Bilateral cochlear implantation in children with anomalous cochleovestibular anatomy.
OBJECTIVE
To outline clinical experience with bilateral cochlear implantation in children with cochleovestibular anomalies.


METHODS
A prospective cohort study with a mean follow-up of 12 months.


METHODS
An academic, pediatric, tertiary referral center.


METHODS
All eligible children were prospectively recruited from January 1, 2007, through October 31, 2008. Ten children aged 9 to 33 months who had congenital inner ear malformations, including common cavity, incomplete partition, and cochleovestibular hypoplasia, participated.


METHODS
Bilateral cochlear implantation was performed sequentially with an interimplantation delay greater than 2 years in 7 children and less than 1 year in 1 child. Bilateral simultaneous implantation was performed in 2 children.


METHODS
Complications, hearing outcomes, and balance outcomes.


RESULTS
All children underwent successful implantation. Five children had a perilymph "gusher" (on 1 side only), and there were no other complications. All children had 22 active electrodes bilaterally and achieved speech reception. All 8 children who underwent closed-set speech perception testing scored above 75%, and 5 of the 7 children who underwent open-set testing achieved scores above 75%. Despite variable vestibular function before bilateral implantation, no prolonged imbalance occurred, although 3 children (30%) had transient unsteadiness for up to 2 weeks after the second implantation.


CONCLUSIONS
Bilateral cochlear implantation was performed safely and successfully in children with a spectrum of bilaterally anomalous cochleovestibular anatomy. Hearing outcomes suggest that these children should not be excluded from undergoing bilateral implantation. This study provides guidance on candidacy issues, surgical decision making, and surgical techniques in this group.
Chadha
Neil K
NK
Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada. neil.chadha@utoronto.ca
James
Adrian L
AL
Gordon
Karen A
KA
Blaser
Susan
S
Papsin
Blake C
BC
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000601:surgery*; D001299:Audiometry; D002675:Child, Preschool; D003051:Cochlea / Q000002:abnormalities* / Q000601:surgery; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D015331:Cohort Studies; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D018570:Risk Assessment; D013067:Speech Perception; D013068:Speech Production Measurement; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000002:abnormalities* / Q000601:surgery