title: Determination of benefits of cochlear implantation in children with auditory neuropathy.
abstract: BACKGROUND
  Auditory neuropathy (AN) is a recently recognized hearing disorder characterized by intact outer hair cell function, disrupted auditory nerve synchronization and poor speech perception and recognition. Cochlear implants (CIs) are currently the most promising intervention for improving hearing and speech in individuals with AN. Although previous studies have shown optimistic results, there was large variability concerning benefits of CIs among individuals with AN. The data indicate that different criteria are needed to evaluate the benefit of CIs in these children compared to those with sensorineural hearing loss. We hypothesized that a hierarchic assessment would be more appropriate to evaluate the benefits of cochlear implantation in AN individuals.
  
  
  METHODS
  Eight prelingual children with AN who received unilateral CIs were included in this study. Hearing sensitivity and speech recognition were evaluated pre- and postoperatively within each subject. The efficacy of cochlear implantation was assessed using a stepwise hierarchic evaluation for achieving: (1) effective audibility, (2) improved speech recognition, (3) effective speech, and (4) effective communication.
  
  
  RESULTS
  The postoperative hearing and speech performance varied among the subjects. According to the hierarchic assessment, all eight subjects approached the primary level of effective audibility, with an average implanted hearing threshold of 43.8 ± 10.2 dB HL. Five subjects (62.5%) attained the level of improved speech recognition, one (12.5%) reached the level of effective speech, and none of the subjects (0.0%) achieved effective communication.
  
  
  CONCLUSIONS
  CIs benefit prelingual children with AN to varying extents. A hierarchic evaluation provides a more suitable method to determine the benefits that AN individuals will likely receive from cochlear implantation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Ji
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jianan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Mengdi
authors.initials: M
authors.lastname: Hong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Aiting
authors.initials: A
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Qingshan
authors.initials: Q
authors.lastname: Jiao
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Sichao
authors.initials: S
authors.lastname: Liang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Shiming
authors.initials: S
authors.lastname: Yang
mesh_terms: D002675:Child, Preschool; D003054:Cochlear Implants; D005260:Female; D006309:Hearing; D006313:Hearing Loss, Central / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007858:Learning; D008297:Male; D013067:Speech Perception