scores or in integration into the mainstream primary school (20 to 30% of cases). Implantation between the age of 2 and 4 years always resulted in normal CAP scores after 3 years with a 66% probability of integration into the primary school. Implantation before the age of 2 years always resulted in immediate normalization of the CAP scores, with a 90% probability of integration into the mainstream kindergarten, well before entrance into the primary school. CONCLUSION All children with congenital deafness who underwent implantation before the age of 6 years appeared to benefit from the implant. However, these data add evidence to the importance of early implantation (before the age of 2 years). Intervention before the age of 4 years seemed to be critical to avoid irreversible auditory performance losses, and intervention before the age of 2 years seemed to be critical to achieve optimal results.