INTRODUCTION: Cochlear Nerve Deficiency, particularly Hypoplastic Auditory Nerve (HAN), creates uncertainty regarding Cochlear Implant (CI) outcomes. This study evaluated the utility of Transtympanic Electrically Evoked...INTRODUCTION: Cochlear Nerve Deficiency, particularly Hypoplastic Auditory Nerve (HAN), creates uncertainty regarding Cochlear Implant (CI) outcomes. This study evaluated the utility of Transtympanic Electrically Evoked Auditory Brainstem Response (TT-EABR) in managing HAN cases. METHODS: Twenty-two children with MRI-confirmed HAN were assessed using TT-EABR to guide ear selection for CI vs Auditory Brainstem Implantation (ABI) candidacy. Consequently, 13 children received CIs (HAN -CI group). Their auditory and speech outcomes -measured via CAP, SIR, and MAIS/IT-MAIS at baseline and 12 months post-implantation (with Auditory-Verbal Therapy) -were compared against an age-matched control group of 13 children with normal auditory nerves. RESULTS: The HAN -CI group demonstrated significant improvements from baseline to 12 months in CAP (p=0.001), SIR (p=0.005), and MAIS/IT-MAIS (p=0.001) scores. Remarkably, no statistically significant differences were found between the HAN and control groups for CAP (p=0.93), SIR (p=0.70), and MAIS/IT-MAIS (p=0.97). Favorable outcomes correlated with Kumar-Dutt Type A and B TT-EABR responses, with Type A yielding the best results. DISCUSSION & CONCLUSION: While historical data associates HAN with poor outcomes, this study highlights that precise preoperative TT-EABR assessment and ear selection can lead to outcomes comparable to non-anomalous cases. TT-EABR is a pivotal prognostic tool, crucial for ear selection and managing parental expectations. Preoperative TT-EABR is essential for tailored clinical management and successful CI intervention in selected HAN cases.
Cochlear Implants Int
· 2026 Jun · PMID 42363937
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OBJECTIVE: The objective of this cross-sectional study was to compare the auditory memory scores obtained using the verbal and picture-pointing response modes in children with cochlear implants and implant-age matched ty...OBJECTIVE: The objective of this cross-sectional study was to compare the auditory memory scores obtained using the verbal and picture-pointing response modes in children with cochlear implants and implant-age matched typically developing children. METHOD: The short-term auditory memory test consisting of word sequences ranging from two-word sequences to five-word sequences was developed and administered to 53 children using unilateral cochlear implants and 53 typically developing children matched in terms of implant age and gender. The implant age of the children ranged from 2 years 8 months to 7 years 9 months, and the mean age of implantation was 3 years 5 months. Each participant was tested twice, once using a verbal response task and once using a picture-pointing response task in two different sessions. RESULTS: The total auditory memory scores were significantly higher (P < 0.05) for the picture-pointing task as compared to the verbal recall task, especially when the memory task placed a high auditory demand and cognitive load on the children. The total auditory memory scores obtained using both the response tasks were lower in children using cochlear implants as compared to implant-age matched typically developing children (P < 0.05). CONCLUSION: The present findings indicate that the type of response task affects the performance on the short-term auditory memory test in children using cochlear implants and typically developing children, with the picture-pointing response task yielding better scores than the verbal response.
