title: Audiological outcomes of cochlear implantation in Waardenburg Syndrome.
abstract: BACKGROUND
  The most relevant clinical symptom in Waardenburg syndrome is profound bilateral sensorioneural hearing loss.
  
  
  OBJECTIVE
  To characterize and describe hearing outcomes after cochlear implantation in patients with Waardenburg syndrome to improve preoperative expectations.
  
  
  METHODS
  This was an observational and retrospective study of a series of cases. Children who were diagnosed with Waardenburg syndrome and who received a multichannel cochlear implant between March 1999 and July 2012 were included in the study. Intraoperative neural response telemetry, hearing evaluation, speech perception, and speech production data before and after surgery were assessed.
  
  
  RESULTS
  During this period, 806 patients received a cochlear implant and 10 of these (1.2%) were diagnosed with Waardenburg syndrome. Eight of the children received a Nucleus 24(®) implant and 1 child and 1 adult received a DigiSonic SP implant. The mean age at implantation was 44 months among the children. The average duration of use of a cochlear implant at the time of the study was 43 months. Intraoperative neural responses were present in all cases. Patients who could use the speech processor effectively had a pure tone average of 31 dB in free-field conditions. In addition, the MUSS and MAIS questionnaires revealed improvements in speech perception and production. Four patients did not have a good outcome, which might have been associated with ineffective use of the speech processor.
  
  
  CONCLUSIONS
  Despite the heterogeneity of the group, patients with Waardenburg syndrome who received cochlear implants were found to have hearing thresholds that allowed access to speech sounds. However, patients who received early intervention and rehabilitation showed better evolution of auditory perception.
authors.affiliation: Audiologist. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Ana Tereza de Matos
authors.initials: AT
authors.lastname: Magalhães
authors.affiliation: Audiologist. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Paola Angélica
authors.initials: PA
authors.lastname: Samuel
authors.affiliation: Audiologist, PhD. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Maria Valeria Schimdt
authors.initials: MV
authors.lastname: Goffi-Gomez
authors.affiliation: MD, PHD. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Robinson Koji
authors.initials: RK
authors.lastname: Tsuji
authors.affiliation: MD, PHD. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Rubens
authors.initials: R
authors.lastname: Brito
authors.affiliation: MD, PHD. Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Ricardo Ferreira
authors.initials: RF
authors.lastname: Bento
keywords: Cochlear Implants; Hearing; Hearing Loss; Speech Perception; Waardenburg Syndrome