Optimizing Outcomes in Children with Cochlear Implants and Residual Acoustic Hearing

Organization: New York University School of Medicine Cochlear Implant Center

Project Rationale: Improvements in cochlear implant (CI) outcomes have been brought about by a number of factors. For example, earlier age at implantation have allowed children to take advantage of maximal brain plasticity. Additionally, improvements in electrode design and surgical technique have allowed the preservation of low frequency acoustic hearing in patients with inadequate high frequency information for adequate speech perception and effective communication.

Studies have shown that this low frequency acoustic hearing provides additional benefits to such patients including improved ability to hear in noise, enhanced music perception, sound localization and more generally improved performance on standard clinical measures of speech perception. In the adult population, patients successfully using electro-acoustic stimulation (EAS) are among the top performing CI users.

Currently the audiogram is the primary measure used to quantify residual hearing, despite its inability to predict who will use the AC and benefit from it. This project will test pediatric patients on measures of spectral and temporal resolution pre- and post-implantation Since these are measures correlated not only with speech perception, but on other complex listening tasks such as hearing in background noise and music perception AS WELL. We plan to administer the test measures in three test conditions: (1) acoustic, (2) electric alone, (3) acoustic + electric.
Since the disease process, plasticity, and processing is different in children compared with adults, the parameters and benefits of electro-acoustic stimulation in the pediatric population need to be studied.