Cochlear Implants Int
· 2026 Jun · PMID 42259770
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OBJECTIVES: To identify barriers that audiologists face in adopting telemedicine in adult cochlear implant care, and to determine what is needed to overcome these barriers. METHODS: Prospective mixed-methods anonymous on...OBJECTIVES: To identify barriers that audiologists face in adopting telemedicine in adult cochlear implant care, and to determine what is needed to overcome these barriers. METHODS: Prospective mixed-methods anonymous online survey of cochlear implant audiologists working with adults in the United Kingdom. RESULTS: Thirty-one complete responses were received in August - September 2024. Eighty-seven percent (27) had used remote care tools in their care of adults with cochlear implants. Twenty-nine percent (9) had never used remote care tools or used them rarely; no respondents used them daily. Sixty-eight percent of respondents reported frequent technical issues with remote care tools. Respondents were split equally when asked if remote care is less effective than in-person care, but 81% felt that the gold standard of clinical care is in-person care. Barriers to remote care could be overcome by improvements and enhancements to the cochlear implant manufacturers' tools, and easier and fuller integration into patient pathways and systems. CONCLUSION: The main barriers to audiologists using remote care were frequent technical problems and the perception that the gold standard of clinical care was in-person care. When telemedicine offers a seamless, accessible, person-centred care experience, perceptions about the gold standard of care may change.
Cochlear Implants Int
· 2026 May · PMID 42237499
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OBJECTIVES: To assess the effects of frequency overlap across ears on functional listening outcomes in postlingually deafened experienced bimodal users with aidable low-to-mid frequency acoustic hearing. METHODS: Two exp...OBJECTIVES: To assess the effects of frequency overlap across ears on functional listening outcomes in postlingually deafened experienced bimodal users with aidable low-to-mid frequency acoustic hearing. METHODS: Two experimental conditions were compared: (1) frequency overlap (full cochlear implant [CI] bandwidth) and (2) frequency non-overlap (CI stimulation restricted to frequencies beyond the 65 dB HL threshold). Hearing aid (HA) amplification remained constant, with gain applied up to and including the 65 dB HL threshold. Fourteen participants were assessed on speech perception in quiet, co-located, and spatially separated noise, localisation, and subjective evaluation of sound quality. RESULTS: Frequency overlap resulted in significantly better outcomes on all measures except localisation, which showed no difference. Bimodal listening resulted in better speech perception in quiet and co-located noise compared to CI or HA alone. When noise was presented to the HA side, speech perception improved relative to noise on the CI side. Participants preferred the frequency overlap condition. DISCUSSION: Findings suggested that providing full CI frequency bandwidth may offer perceptual benefits for some experienced bimodal users under specific programming conditions. No evidence of signal interference across ears was observed. The consistent absence of interference may reflect, in part, the restriction of HA amplification to below cochlear dead region thresholds; however, further studies are required to investigate this relationship. CONCLUSION: While this study provides preliminary evidence supporting the potential benefits of frequency overlap in bimodal fittings, further research involving larger and more diverse samples is necessary to confirm these effects and to assess longer-term outcomes.
Boyle S, Brennan M, Alshaikh K
… +6 more, Franklin CS, Bacon L, Flavin R, Glynn F, Walshe P, Gendre A
Cochlear Implants Int
· 2026 May · PMID 42217228
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OBJECTIVES: Langerhans cell histiocytosis (LCH) is a rare disorder that may involve the temporal bone and, in rare cases, result in sensorineural hearing loss. This report highlights the importance of close radiological...OBJECTIVES: Langerhans cell histiocytosis (LCH) is a rare disorder that may involve the temporal bone and, in rare cases, result in sensorineural hearing loss. This report highlights the importance of close radiological surveillance and timely cochlear implantation in the setting of progressive otic capsule ossification. METHODS: A 21-year-old male presented with a five-year history of progressive bilateral hearing loss, tinnitus, vertigo and imbalance. Following multidisciplinary team (MDT) discussion, cochlear implantation was deferred until completion of chemotherapy. RESULTS: Repeat CT imaging demonstrated progressive cochlear ossification involving the otic capsules. A repeat discussion followed, which led to an expedited cochlear implantation. The left side was implanted first due to lesser ossification, achieving full electrode insertion. Sequential implantation of the contralateral ear was performed four months later. However, insertion was limited due to advanced ossification. DISCUSSION: The second implantation was technically more challenging, with only partial electrode insertion possible due to advanced ossification. We advocate for close surveillance in the case of LCH to monitor for signs of otic capsule ossification. CONCLUSION: This case demonstrates that cochlear ossification in LCH may progress rapidly, narrowing the window for optimal implantation. Early cochlear implantation should be strongly considered in such cases.
