title: Is very early hearing assessment always reliable in selecting patients for cochlear implants? A case series study.
abstract: BACKGROUND
  This study concerns a case series of 23 infants with a diagnosis of severe-to-profound hearing loss at 3 months old, who significantly improved (even reaching a normal auditory threshold) within their first year of life.
  
  
  METHODS
  All infants were routinely followed up with audiological tests every 2 months after being fitted with hearing aids as necessary. A reliable consistency between the various test findings (DPOAE, ABR, behavioral responses, CAEP and ECoG) clearly emerged in most cases during the follow-up, albeit at different times after birth.
  
  
  RESULTS
  The series of infants included 7 cases of severe prematurity, 6 of cerebral or complex syndromic malformations, 5 healthy infants, 2 with asymptomatic congenital CMV infection, and 1 case each of hyperbilirubinemia, hypoxia, and sepsis. All term-born infants showed a significant improvement over their initial hearing threshold by 6 months of age, while in most of those born prematurely the first signs of threshold amelioration occurred beyond 70 weeks of gestational age, and even beyond 85 weeks in one case.
  
  
  CONCLUSIONS
  Cochlear implantation (CI) should only be considered after a period of auditory stimulation and follow-up with electrophysiological and behavioral tests, and an accurate analysis of their correlation. In our opinion, CI can be performed after a period of 8 months in all term-born infants with persistent severe-to-profound hearing loss without risk of diagnostic error, whereas the follow-up for severely preterm infants should extend to at least 80 weeks of gestational age.
authors: ENT Clinic, Padova University Hospital, Italy. Electronic address: roberto.bovo@sanita.padova.it.
authors: R
authors: R
authors: Bovo
authors: ENT Clinic, Padova University Hospital, Italy.
authors: P
authors: P
authors: Trevisi
authors: ENT Clinic, Padova University Hospital, Italy.
authors: S
authors: S
authors: Ghiselli
authors: ENT Clinic, Padova University Hospital, Italy.
authors: A
authors: A
authors: Benatti
authors: ENT Clinic, Padova University Hospital, Italy.
authors: A
authors: A
authors: Martini
mesh_terms: D000367:Age Factors; D001309:Auditory Threshold / Q000502:physiology; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000151:congenital / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006310:Hearing Aids; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D018579:Patient Selection; D015203:Reproducibility of Results
keywords: Cochlear implant; Cortical auditory evoked potentials; Diagnosis; Hearing aids; Hearing loss; Prematurity