Cochlear Implant Surgery: How Young Is Too Young?

“Can you implant children at 10 or 11 months of age? Sure—we do it and consistently achieve very acceptable results. But I don’t know of any other group, other than Dr. Colletti’s, [that] has shown that this procedure works in younger children,” said Dr. Gantz. “For me, if the child is not old enough to [undergo] a behavioral audiogram, I’m not even going to consider that patient to be a viable candidate for CI surgery.”

In the case of residual hearing, Dr. Colletti agreed “that a standard implant can destroy residual hearing in this population.” To protect against that outcome, “we performed routine intraoperative ECoG in all children during CI surgery,” he added.

For Dr. Papsin, there is one instance where patients younger than six months of age often receive a cochlear implant—in cases of post-meningitic deafness, “where the potential risks of intracochlear ossification drives us to operate early,” he said. But without that particular history of infectious disease, “I certainly would not let my child undergo an elective operation based on this low-level data.”

Disclosures: Dr. Papsin is a member of the Speakers Bureau of Cochlear Americas Corp., and Dr. Gantz is a consultant for Cochlear Corporation and Advanced Bionics.