Garcia-Chabur MA, Ronderos A, Moreno-López S
… +7 more, Pérez-Herrera LC, Gantiva M, Ramírez M, González D, García A, Barón C, García JM
Cochlear Implants Int
· 2026 May · PMID 42152236
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OBJECTIVE: This study aimed to assess the long-term results in speech discrimination and quality of life (QoL) in a population of adults with congenital hearing loss who received a cochlear implant during their childhood...OBJECTIVE: This study aimed to assess the long-term results in speech discrimination and quality of life (QoL) in a population of adults with congenital hearing loss who received a cochlear implant during their childhood. METHODS: This was a cross-sectional and observational study including three otology referral hospitals in Bogotá (Colombia). Audiological outcomes (Hearing in Noise Test - HINT results), Speech, Spatial, and Qualities of hearing scale-12 (SSQ-12) scores, Glasgow Benefit Inventory (GBI) scores, and sociodemographic questionnaires were applied to adults with hearing loss who received a cochlear implant between 1995 and 2011. RESULTS: A total of 19 adults with hearing loss were included. For the Hearing in Noise Test (HINT) results, the study sample showed an average word repetition rate of 72.8% in fixed noise and 82.3% in a quiet environment. The SSQ-12 scores were p50 of 6.4 for the speech scale, 6.6 for the spatial scale, and 6.75 for the quality of hearing scale. In terms of QoL, 78% of participants reported improvement in GBI score. A positive correlation was observed between older age of implantation, higher quality of life, and better speech discrimination in noisy environments (higher SSQ-12 score). CONCLUSIONS: The patients with cochlear implants from a low/middle-income country included in this study, demonstrated long-term benefits in hearing, speech perception, and quality of life after more than 10 years of implantation.
Cochlear Implants Int
· 2026 May · PMID 41969253
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OBJECTIVES: Inner ear malformations (IEMs) represent a major structural cause of congenital sensorineural hearing loss. This study aimed to examine the impact of IEM subtype on auditory perception and language developmen...OBJECTIVES: Inner ear malformations (IEMs) represent a major structural cause of congenital sensorineural hearing loss. This study aimed to examine the impact of IEM subtype on auditory perception and language development outcomes in pediatric cochlear implant (CI) users. DESIGN: A total of 51 children with IEMs who underwent cochlear implantation were included. Of these, 12 (23.5%) had an incomplete partition type 1 (IP-1), 21 (41.2%) had incomplete partition type 2 (IP-2), 11 (21.6%) had enlarged vestibular aqueduct (EVA), and seven (13.7%) had cochlear aperture abnormalities. STUDY SAMPLE: In this cross-sectional study, auditory perception and language development were assessed in pediatric CI users with different types of IEM. RESULTS: The mean age of implantation was 37.29 ± 23.24 months, and the mean age at language assessment was 112.84 ± 38.67 months. Significant differences in auditory and language test scores were observed among the IEM subgroups (P = 0.001). CONCLUSIONS: IEM subtype significantly influences auditory performance and language development outcomes in pediatric CI users. These anatomical differences should be considered during preoperative counseling and in the planning of postoperative rehabilitation. Notably, despite intergroup variability, all participants demonstrated measurable improvements in auditory perception and speech production following cochlear implantation.
