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Good Cochlear Implant Outcomes Seen In Pediatric Patients with Cytomegalovirus-Related Deafness: Presented at AAO-HNSF

By Paula Moyer
Special to DG News

SAN DIEGO, CA -- September 24, 2002 -- Children who are deaf from congenital cytomegalovirus (CMV) infection have sufficient speech recognition after receiving cochlear implant to justify the implants in this population, according to Dr. Daniel J. Lee.

Because children with congenital CMV-induced deafness are at risk for other severe sequelae, including developmental delays due to severe neurological deficits, there has been some controversy about the benefits they would receive from cochlear implants, he said.

However, findings from a retrospective study presented here at the 106^th Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF), he and colleagues found that 12 of the 13 patients who received implants in the trial had improved speech-recognition scores.

"These findings show that even high-risk patients improve after implant surgery," said Dr. Lee. Dr. Lee is the medical director of the cochlear implant program at the University of Massachusetts Memorial Centre in Worcester, Massachusetts, where he is also an assistant professor of otolaryngology and an attending physician at Massachusetts Eye and Ear Infirmary in Boston.

He and colleagues reviewed the records of 13 patients, seven boys and six girls, from the Johns Hopkins Pediatric Cochlear Implant Database who had CMV-related sensorineural hearing loss and who had received cochlear implants. The children ranged in age from .2 to 2.0 years at the time of their hearing loss diagnosis, with a mean age of 1.1 years at diagnosis. They were an average of 5.6 years old when they underwent cochlear implant surgery.

Eight patients were assessed by conventional speech recognition testing. Because of the young age of the remaining five patients, they were assessed through parent-based observational surveys. The postoperative follow-up period ranged from six to 48 months. The patients' preliminary data word and phenome scores averaged 61.2 percent and 73.4 percent respectively at 24 months after activation.

Speech-recognition scores were quantified across six categories, ranging from Category 1, simple detection of sound, to Category 6, a high level of speech recognition. Over 90 percent of the children showed some improvement, and over half showed improvement in Category 6.

"We were pleasantly surprised to see that speech outcomes rivalled that of children without CMV-induced deafness," Dr. Lee said. "There has always been controversy regarding the use of cochlear implants in severely handicapped children, and a need to convey to the parents realistic expectations for the surgery. However, these findings show that the implant can be used to maximize the children's learning environment."

He stressed that cochlear implants for this patient group, as well as others, should be used in a context of multidimensional rehabilitation. Rehabilitation for this patient group is important because many of them have concomitant neurological deficits that can hinder language and communication skills acquisition, said Dr. Lee.

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