scholarly journals Cochlear Implantation in Infants: Why and How

2021 ◽  
Vol 25 ◽  
pp. 233121652110317
Author(s):  
Patricia L. Purcell ◽  
Nicholas L. Deep ◽  
Susan B. Waltzman ◽  
J. Thomas Roland ◽  
Sharon L. Cushing ◽  
...  

In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.

2009 ◽  
Vol 19 (2) ◽  
pp. 63-68 ◽  
Author(s):  
K. A. Gordon

Abstract Universal newborn hearing screening programs have resulted in earlier identification of children born with hearing loss. Because of the severity of their hearing impairment, some of these children receive limited benefit from hearing aids and are at risk for compromised speech, language, and auditory development. These children are often good candidates for cochlear implantation. A recent trend in pediatric hearing health care is the provision of a cochlear implant prior to one year of age for children who receive limited to no benefit from hearing aids. The following article discusses the benefits and limitations of cochlear implantation prior to one year of age and also discusses our clinical experiences with children who have received a cochlear implant prior to their first birthday.


2021 ◽  
Vol 10 (13) ◽  
pp. 2784
Author(s):  
Christine Yoshinaga-Itano ◽  
Vinaya Manchaiah ◽  
Cynthia Hunnicutt

Background: This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). Materials and methods: Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. Results: 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. Conclusions: In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.


ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 64-65
Author(s):  
Mădălina Georgescu ◽  
Violeta Necula ◽  
Sebastian Cozma

Hearing loss represents a frequently met sensorial handicap, which has a major and complex impact not only on the hearing-impaired person, but also on his family and society. The large number of hard-of-hearing persons justifies the acknowledgement of hearing loss as a public health issue, which oblige to appropriate health politics, to offer each hearing-impaired person health services like those in Europe. These can be obtained through: appropriate legislation for mandatory universal newborn hearing screening; national program for follow-up of hearing-impaired children up to school age; national register of hard-of-hearing persons; smooth access to rehabilitation methods; appropriate number of audiologists, trained for health services at European standards, trained through public programs of education in the field of audiology.  


Author(s):  
Nina Jakhelln Laugen

In some respects, hard-of-hearing children experience the same difficulties as deaf children, whereas other challenges might be easier or more difficult to handle for the hard-of-hearing child than it would be for the deaf child. Research has revealed great variability in the language, academic, and psychosocial outcomes of hard-of-hearing children. Universal newborn hearing screening enables early identification and intervention for this group, which traditionally has been diagnosed rather late; however, best practices regarding the scope and content of early intervention have not yet been sufficiently described for hard-of-hearing children. This chapter summarizes the current knowledge concerning psychosocial development in hard-of-hearing children. Risk and protective factors, and their implications for early intervention, are discussed with a special emphasis on preschoolers.


2021 ◽  
Vol 5 (1) ◽  
pp. e000976
Author(s):  
Ayanda Gina ◽  
Nadja F Bednarczuk ◽  
Asitha Jayawardena ◽  
Peter Rea ◽  
Qadeer Arshad ◽  
...  

Hearing screening for newborn babies is an established protocol in many high-income countries. Implementing such screening has yielded significant socioeconomic advantages at both an individual and societal level. This has yet to permeate low/middle-income countries (LMIC). Here, we illustrate how newborn hearing screening needs to be contextually adapted for effective utilisation and implementation in an LMIC. Specifically, this advocates the use of auditory brainstem testing as the first-line approach. We propose that such adaptation serves to maximise clinical efficacy and community participation at a reduced cost.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii349-iii350
Author(s):  
Torsten Pietsch ◽  
Christian Vokuhl ◽  
Gerrit H Gielen ◽  
Andre O von Bueren ◽  
Everlyn Dörner ◽  
...  

Abstract INTRODUCTION Glioblastoma in infancy and early childhood is characterized by a more favorable outcome compared to older children, a stable genome, and the occurrence of tyrosine kinase gene fusions that may represent therapeutic targets. METHODS 50 glioblastomas (GBM) with supratentorial location occurring in children younger than four years were retrieved from the archives of the Brain Tumor Reference Center, Institute of Neuropathology, University of Bonn. DNA and RNA were extracted from FFPE tumor samples. Gene fusions were identified by FISH using break-apart probes for ALK, NTRK1, -2, -3, ROS1 and MET, Molecular Inversion Probe (MIP) methodology, and targeted RNA sequencing. RESULTS 37 supratentorial GBM occurred in the first year of life, 13 GBM between one and four years. 18 cases showed fusions of ALK to different fusion partners; all occurred in the first year of life (18/37 cases, 48.6%). Fusions of ROS1 were found in 5, MET in 3, NTRK1, -2, -3 in 10 cases. 12 cases showed no and two novel fusions. The different methods led to comparable results; targeted RNA sequencing was not successful in a fraction of cases. Break-apart FISH led to reliable results on the next day, MIP technology represented the most sensitive method for analysis of FFPE samples. CONCLUSIONS Gene fusions involving the tyrosine kinase genes ALK, MET, ROS1 and NTRK1, -2, -3 occurred in 72% of glioblastomas of children younger than four years; the most frequent were ALK fusions occurring in infant GBM. DNA based MIP technology represented the most robust and sensitive assay.


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