Hariz B, Tahon A, Alhedaithy M
… +9 more, Alsaeed M, Alkoheji L, Alharbi T, Shathan H, Algahtani A, Orabi S, El-Deek S, Cayé-Thomasen P, Percy-Smith L
Cochlear Implants Int
· 2026 May · PMID 41944617
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AIM: This study aims to investigate the language and listening development of children with cochlear implants (CI) in the Gulf Cooperation Council (GCC) region over 24 months. It seeks to identify factors influencing pro...AIM: This study aims to investigate the language and listening development of children with cochlear implants (CI) in the Gulf Cooperation Council (GCC) region over 24 months. It seeks to identify factors influencing progress and the impact of challenges on CI outcomes, focusing on children without additional disabilities. MATERIALS AND METHODS: The project design is explorative, with a descriptive, longitudinal, ambispective analysis conducted across six hospitals in four GCC countries. Qualified speech and language therapists evaluated children diagnosed with prelingual severe to profound bilateral sensorineural hearing loss who received CIs between 2018 and 2024. The Integrated Scales of Development (ISD) assessed progress in six developmental domains at five intervals (T0-T4). Data also included demographics, prior hearing aid use, and parental education. RESULTS: The results indicated significant improvements across all six developmental domains over the 24-month period, with median scores increasing consistently. Statistical analysis revealed a strong linear trend in development ( = 0.000). Children who received CIs earlier showed better outcomes, whereas prior hearing aid use did not significantly affect results. Parental education levels had no impact on developmental outcomes. CONCLUSION: The study underscores the importance of early cochlear implantation and ongoing auditory-focused intervention for enhancing listening and spoken language skills in children with CIs in the GCC. Despite significant progress, children did not fully match their hearing peers within the 24-month timeframe, suggesting the need for extended support.
Cochlear Implants Int
· 2026 May · PMID 41913553
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Meniere's Disease (MD) may present as a complication in the hearing outcomes of patients with hearing loss who are treated with either hearing aids or cochlear implants (CI). This case study aims to highlight the course...Meniere's Disease (MD) may present as a complication in the hearing outcomes of patients with hearing loss who are treated with either hearing aids or cochlear implants (CI). This case study aims to highlight the course of treatment for MED as well as being inflicted by MD, which was discovered after transferring care from a private practice to an academic medical center for treatment of internal failure of her left device, as indicated by manufacturer recall. This patient is a long-time user of bilateral cochlear implants who has experienced multiple fluctuations in performance, most notably in her dominant right CI. Pressure changes in patients with middle ear dysfunction (MED) may impact the programming levels. The patient has shown significant improvement following substantial programming changes in her right CI. She has become more aware of Meniere's attacks and is utilizing available self-adjustment of current parameters. In doing so, she is able to improve her hearing status regardless of the presence of Meniere's attacks through programming changes.
Sullivan A, Bass JK, Warren SE
… +8 more, Morlet T, Shakhtour L, Richardson E, Coppedge MO, Merchant TE, Hudson MM, Macdonald CB, Richard C
Cochlear Implants Int
· 2026 May · PMID 41821303
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INTRODUCTION: Cochlear implant (CI) pathways are well established in the general population, but data on pediatric and young adult cancer survivors are limited. This study evaluated the feasibility and safety of cochlear...INTRODUCTION: Cochlear implant (CI) pathways are well established in the general population, but data on pediatric and young adult cancer survivors are limited. This study evaluated the feasibility and safety of cochlear implantation in this population, described demographic and clinical characteristics, examined timelines to hearing rehabilitation, and reported short-term outcomes and complications. MATERIALS AND METHODS: Retrospective case-control study on patients aged 0-22 years with cancer-related hearing loss and matched peers who underwent CI between December 2010 and January 2023. RESULTS: Eight oncologic patients and 20 controls (37 implantations) were analyzed. All had bilateral progressive hearing loss. Except for three oncologic patients, all used bilateral hearing aids before implantation. The time from meeting candidacy criteria to CI was significantly longer in cases than controls (2.8 vs. 0.5 years; p = 0.004). Although most cases qualified for bilateral implants, only two received them. Five of eight oncologic patients demonstrated excellent CI use with good speech recognition. CONCLUSION: Pediatric and young adult oncology patients with limited benefit from hearing aids may be good candidates for cochlear implantation. Multidisciplinary care is essential to guide timely, evidence-based implantation in this population.
