gms | German Medical Science

84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

08.05. - 12.05.2013, Nürnberg

Longterm results in children who received cochlear implant during first and second year of life

Meeting Abstract

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Nürnberg, 08.-12.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13hno20

doi: 10.3205/13hno20, urn:nbn:de:0183-13hno202

Published: July 30, 2013

© 2013 Illg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Since implementation of newborn hearing screening the age of diagnosis and therapy in children with profound hearing loss could decline to 4–5 months. This is one reason for early implantation in very young age. Another reason is that speech development in children with CI is similar to speech development in normal hearing children. Since 1996 we started to implant children in very early age, younger than 1 year. After years of hearing- and speech development it is necessary to analyse if there is a difference between the speech development in the children implanted during first year of life and children implanted during second year of life.

The speech perception data (numbers, monosyllables, sentences in quite and noise 10dB S/N ratio) of 126 children who received their cochlear implant during 1996 to 2002 were evaluated retrospectively. The evaluation happened into two groups: group A (n=24) children, who received their CI under the age of one year and group B (n=80): children, who received their CI between one and two years of life.

The first implanted children at implantation age of one and two years wear their device 8 to 12 years. Their chronological age is 10 to 14 years. All data were analysed statistically with Wilcoxon Test.

Group A show mean scores of 67% understanding of numbers, 53% monosyllable words, 54% sentences in quite and 29% sentence in noise after 5 to 6 years of experiences CI.

Group B show mean scores of 84% understanding of numbers, 54% monosyllable words, 55% sentences in quite and 14% sentence in noise after 5 to 6 years of experiences CI.

After wearing the device 7 to 8 years results of both groups grew.

Group A had scores of 99% understanding of numbers, 71% monosyllable words, 86% sentences in quite and 37% sentences in noise.

Group B had scores of 93% understanding of numbers, 64% monosyllable words, 76% sentences in quite and 26% sentences in noise.

After wearing the speech processor 9 to 10 years the results remain. In all results between both implantation groups no significant differences were evaluated.

If we analyse the process in same children of group A (3 children), there is no significant difference between the results after 5–6 years and 7–10 years. The children, who received their implant before age of one year, showed same results after 5–6 years and 7–10 years.

In group B (17 children) the scores show significant differences in monosyllables and sentence in quite. The results after 7–10 years of CI experiences are significant higher than after 5–6 years.

Also in sentences with noise the results are higher but not significant.

In our clinic it is custom to use performance classes to divide the results in good, middle and worse classes. The performance classes are built in connection to the results of the sentence test (HSM). Following formula is used: f(HSM) = HSM_quite + 2*HSM_noise10 dB/SN ratio. 7 children of group A were divided into the performance classes. 1 child belongs to the worse class, 1 child to the middle and 5 children to the good class. 47 children of group B were divided into the performance classes. 7 belong to the worse classification, 21 to the middle and 19 to the good class.

The results of both implantation groups show differences. The results of the very young implanted children (group A) are earlier available. Probably these children have their outcome faster. The children who received their implant during one and two years (group B) show also increasing results after years of wearing their device. It seems that these children need more time to receive similar results than the younger group A.

In comparison to adults, the main results of the very young implanted children (group A) are in the good performance class and the results of group B are in good and middle performance class. It seems that the very early implanted children have better chances to develop hearing and speech. It happens earlier and they are able to remain their results. We can estimate that maturing processes which normally take place during the first year of life are not completely to be regained at a later time in life.


Joseph G, Bloemer J, Dörschel D, Lenarz M, Büchner A, Lenarz T. Objektive und subjektive Beurteilung des Hörerfolgs mit dem CI. Proceedings of the 15th Jahrestagung der Deutschen Gesellschaft für Audiologie; 2012 March 7-10; Erlangen, Germany. 2012. Available from: External link