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KMID : 1195620240170010046
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Clinical and Experimental Otorhinolaryngology
2024 Volume.17 No. 1 p.46 ~ p.55
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Early Postoperative Benefits in Receptive and Expressive Language Development After Cochlear Implantation Under 9 Months of Age in Comparison to Implantation at Later Ages
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Lee Seung-Jae
Oh Heon-Jeong
Shin Kyu-Ha
Park Sung-Min
Kim Yun-Kyeong
Jung Do-Hyun
Yang Ji-Yeon
Chun Ye-Jun
Kim Min-Young
Han Jin-Hee
Kim Ju-Ang
Ngoc-Trinh Tran
Kim Bong-Jik
Choi Byung-Yoon
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Abstract
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Objectives. The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA)to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pe-diatric CI. Our study compared the early postoperative trajectories of receptive and expressive language developmentin children who received CI before 9 months of age with those who received it between 9 and 12 months. This studyinvolved a unique pediatric cohort with documented etiology, where the timing of CI was based on objective criteriaand efforts were made to minimize the influence of parental socioeconomic status.
Methods. A retrospective review of 98 pediatric implantees recruited at a tertiary referral center was conducted. The timingof CI was based on auditory and language criteria focused on the extent of delay corresponding to the bottom 1st per-centile of language development among age-matched controls, with patients categorized into very early (CI at <9 months),early (CI at 9?12 months) and delayed (CI at 12?18 months) CI groups. Postoperative receptive/expressive languagedevelopment was assessed using the Sequenced Language Scale for Infants receptive and expressive standardizedscores and percentiles.
Results. Only the very early CI group showed significant improvements in receptive language starting at 3 months post-CI,aligning with normal-hearing peers by 9 months and maintaining this level until age 2 years. During this period(<2 years), all improvements were more pronounced in receptive language than in expressive language.
Conclusion. CI before 9 months of age significantly improved receptive language development compared to later CI, withimprovements sustained at least up to the age of 2. This study supports the consideration of earlier CI, beyond pediat-ric Food and Drug Administration labeling criteria ( >9 months), in children with profound deafness who have a cleardeafness etiology and language development delays ( <1st percentile).
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KEYWORD
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Cochlear Implantation, Cochlear Implants, Sensorineural Hearing Loss, Language Development, Speech Disorder
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