Cortical Changes in Total and Partial Vestibular Dysfunction, As Measured by EEG

Study Supports Expanded Candidacy for Pediatric Cochlear Implantation

For children less than two years of age, current Food and Drug Administration (FDA) candidacy criteria for pediatric cochlear implantation (CI) require a bilateral profound sensorineural hearing loss (SNHL) and for those two years and older, a bilateral severe-to-profound SNHL. However, research has shown significantly better language development (Young & Iler, 2024) and speech perception (Chweya et al, 2021) for children implanted before vs. after 12 months of age. FDA-approved candidacy has changed little over the past three decades. 

Recently, researchers conducted a multi-center, non-randomized, single-subject, repeated-measures study with prospective and retrospective patient cohorts. There were 28 prospective children and 209 retrospective patients included. All received MED-EL cochlear implants before the age of 6 years. Efficacy of implantation was assessed using speech perception tests before and after implantation (with hearing aids).

Results revealed that 80.6 percent of prospective patients and 88 percent of retrospective subjects with 12-month efficacy data met the efficacy goals. The authors conclude that it is appropriate to expand pediatric CI indications to include children aged 7-11 months with profound SNHL and children aged 12-71 months with residual hearing.

References

Chweya, C. M., May, M. M., DeJong, M. D., Baas, B. S., Lohse, C. M., Driscoll, C. L. W., & Carlson, M. L. (2021). Language and audiological outcomes among infants implanted before 9 and 12 months of age versus older children: A continuum of benefit associated with cochlear implantation at successively younger ages. Otology & Neurotology, 42(5), 686–693. https://doi.org/10.1097/mao.0000000000003011

Young, N. M., & Iler Kirk, K. (2024). Pediatric Cochlear Implantation. Springer Nature.

Young, N. M., Thomas, D., Hoff, S. R., Carron, J. D., Gonzalez, V. B., Sanchez, C. M., Cejas, I., Bauer, P. W., Gross, A. J., Richter, M. E., Park, L. R., & Brown, K. D. (2026). Multicenter study results on expanded indications in MED‐EL pediatric cochlear implant population. The Laryngoscope. https://doi.org/10.1002/lary.70840