The Cochlear Implant Outcome and Factors Associated of Pre-Operative among Prelingual Deafness Patients Under 3 Years and 6 Months Old in Rajavithi Hospital: A Single Center Experience

Background: The recent government announcement that fees for cochlear implants in prelingual patients will be reimbursed means that this treatment will be more accessible in the near future. The data in the present study would form the baseline for improving the care process in Rajavithi Hospital. Objective: To study the outcomes of cochlear implants in prelingual hearing loss patients younger than three years and six months, and to determine preoperative assessment factors that affect the outcomes. Materials and Methods: A retrospective review was conducted of the medical records of prelingual deafness patients younger than three years and six months that underwent cochlear implants between 2013 and 2019. Forty patients were enrolled, and their demographic data, preoperative assessment, and Category Auditory Performance (CAP) score outcomes were recorded. The preoperative factors affecting the CAP score at 2 years post-operation were analyzed. Results: A CAP score above 5 at two years after cochlear implant, considered to be good habilitation, was reported in 55% (22 cases). After further follow up, the number of patients whose CAP score reached 5 or more was 31 (77.5%). The mean age of diagnosis was 13.28±9.38 months, and the mean age at surgery was 25.73±9.74 months. The preoperative factors associated with poor CAP scores were Goldenhar syndrome, Waardenburg syndrome, Autism, small inner ear canal, and poor eye contact. The differences in preoperative factors between patients with CAP scores of 5 or more and those with scores less than 5 at two years after cochlear implant were not statistically significant. Conclusion: The outcomes of cochlear implant operations may be improved by early age at surgery, which will be assessed by the Newborn Hearing Screening policy. Preoperative assessment factors associated with poor outcomes were identified, but they were not statistically significant in the present study. Keywords: Cochlear implant; CAP score; Preoperative factors