What can be expected from a late cochlear implantation?
OBJECTIVE
Verify if late cochlear implantation allows pre-lingual deafs to convert from visual to oral communication mode only.


METHODS
Thirteen pre-lingual profoundly deaf patients implanted the ages of 8 and 22 years were included in the study. Before cochlear implantation, none of the patients used the oral language. Six patients used cued speech and seven used the sign language to communicate. Evaluations were made with measures of hearing thresholds, phoneme identification, categories of auditory performance and rating of the intelligibility of speech before and after implantation. Changes in principal mode of communication (i.e. oral, cued speech or sign language) were also monitored.


RESULTS
The former users of cued speech benefited significantly more from cochlear implantation than the sign language users for phoneme identification and categories of auditory performance, although all had similar hearing thresholds before and after cochlear implantation. After a mean implant use of 4.5 years, four out of six cued speech users converted to exclusive use of the oral language, while only one out of seven former users of the sign language converted to the use of the oral language.


CONCLUSIONS
It is possible for pre-lingual or congenital deafs to convert totally from a visual to an oral communication mode even in case of late cochlear implantation. Previous awareness of the structure of the oral language, even without hearing (e.g. via cued speech) influences positively the outcome of delayed implantations. We recommend the adoption of oral communication with the cued speech code in cases where a late cochlear implantation is envisioned.
Kos
Maria-Izabel
MI
Geneva Cochlear Implant Centre, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Geneva University Hospitals, Switzerland. izabel.kos@hcuge.ch
Deriaz
Marielle
M
Guyot
Jean-Philippe
JP
Pelizzone
Marco
M
D000293:Adolescent; D001309:Auditory Threshold; D002648:Child; D019929:Cochlear Implantation; D003638:Deafness / Q000534:rehabilitation* / Q000628:therapy*; D005260:Female; D006320:Hearing Tests; D006801:Humans; D007802:Language; D008297:Male; D012813:Sign Language; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult