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Scientific Oral Presentations

Pediatric Otolaryngology

Session: Scientific Oral Presentations 4 - Pediatric Otolaryngology

Hearing Preservation Techniques in Pediatric Cochlear Implantation: A Systematic Review and Meta-analysis

Sunday, September 29, 2024
3:18 PM – 3:24 PM EDT
Location: MBCC, 225
Disclosure(s):
Ory Madgar, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amber D. Shaffer, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel I. Gerges, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Dennis J. Kitsko, DO:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David H. Chi, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Preserving residual hearing following cochlear implantation (CI) improves outcomes and allows patients to use electrical and acoustic stimulation. Hearing preservation and minimizing intracochlear trauma during implantation have become a major focus of research and device development in recent years.
This meta-analysis aimed to evaluate if patient characteristics or surgical methodology impact hearing preservation post-pediatric CI.

Methods: A systematic search was performed in PubMed, Web of Science, Cochrane Library, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature of English studies published prior to November 2021. Search terms were “hearing preservation,” “cochlear implant,” “audiometry,” “pediatric,” and their synonyms. The main outcome was the percentage of ears with hearing preservation after CI. Patient, audiological, device, and surgical technique characteristics were extracted. The impact of these factors on hearing preservation was evaluated using random-effects models and the restricted maximum likelihood method.

Results: A total of 27 studies were included, with a total of 538 patients. Male patients comprised 49% of the sample (95% CI: 43%, 56%). Mean patient age was 10 years (95% CI: 8.8, 11.2 years). Mean PTA before and after CI was 73.9 dB (95% CI: 63.5, 84.3 dB) and 83.0 dB (95% CI: 71.6, 93.4 dB), respectively, with a mean worsening of 9.8 dB (95% CI: 7.6, 12 dB). Data regarding the number of ears with hearing preservation were available from 6 studies; in these, 85% (95% CI: 76, 93%) had hearing preservation (I²=64.6%). Gender (logOR: -0.05, 95% CI: 1.09, 0.99), surgical approach (cochleostomy vs round window, logOR: -0.71, 95% CI: -2.65, 1.23), age (Hedge’s g = 0.24, 95% CI: -0.24, 0.72), and initial PTA (Hedge’s g = 0.13, 95% CI: -1.33, 1.07) were not significantly associated with hearing preservation.

Conclusions: Hearing preservation following pediatric CI is feasible. In this meta-analysis, no patient characteristic or surgical technique was significantly associated with hearing preservation.

    Presenting Author(s)

  • Ory Madgar, MD

    Pediatric Otolaryngologist
    Department of Otolaryngology, Head and Neck Surgery, the Sheba Medical Center, Tel-Hashomer, Israel
    Ramat Gan, Tel Aviv, Israel

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • AS

    Amber D. Shaffer, PhD

    Research Assistant Professor
    UPMC Children's Hospital of Pittsburgh
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Daniel I. Gerges, MD

    Otolaryngologist, Assistant Professor
    Larner College of Medicine, University of Vermont
    Burlington, VT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • DK

    Dennis J. Kitsko, DO

    Associate Professor
    Children's Hospital of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • DC

    David H. Chi, MD

    Division Chief
    University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.