title: Pediatric cochlear implantation in residual hearing candidates.
abstract: OBJECTIVE
  To propose categories for the various types of residual hearing in children and to review the outcomes of cochlear implantation (CI) in children with these different hearing conditions.
  
  
  METHODS
  We identified 53 children with residual hearing who had received a cochlear implant. Five groups were arbitrarily defined based on auditory features: G1, characterized by low-frequency residual hearing (n=5); G2, characterized by severe sensorineural hearing loss (SNHL) and low speech discrimination (n=12); G3, characterized by asymmetric SNHL (n=9); G4, characterized by progressive SNHL (n=15); and G5, characterized by fluctuating SNHL (n=12). The main audiometric features and outcomes of the groups were analyzed.
  
  
  RESULTS
  The mean age at implantation was 10.15 years (range, 2.5-21 years). The mean preoperative score for the discrimination of open-set words was 48%; this score increased to 74% at 12 months and 81% at 24 months after the CI procedure (G1 to G5, respectively: 79/62/77%, 50/81/88%, 59/75/86%, 35/74/67%, and 39/69/80%). Children who were implanted after 10 years of age did not improve as much as those who were implanted at a younger age (open-set word list speech perception [OSW] score at 12 months: 62% vs 83%; P=.0009). Shorter delays before surgery were predictive of better performance (P=.003). Inner ear malformation and SLC26A4 mutations were not predictive of the outcome.
  
  
  CONCLUSIONS
  CIs provide better results compared with hearing aids in children with residual hearing. Factors that may impact the benefits of CIs in patients with residual hearing are age, delay in performing the CI procedure, which ear is implanted, and initial underestimation of the patient's hearing difficulties.
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France gratacapm@gmail.com.
authors.forename: Maxime
authors.initials: M
authors.lastname: Gratacap
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France.
authors.forename: Briac
authors.initials: B
authors.lastname: Thierry
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Rouillon
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Marlin
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France.
authors.forename: Noel
authors.initials: N
authors.lastname: Garabedian
authors.affiliation: Hôpital Necker Enfants Malades, Département d'otorhinolaryngologie, Paris, France.
authors.forename: Natalie
authors.initials: N
authors.lastname: Loundon
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003657:Decision Making; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: asymmetric hearing loss; children; cochlear implantation; hearing fluctuation; partial deafness; residual hearing