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Early pediatric Cochlear implantation: An update

Journal

LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY
Volume 6, Issue 3, Pages 512-521

Publisher

WILEY
DOI: 10.1002/lio2.574

Keywords

anesthesia risk; infant; language and speech development; pediatric cochlear implantation; surgical safety

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The criteria and candidacy for pediatric cochlear implantation have changed significantly in recent decades, with a focus on earlier implantation for neuroplasticity benefits. However, there is still a lack of consensus on the optimal age for implantation.
The criteria and candidacy for pediatric cochlear implantation (CI) has significantly transformed over the past few decades and continues to evolve with technological advancements, and recognition of benefit in more diverse populations. Prolonged auditory deprivation among patients with profound sensorineural hearing loss has been shown to cause widespread degeneration in the central auditory system. Thus, there is increasing evidence advocating for earlier implantation within a critical neuroplastic window. However, there is a lack of consensus on this optimal age of implantation. Historically, there were concerns regarding surgical feasibility and safety, anesthesia risk, and logistical considerations in very young infants <12 months. Recent literature has investigated surgical safety and anesthesia risk as well speech and language outcomes with early implantation, resulting in the long-awaited reduction in approved age by the FDA (<9 months for certain devices). This article reviews logistical considerations, surgical safety, anesthesia risk, and language developmental outcomes associated with early CI (<12 months).

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