Simultaneous bilateral cochlear implantation in very young children without preoperative computed tomography
23 April 2019 (online)
Bilateral cochlear implantation (CI) is surgical standard in infants and young children suffering from profound hearing loss or deafness. Up till now preoperative radiological diagnostics included Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Recent studies have shown, that X radiation and especially CT diagnostics of the brain and the facial bones within the first year of life increases the risk of brain and lymphoid cancer. Therefore, the preoperative CT was taken out of the routine program in children without suspicion of a cochlear malformation in MRI.
From 2012 till 2017, 35 children with congenital hearing loss have been bilaterally simultaneously implanted under the age of three years. Mean age of the children at the time of implantation was 14.47 ± 7.51 month. The mean duration of CI operation for both sides was 2:48 ± 0:46 hours. Neither postoperative complications nor complications related to anaesthesia were evident.
Before July 2013 in all children a CT was performed, regardless of whether there was suspicion for malformation or not. Since July of 2013 only 5% of the children were examined by CT diagnostics preoperatively. Both groups did not differ in operative time and complication rate. All children achieved a remarkable improvement in hearing and speech development, confirmed by various age appropriate evaluation procedures.
The data demonstrate that bilateral simultaneous CI can be performed safely in very young children within a reasonable operative time and without any complications. Leaving out preoperative CT diagnostics did not affect safety of the procedure. Bilateral activation and rehabilitation results in a very satisfactory improvement of hearing capability and of speech development.