title: Cochlear implantation in children under the age of two--what do the outcomes show us?
abstract: OBJECTIVE
  Literature that discusses the benefits of cochlear implantation (CI) in children under the age of two is limited. Previous concerns about surgical risk have been raised and addressed; however, actual benefit in terms of outcomes needs to be clearly defined. This study evaluates outcomes of children implanted under the age of two and compares them to children implanted at a later age.
  
  
  METHODS
  Data were reviewed from the MED-EL International Children's study database. Thirty-seven children enrolled in the study have received cochlear implants before the age of two. Outcomes were assessed using the LiP and MTP tests and the MAIS and MUSS questionnaires pre-operatively and then at initial fitting, 1, 3, 6 and 12 months after first fitting and then annually thereafter.
  
  
  RESULTS
  Statistical analysis demonstrated that these children's scores improved significantly over time. Improvement was shown to occur at a quicker rate than for children implanted at an older age with the MTP and MUSS, but not with the LiP and the MAIS. Scores may be limited by sample size and the fact that children reached ceiling on some tests.
  
  
  CONCLUSIONS
  Results suggest a distinct advantage early implantation may have for severe to profoundly hearing impaired children. This may be particularly the case for skills necessary for development of receptive and expressive language skills.
authors.affiliation: Clinical Research Department, MED-EL Worldwide Headquarters, Innsbruck, Austria. ilona.anderson@medal.com
authors.forename: Ilona
authors.initials: I
authors.lastname: Anderson
authors.forename: Viktor
authors.initials: V
authors.lastname: Weichbold
authors.forename: Patrick S C
authors.initials: PS
authors.lastname: D'Haese
authors.forename: Joanna
authors.initials: J
authors.lastname: Szuchnik
authors.forename: Manuel Sainz
authors.initials: MS
authors.lastname: Quevedo
authors.forename: Jane
authors.initials: J
authors.lastname: Martin
authors.forename: Wafaa Shehata
authors.initials: WS
authors.lastname: Dieler
authors.forename: Lucy
authors.initials: L
authors.lastname: Phillips
mesh_terms: D000367:Age Factors; D001307:Auditory Perception; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D005260:Female; D034381:Hearing Loss / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome