91 dB hearing loss - the threshold for a cochlear implant?

Background and objective. Recent indications for cochlear implant in childr en are bilateral total cochlear deafness and an age of 2 or more. Reports o n successful implantations in adults with residual hearing pose the questio n of whether this indication might be expanded to children with residual he aring. Patients/Methods. In a retrospective analysis of 106 hearing-impaired child ren with binaural amplification, we were able to ask parents in 90 cases ab out their children's education. The pure-tone average of the frequencies of 1-4 kHz was correlated to education. Results. The results showed that all children except one with a pure-tone a verage of less than or equal to 90 dB could successfully attend regular sch ool or kindergarten. However, those with a pure-tone average of greater tha n or equal to 91 dB had to be educated in special units for children with i mpaired hearing. Conclusions. Our results indicate that amplification in children with profo und hearing loss (pure-tone average >91 dB) is not sufficiently effective t o enable them to attend regular schools or kindergarten. We conclude that t he only chance to integrate these children into the world of hearing might be cochlear implantation.