Selwyn D, Raine CH, Peebles H
… +2 more, Chabaluka C, Strachan D
Cochlear Implants Int
· 2026 May · PMID 41815041
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To assess functional language performance on paediatric cochlear implant patients in Malawi. Sixteen patients who received cochlear implantation before the age of 18 years from a single site were invited for an intervie...To assess functional language performance on paediatric cochlear implant patients in Malawi. Sixteen patients who received cochlear implantation before the age of 18 years from a single site were invited for an interview. Parents or guardians of twelve of these participated in the PEACH and BAPP questionnaires, whilst four others who had become adults answered independently. The PEACH scale is a 13-question survey with a maximum score of 52. The BAPP score has four domains with a total score of 16. Most patients acquired profound hearing loss through either mumps, meningitis, malaria or a combination (15/16). The mean age of onset of profound deafness was 8.8 years of age (range = 4-16 years) and implantation was 10.6 years (range = 4-18 years). The mean 'Quiet Sounds' questions were 23.56/24 ( +/-1.75) and 'Loud Sounds' were 27.06/28 ( +/-1.57). The mean total PEACH score was 50.63/52 ( +/-2.73). There was no correlation with age of implant and PEACH score. The BAPP score was 16/16 for each patient. Despite a very low socio-economic environment, this cohort shows cochlear implantation has a strong perceived benefit from the parents and guardians of post-lingually profoundly deaf children.
Chaudhuri T, Silver B, Patel A
… +1 more, Kanona H
Cochlear Implants Int
· 2026 Mar · PMID 41793270
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OBJECTIVE: To evaluate sagittal-plane cone-beam computed tomography (CBCT) as a reliable method for estimating facial recess (FR) width, enabling preoperative assessment of posterior tympanotomy (PT) size in cochlear imp...OBJECTIVE: To evaluate sagittal-plane cone-beam computed tomography (CBCT) as a reliable method for estimating facial recess (FR) width, enabling preoperative assessment of posterior tympanotomy (PT) size in cochlear implantation without complex image reconstruction. BACKGROUND: Posterior tympanotomy provides the surgical corridor for cochlear implantation but carries risk of facial/chorda tympani nerve injury. Accurate preoperative imaging is essential for anticipating surgical difficulty. Although multiplanar and 3D reconstructions can estimate PT dimensions, these require additional technology. The sagittal plane may offer a more intuitive view aligned with the surgeon's operative perspective. METHODS: A retrospective study of 100 adult cochlear implant candidates was conducted using a standardised CBCT temporal bone protocol. FR width was measured in the sagittal plane from the intraosseous chorda tympani to the second genu of the facial nerve. Measurements were compared with axial-plane values obtained by two consultant radiologists. Statistical analysis used a paired two-tailed t-test. RESULTS: No statistically significant difference was found between sagittal and axial measurements ( = 0.3851, SEM = 0.02281). Measurements were consistent within 0.05 mm, demonstrating strong concordance. CONCLUSION: Sagittal-plane CBCT offers a simple, reproducible, and widely accessible method for estimating PT size. It aligns radiological imaging with the surgeon's intraoperative perspective, improving preoperative planning and risk stratification in cochlear implantation.
Cochlear Implants Int
· 2026 Mar · PMID 41778354
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OBJECTIVE: Cochlear implant (CI) speech processors have undergone technological advancements. Therefore, patients upgrade speech processors when new features are available or when their previous device becomes broken and...OBJECTIVE: Cochlear implant (CI) speech processors have undergone technological advancements. Therefore, patients upgrade speech processors when new features are available or when their previous device becomes broken and is no longer serviceable. This study aimed to identify factors that impact the time to a speech processor upgrade and to evaluate patient experiences with upgrading and following upgrade. METHODS: In this retrospective cohort study, 46 CI surgeries at a single tertiary care center in 2017 and that subsequently received a speech processor upgrade were included. Data on patient demographics, hearing loss history, CI manufacturer, insurance type and status, and configuration were collected. Time to first upgrade, reasons for upgrade, patient-reported satisfaction, and speech perception scores were analyzed. RESULTS: The mean time to a speech processor upgrade was 5.13 years after implantation. The most common reason for an upgrade was the device being over five years old, followed by the device being out of warranty. 45.7% of patients expressed satisfaction with speech processor upgrade, while 8.7% were not satisfied. There were no statistically significant associations between the time to upgrade and demographic factors such as age, sex, insurance type, or CI manufacturer. Following the upgrade, there were no significant changes in speech perception scores. CONCLUSION: Speech processor upgrades at this center align with when insurance companies typically deem upgrades medically necessary. Demographic factors, insurance, and device manufacturer did not significantly influence time to upgrade. While objective speech perception measures did not significantly improve, many patients reported subjective satisfaction with the upgrade.
