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Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients
Institution:1. Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea;2. Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea;3. Myongji University Graduate School, Department of Speech and Language Pathology, Seoul, South Korea;4. Dankook University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Cheonan, South Korea
Abstract:IntroductionDespite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear.ObjectivesThis investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant.MethodsObservational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1 + HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1 + CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1 + CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis.ResultsCompared to the CI1 + HA, CI1 + CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio = 4.38, 95% confidence interval – 95% = 1.07–17.93, p = 0.04).ConclusionsThe children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.
Keywords:Bilateral cochlear implant  Pediatric  Predictive factors  Speech perception  Implante coclear bilateral  Pediátrico  Fatores preditivos  Percepção da fala
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