SPEECH-PERCEPTION RESULTS FOR CHILDREN WITH IMPLANTS WITH DIFFERENT LEVELS OF PREOPERATIVE RESIDUAL HEARING

Objective: Many reports have established that hearing-impaired childre n using the Nucleus 22-channel cochlear implant may show both signific ant benefits to lipreading and significant scores on open-set words an d sentences using electrical stimulation only. These findings have rai sed questions about whether severely or severely-to-profoundly deaf ch ildren should be candidates for cochlear implants. To study this quest ion, postoperative results for implanted children with different level s of preoperative residual hearing were evaluated in terms of speech p erception benefits. Study Design/Setting: A retrospective study of the first 117 children, sequentially, to undergo implantation in the Melb ourne and Sydney Cochlear Implant Clinics was undertaken. All children had been assessed by and received their implants in a tertiary referr al centre. Main Outcome Measures: To assess aided residual hearing, th e children were grouped into four categories of hearing on the basis o f their aided residual hearing thresholds measured preoperatively. To assess benefits, the scores of children on standard speech perception tests were reviewed. As different tests were used for children with di fferent ages and language skills, children were grouped into categorie s according to the level of postoperative speech perception benefit. R esults: The results showed that children in the higher cate gories of aided preoperative residual hearing showed significant scores on open- set word and sentence perception tests using the implant alone. For ch ildren in lower categories of aided residual hearing, results were var iable within the groups. More than 90% of children with implants with aided residual hearing thresholds in the speech range above 1 kHz achi eved open-set understanding of words and sentences. Conclusion: While the results of this preliminary study confirm previous findings of dif ferential outcomes for children with different levels of preoperative residual hearing, they suggest that children with severe to profound h earing impairments should be considered for cochlear implantation.