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Mansoura University habilitation outcome of prelingual cochlear-implanted children: 5 years of experience




The aim of this study was to explore the effects of different preimplantation and postimplantation factors on the postimplant outcome of prelingual cochlear-implanted (CI) children as regards their auditory and language development.

Patients and methods

This retrospective study included a sample of 33 prelingual CI children who were presented to the Phoniatric Unit, Mansoura University Hospitals, Mansoura, Egypt, and were implanted during the last 5 years starting from August 2009 to August 2014. All children received structured auditory and language therapy sessions after CI twice weekly. They were subjected to the protocol of assessment of a delayed language development (before and after language therapy sessions) using subjective and quasiobjective measures of evaluation including improvement quotient assessment, language assessment, and assessment of auditory abilities including detection, discrimination, identification, and comprehension.


The results of the study proved that the better habilitation outcomes after CI children are correlated with young age at CI surgery, preoperative improvement quotient, language therapy before and after implantation, and regularity of hearing aids usage before surgery.


Early CI of the prelingual children is recommended to minimize initial language delays and to promote the development of age-appropriate communication skills.


  1. Stevens G, Flaxman S, Brunskill E, Mascarenhas M, Mathers CD, Finucane M. Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health 2011; 23: 146–152.

    Article  Google Scholar 

  2. Bradham T, Jones J. Cochlear implant candidacy in the United States: prevalence in children 12 months to 6 years of age. Int J Pediatr Otorhinolaryngol 2008; 72: 1023–1028.

    Article  Google Scholar 

  3. Mudry A, Mills M. The early history of the cochlear implant: a retrospective. JAMA Otolaryngol Head Neck Surg 2013; 139: 446–453.

    Article  Google Scholar 

  4. Manrique M, Cervera-Paz FJ, Huarte A, Perez N, Molina M, García-Tapia R. Cerebral auditory plasticity and cochlear implants. Int J Pediatr Otorhinolaryngol 2001; 49: S193–S197.

    Article  Google Scholar 

  5. Kameswaran M, Natarajan K, Basheth N. Clinical audit of outcomes in cochlear implantation an Indian experience. Indian J Otolaryngol Head Neck Surg 2006; 58: 69–73.

    Article  Google Scholar 

  6. Cosetti MK, Waltzman SB, Lin Frank R. Outcomes in cochlear implantation: variables affecting performance in adults and children. Otolaryngol Clin North Am 2012; 45: 155–171.

    Article  Google Scholar 

  7. Zwolan Teresa A, Thomas E, Cohen N. Perspectives on hearing and hearing disorder in childhood. ASHA 2010;19:4–5.

    Google Scholar 

  8. Melika L. Stanford Binet Intelligence Scale (4th Arabic version). 2nd ed. Cairo, Egypt: Victor Kiorlos Publishing; 1998.

    Google Scholar 

  9. Snijder ML, Oomen S. Non-verbal intelligence for deaf and hearing Subjects. Groningen, The Netherlands: Walters JP; 1939.

    Google Scholar 

  10. Caldwell A, Nittrouer S. Speech perception in noise by children with cochlear implants. J Speech Lang Hear Res 2013; 56: 13–30.

    Article  Google Scholar 

  11. Geers AE, Nicholas JG, Moog JS. Estimating the influence of cochlear implantation on language development in children. Audiol Med 2007; 5: 262–273.

    Article  Google Scholar 

  12. Kirk KI, Miyamoto RT, Lento CL, Ying E, O’Neill T, Fears B. Effects of age at implantation in young children. Ann Otol Rhinol Laryngol Suppl 2002; 189: 69–73.

    Article  Google Scholar 

  13. Fryauf-Bertschy H, Tyler RS, Kelsay DR, Gantz BJ, Woodworth GG. Cochlear implant use by prelingually deafened children: the influences of age at implant and length of device use. J Speech Lang Hear Res 1997; 40: 183–199.

    Article  CAS  Google Scholar 

  14. Svirsky MA, Robbins AM, Kirk KI, Pisoni DB, Miyamoto RT. Language development in profoundly deaf children with cochlear implants. Psychol Sci 2000; 11: 153–158.

    Article  CAS  Google Scholar 

  15. Lynessa C, Wollb B, Campbe R, Cardinb V. How does visual language affect crossmodal plasticity and cochlear implant success? Neurosci Biobehav Rev 2013; 37: 2621–2630.

    Article  Google Scholar 

  16. Spival L, Chin SB, Jester A. The effects of age at implantation on speech intelligibility in pediatric cochlear implant users: clinical outcomes and sensitive periods. Audiol Med 2009; 5: 293–306.

    Google Scholar 

  17. Tobey EA, Geers AE, Brenner CB, Altuna D, Gabbert G. Factors associated with development of speech production skills in children implanted by age five. Ear Hear 2003; 24: 36S–45S.

    Article  Google Scholar 

  18. Ching TY, Hill M, Brew J, Incerti P, Priolo S, Rushbrook E, Forsythe L. The effect of auditory experience on speech perception, localization, and functional performance of children who use a cochlear implant and a hearing aid in opposite ears. Int J Audiol 2005; 44: 677–690.

    Article  Google Scholar 

  19. Watson CS, Kidd GR. On the lack of association between basic auditory abilities, speech processing, and other cognitive skills. Rehabilitation 2002; 23: 83–94.

    Google Scholar 

  20. Shrestha DG, Mahajan S. A study of various factors affecting habilitation outcome in children with severe to profound hearing loss. Internet J Otorhinolaryngol 2014; 16: 1–8.

    CAS  Google Scholar 

  21. Osberger MJ, Fisher L. Preoperative predictors of postoperative implant performance in children. Ann Otol Rhinol Laryngol 2000; 109: 44–46.

    Article  Google Scholar 

  22. Tobey EA, Geers AE, Douek BM, Perrin J, Skellet R, Brenner C, Toretta G. Factors associated with speech intelligibility in children with cochlear implants. Ann Otol Rhinol Laryngol Suppl 2000; 185: 28–30.

    Article  CAS  Google Scholar 

  23. Young N, Grohne K, Carrasco V, Brown CJ. Speech perception in young children using nucleus or Clarion Cochlear Implants: effect of communication mode. Ann Otol Rhinol Laryngol Suppl 2000; 185: 77–79.

    Article  CAS  Google Scholar 

  24. Eisenberg LS, Johnson KC, Martinez AS, Cokely CG, Tobey EA, Quittner AL et al. Speech recognition at 1-year follow-up in the childhood development after cochlear implantation study: methods and preliminary findings. Audiol Neurootol 2006; 11: 259–268.

    Article  Google Scholar 

  25. Yoshinaga-Itano C, Baca RL, Sedey AL. Describing the trajectory of language development in the presence of severe-to-profound hearing loss: a closer look at children with cochlear implants versus hearing aids. Otol Neurotol 2010; 31: 1268–1274.

    Article  Google Scholar 

  26. Geers AE. Speech, language, and reading skills after early cochlear implantation. Arch Otolaryngol Head Neck Surg 2010; 130: 634–663.

    Article  Google Scholar 

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Correspondence to Tamer Abou-Elsaad MD.

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Abou-Elsaad, T., Baz, H., Allatif, G.A. et al. Mansoura University habilitation outcome of prelingual cochlear-implanted children: 5 years of experience. Egypt J Otolaryngol 32, 222–228 (2016).

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