What influence does the introduction of newborn hearing screening programs have on the age at which cochlear implantation occurs in children?
Background: Early cochlear implantation in children has a positive effect on the development of the auditory pathway and on post-operative outcomes, but delays in the severe hearing impairment detection or recognition could introduce undesired speech development and verbal communication skills retardation. The introduction of newborn hearing screening programs has allowed very early detection of hearing impairment, but the extent of this influence is unknown.
Explore this issue:April 2015
Study design: Retrospective, multicenter cohort study of 1,299 pediatric cochlear implant (CI) users who received their implants before age 5 between 1995 and 2011.
Setting: Hannover Medical School (MHH), Germany, and University Medical Center (UMC) Utrecht, Netherlands.
Synopsis: The age at implantation decreased significantly between 1995 and 2011 at both centers (median age at UMC: 3.4 to 0.9 years; mean age at MHH: 3.1 to 1.9 years). The number of children receiving CIs before age 3.5 years increased at MHH from 67% (1995–1998) to 86% (2008–2011) and at UMC from 60% (1995–1998) to 96% (2008–2011). After introduction in the Netherlands in July 2006, there was a significant decline in the age at implantation, but there was no marked decline at MHH after program introduction in Germany in 2009. The percentage of children who received their implants before age 1 increased from 9% (2003–2006) to 37% (2007–2010) at UMC, and from 18% (2006–2008) to 24% (2009–2011) at MHH. A considerable delay between the first visit and surgery at UMC may suggest that reducing delays increases the likelihood that children will receive implants within their first year. Limitations include limited or missing data on the cause of deafness and insufficient data to evaluate the onset age of deafness, residual hearing, comorbidities, and the duration and effect of previous hearing aid trials.
Bottom line: The introduction of the national newborn hearing screening program has reduced the age at which young children receive CIs in the Netherlands but not in Germany. Correspondingly, the program resulted in an increase in the number of children implanted early in life.
Citation: Lammers MJW, Jansen, TTG, Grolman W, et al. The influence of newborn hearing screening on the age at cochlear implantation in children. Laryngoscope. 2015;125:985-990.