Findlay C, Arthur E, Hough K
… +2 more, Grasmeder M, Newman TA
Cochlear Implants Int
· 2026 Mar · PMID 41776971
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OBJECTIVES: Incomplete Partition type II (IP-II), or Mondini dysplasia, accounts for half of congenital cochlear malformations and results in profound sensorineural hearing loss. Cochlear implantation restores hearing in...OBJECTIVES: Incomplete Partition type II (IP-II), or Mondini dysplasia, accounts for half of congenital cochlear malformations and results in profound sensorineural hearing loss. Cochlear implantation restores hearing in patients with IP-II however low numbers mean reporting of auditory performance outcomes is limited. Here we review English language articles between 2010 and 2025 reporting hearing outcomes following cochlear implantation in individuals IP-II. RESULTS: Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) and parental reports of cochlear implantation in 731 individuals, across 20 studies, with a follow-up of 1-3 years, met the inclusion criteria. Findings suggest that auditory perception and speech develop more slowly in people with IP-II compared to controls but there was no difference between groups by 1-2 years post-implantation. DISCUSSION: Most patients with IP-II have better hearing with a cochlear implant than before. However, there is limited evidence that this is comparable to those with normal middle ear anatomy. Findings were typically derived from questionnaires with small cohorts and short follow-up. CONCLUSION: Patient counselling for people IP-II should identify that prediction of hearing outcomes is uncertain. Informed prognostication of timing of surgery and hearing outcomes after cochlear implantation in IP-II needs further study with long-term follow-up including surgical and hearing outcome measures.
Le M, Psarros C, Leigh J
… +2 more, Anderson RB, Šarkić B
Cochlear Implants Int
· 2026 Mar · PMID 41766054
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OBJECTIVES: Cochlear implantation among adults remains disproportionately low compared with paediatric populations. This systematic review identified and synthesised the patient-related barriers that limit access to and...OBJECTIVES: Cochlear implantation among adults remains disproportionately low compared with paediatric populations. This systematic review identified and synthesised the patient-related barriers that limit access to and uptake of cochlear implantation in adults. METHODS: A systematic search of English-language literature was performed from January 1st, 1990, to November 21st, 2025, using PubMed, MEDLINE, CINAHL, EMBASE and PsycINFO databases. Twenty-eight studies met the inclusion criteria, and findings were synthesised descriptively. This systematic review was registered with PROSPERO (Registration number: CRD42024540401). RESULTS: Ninety-five patient-related barriers were identified and grouped into four overarching themes: (1) uncertainties, fears, and beliefs, (2) knowledge and professional guidance, (3) system and organisational factors, and (4) psychosocial and practical support. Common barriers included fear of surgery and residual hearing loss, limited professional guidance, perceived financial burden, fragmented funding systems, and inadequate psychosocial support. DISCUSSION: Adult cochlear implantation is limited by multifactorial barriers spanning psychological, informational, systemic, and social domains. CONCLUSION: Addressing these challenges requires coordinated strategies, including improved CI-specific education for healthcare professionals, clearer communication of funding options, standardised adult hearing screening programs, and integration of telehealth to reduce logistical burdens. Targeted interventions addressing fear, misinformation, and psychosocial support are essential to improve timely access and uptake of cochlear implantation.
