PREDICTORS OF PEDIATRIC COCHLEAR IMPLANTATION OUTCOMES IN SOUTH AFRICA

• Published in: International journal of pediatric otorhinolaryngology 2016-05, Vol.84, p.61-70
• Main Authors: le Roux, Talita, Vinck, Bart, Butler, Iain, Cass, Nicolize, Louw, Liebie, Nauta, Leone, Schlesinger, Dani, Soer, Maggi, Tshifularo, Mashudu, Swanepoel, De Wet
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; Children; Cochlear implant; Cochlear Implantation; Cross-Sectional Studies; Deafness - surgery; Female; Humans; Infant; Male; Otolaryngology; Outcomes; Pediatric cochlear implantation; Pediatrics; Prognosis; Prognostic factors; Retrospective Studies; South Africa
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2016.02.025

Abstract Objective To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population. Methods A retrospective study of 301 pediatric CI recipients from five cochlear implant programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including biographical, cochlear implant (CI), family and risk factors. Multiple regression analyses was performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement. Results Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education. Conclusion An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counselling.