Delayed implantation in congenitally deaf children and adults.
OBJECTIVE
To determine the efficacy of cochlear implants with current processing strategies in children and adults with long-term congenital deafness, and to determine whether the growth of auditory perceptual skills in these patients is similar to the data reported for patients who have undergone implantation with earlier devices and coding strategies.


METHODS
A prospective study of children and adults fulfilling the study inclusion criteria.


METHODS
University medical center.


METHODS
Thirty-five congenitally deaf children who received implants after the age of 8 years and 14 congenitally deaf adults who received implants as adults participated in this study. Length of device use ranged from 6 months to 3 years.


METHODS
Open set phoneme, word recognition tests, and sentence recognition tests were administered in quiet and noise auditory only conditions preoperatively and postoperatively. Changes in test scores were examined by paired t tests, and differences between groups were compared by Student's t tests. Spearman correlation coefficients were calculated to identify associations between scores and subject characteristics. A two-sided alpha of less than 0.05 was considered statistically significant.


RESULTS
The results indicated significant improvement in open set speech perception skills in the children after implantation; the adults demonstrated improved mean scores on both word and sentence recognition. A shorter length of deafness correlated with better postoperative performance, but all subjects continued to improve over time. The improvement in test scores was similar between the devices, and no significant differences were detected between the different processing strategies.


CONCLUSIONS
Children and adults with long-term congenital deafness can obtain considerable open set speech understanding after implantation. Length of deafness (age at implantation), length of device use, and mode of communication contribute to outcome.
Waltzman
Susan B
SB
Department of Otolaryngology, Cochlear Implant Center, New York University School of Medicine, 660 First Avenue, 7th floor, New York, NY 10016, U.S.A. susan.waltzman@med.nyu.edu
Roland
J Thomas
JT
Cohen
Noel L
NL
D000293:Adolescent; D000328:Adult; D002648:Child; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D011446:Prospective Studies; D013067:Speech Perception; D013997:Time Factors; D016896:Treatment Outcome