BMC Ear, Nose and Throat Disorders

Background: There has been increasing demand for the cochlear implantation of children who demonstrate some auditory capacity with conventional hearing aids. The purpose of this study was to examine speech recognition outcomes in a group of children who were regarded as borderline candidates for cochlear implantation as their residual hearing and/or auditory functioning levels exceeded typical audiologic candidacy criteria. Methods: A retrospective chart review was undertaken at one Canadian cochlear implant centre to identify children implanted at age 4 or older with a pure-tone-average of 90 dB or better and speech recognition of 30% or greater. Pre-implant and post-implant open-set word and sentence test scores were analyzed. Results: Eleven children of 195 paediatric cochlear implant recipients met the inclusion criteria for this study. Speech recognition results for the10 English-speaking children indicated significant gains in both open-set word and sentence understanding within the first 6 to 12 months of implant use. Seven of 9 children achieved 80% open-set sentence recognition within 12 months post-surgery. Conclusion: Children with several years of experience using conventional amplification demonstrated rapid progress in auditory skills following cochlear implantation. These findings suggest that cochlear implantation may be an appropriate intervention for selected children with severe hearing losses and/or auditory capacity outside current candidacy criteria. Background Cochlear implants have considerably improved speech and language outcomes in children with bilateral severe to profound hearing loss [1,2]. Cochlear implantation is typically offered to individuals who receive limited benefit from conventional stimulation with well-fitted hearing aids. The definition of "limited benefit" for children has changed appreciably in the past 15 years. Early criteria for paediatric cochlear implantation restricted the procedure to children with profound hearing loss who derived essentially no benefit from conventional hearing aids. However, as cochlear implant technology progressed and documented outcomes exceeded early expectations, the audiologic boundaries of candidacy broadened to include children with more residual hearing. Current paediatric audiologic criteria include a sensorineural hearing loss of 90 dB HL or greater and up to 30% or less open-set word speech recognition. However, there appears to be considPublished: 19 April 2006 BMC Ear, Nose and Throat Disorders 2006, 6:7 doi:10.1186/1472-6815-6-7 Received: 27 December 2005 Accepted: 19 April 2006 This article is available from: http://www.biomedcentral.com/1472-6815/6/7 © 2006 Fitzpatrick et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.