Liaqat Ali, Arif Tarar, Farooq Rasool, Taeed Ahmed Butt, Tahir Masood Ahmed.
Experience with the cochlear implants in Special school children.
Pak Paed J Jan ;34(4):180-7.

Objectives: To evaluate the contribution of cochlear implants in profoundly deaf children. Study Design: An on going study from June 2009 to June 2010. Settings: Departments of Paediatric Audiology, ENT, Radiology and Paediatric Medicine, The Children’s Hospital & The Institute of Child Health Lahore. Materials and Methods: Ninety five hearing impaired children, in the age range of 4-7 years, from Special Schools of Punjab, were referred to The Children’s Hospital for cochlear implant surgery. After ENT and Medical evaluation, audiological assessment was done with various subjective and objective techniques. Computerized Tomography and Magnetic Resonance Imaging were done to exclude inner ear malformations. Speech and language evaluation, educational achievements and psychological assessment were furnished by Special Education Department. The Cochlear Implant Committee selected 36 children out of 95 after following the criteria, for cochlear implant surgery which was done by inserting cochlear implant devices in cochlea and intra-operative measurements were carried out. After 4-6 weeks, Speech Processor was switched on and called for follow up sessions. Results: A total of 36 profoundly deaf children, [23(63.89%) male and 13(36.11%) female], in the age range of 4-7 years, were studied. Twenty nine (80.55%) were congenitally hearing impaired and 7(19.45%) with acquired deafness. Seventeen (47.22%) had family history of deafness and 19(52.78%) were born to consanguineous parents. Thirty one (86.11%) out of 36 patients were successfully operated. In 2(5.56%), operation was not successful and parents of 3(8.33%) children refused for surgery. One (2.78%) child was re-implanted and 1(2.78%) ex-implanted. During surgery, 15(45.45%) had inner ear malformations. Impedance Field Telemetry was within normal range at all electrodes in 22(70.97%) patients, high impedance at 1 or more electrodes in 7(22.58%) and short circuiting in 2(6.45%) children. Out of 27 children, 25% improvement was documented in 20(74.07%) patients in reading, in 19(70.37%) in writing and 20(74.07%) in speech where as 50% improvement in 5(18.52%) children in writing and in 6(22.22%) in speech. Conclusion: Cochlear implantation is a safe, reliable and efficacious otosurgical procedure, in the age range of 4-7 years of profoundly deaf children, having good psychologically status, with improved scholastic performance.

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