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COCHLEAR IMPLANTS IN THE ADOLESCENT: CHANGING PATTERNS
Noel Cohen, Janet Green, William Shapiro, Susan Waltzman
NYU Medical Center, New York, NY, USA
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INTRODUCTION: It has been thought that the adolescent cochlear implant (CI) candidate presents multiple problems and has a poor prognosis for speech perception with a cochlear implant. We examined this perception and analyzed factors which help determine the outcome of implantation. We will describe the changes which have occurred in the profiles of this group and the results of implantation.■
METHODS: Retrospective chart review. Population; 75 Adolescents with bilateral severe to profound or profound sensorineural hearing loss (SNHL). Hypothesis: Recent changes in the characteristics of adolescents with severe to profound and profound bilateral SNHL, such as younger age, oral education, and increased desire to hear, combined with improved cochlear implants and speech processing strategies have resulted in improved performance with the CI■
DISCUSSION: Adolescents are, inherently, a difficult group; this may lead to poor performance following implantation. Since the length of deafness is usually considered to be a major factor in predicting the success of implantation, the pre-linguistically deaf adolescent is, by definition, at a disadvantage. Changes in demographics and technology may improve the results in this group.■
STUDY: 79 adolescents received cochlear implants at the NYU Cochlear Implant Center. 4 were lost to follow-up and were not included in this study. Age ranged from 11 to 17, with a median of 13. Devices received were: Nucleus 67, Advanced Bionics 11, and Med-El 1. All met the medical and audiological criteria for implantation: all received a single device. Pre- and post-operative evaluation included complete pure-tone and open-set speech perception testing.■
RESULTS: These data indicate that CI performance is improving for the adolescent. Variables correlating with performance include dvancements in cochlear implant technology, mode of communication pre-implantation, and changing CI candidacy by both the CI center and recipients. Shorter duration of deafness, younger age at implantation and oral communication correlated with better performance.■
CONCLUSIONS: Overall performance is improving for the adolescent population. Appropriate counseling regarding the above variables and how they affect performance is critical to successful use of cochlear implants.