Meehan S, Adank ML, Bavinck MB
… +4 more, Lechner M, Dingemanse G, Goedegebure A, Vroegop JL
Cochlear Implants Int
· 2026 Mar · PMID 41686720
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OBJECTIVE: To explore the potential of the internationally-renowned 'Mini-Mental State Examination' (MMSE) cognitive measure to explain variability in cochlear implant (CI) recipients' speech recognition outcomes. The St...OBJECTIVE: To explore the potential of the internationally-renowned 'Mini-Mental State Examination' (MMSE) cognitive measure to explain variability in cochlear implant (CI) recipients' speech recognition outcomes. The Stroop Color-Word Test (SCWT) was also employed as a measure of cognitive inhibition, an ability essential for focusing on target speech whilst ignoring background noise. The authors hypothesize that MMSE and SCWT scores correlate with CI users' performance on established speech recognition tests. METHODS: Cognitive screening was assessed by the MMSE and SCWT in adult CI users one year postoperatively. In addition, speech recognition was assessed using word and sentence lists, in both quiet and noise. Study sample: 28 participants, postlingually deafened adult CI users, median age 75 years. RESULTS: Total MMSE scores correlated significantly with sentence recognition in noise (r = 0.621, P = .004), although no correlation was identified in quiet. Furthermore, the SCWT incongruent condition correlated significantly with CI users' speech recognition in noise (r = -0.644, P = .007). DISCUSSION: Global cognition (as assessed using the MMSE), and inhibition-concentration (as assessed using the SCWT), seem to be important factors in influencing CI recipients' speech intelligibility in noise. This pilot study recommends a larger-scale study; given the global popularity of the MMSE and SCWT as quick cognitive screening tests, they may be useful in CI clinics when speech perception outcomes are unexpectedly poor for older adults and when questions of cognition arise. CONCLUSION: These standardized cognitive measures may prove helpful in counseling patients and families when coming to terms with CI outcomes and optimizing multidisciplinary rehabilitation strategies.
Szabo A, Szegesdi I, Posta B
… +4 more, Perenyi A, Nagy R, Rovo L, Bere Z
Cochlear Implants Int
· 2026 Mar · PMID 41668265
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PURPOSE: Early cochlear implantation during the critical period of neuroplasticity leads to better auditory and language outcomes but presents unique anesthetic challenges in infants. This study retrospectively examined...PURPOSE: Early cochlear implantation during the critical period of neuroplasticity leads to better auditory and language outcomes but presents unique anesthetic challenges in infants. This study retrospectively examined anesthesia-related events throughout the full diagnostic and surgical process over a 10-year period, focusing on pediatic population undervent cochlear implantation - especially under the age of 18 month. METHODS: Data from 175 children under age 3 were analized who received cochlear implants between 2014 and 2024. Anesthesia-related events during audiological tests (BERA/ASSR), imaging (CT/MRI), and surgery were recorded. Collected variables were demographics, comorbidities, ASA and Mallampati scores, anesthetic techniques, procedure durations, complications, and ICU admissions. A subgroup analysis was conducted for patients implanted before 18 months. RESULTS: Of the 175 patients, 35 (20.2%) received implants before 18 months and 8 (4.6%) before 12 months. Anesthesia-related complications occurred in 14 cases (8.1%) in the study population, with laryngospasm during extubation being the most frequent (n = 8); all resolved without reintubation. Difficult intubation was noted in 3 patients, mainly those with craniofacial anomalies. Four children required postoperative ICU care. No complications were observed during diagnostic procedures. No significant association was found between complication rates and age, ASA status, or Mallampati score. CONCLUSION: Cochlear implantation, even in infants under one year, is safe with appropriate anesthesia and experienced teams. Complications were rare and manageable. Recognizing anesthesia risks helps optimize care and reassure parents, supporting timely intervention within the neuroplastic window.