This systematic review with meta-analysis compares cochlear implantation (CI) outcomes (i.e., speech-language and auditory skills) of children, less than 18 years old, with auditory neuropathy spectrum disorder (ANSD) to children with neurosensory hearing loss (HL) or HL due to other causes.
No funding received
2000 to March 2022
Systematic reviews, randomized controlled trials, and prospective and retrospective controlled longitudinal observational studies (i.e., cohort studies).
8 studies included in the meta-analysis. 19 total studies included in the review.
Cochlear implantation (CI) resulted in comparable benefits when comparing children with ANSD to children with HL due to other causes. Both groups of pediatric CI recipients showed significantly improved hearing perception and speech outcomes one-year post-CI. The meta-analysis reported the following comparisons of the two groups:<br />
<ul>
<li>Neurotelemetry showed a relative risk value of 0.91 (<em>p</em><0.001) indicating that both groups showed a robust neural response to CI stimulus (8 studies).</li>
<li>Open-set word recognition showed a mean difference of -3.27 (<em>p</em>=0.92; 2 studies).</li>
<li>Closed-set word recognition showed a mean difference of 0.19 (<em>p</em>=0.32; 2 studies).</li>
</ul>
The qualitative review reported the following findings:<br />
<ul>
<li><span style="color: #333333;">Comparison of neurotelemetry amplitude and speech perception test outcomes showed no statistical difference indicating good performance post-CI (1 study).</span></li>
<li><span style="color: #333333;">In quiet and noisy environments, children with ANSD showed worse outcomes (2 studies); however, this finding conflicts with the meta-analysis results.</span></li>
<li><span style="color: #333333;">Neural responses and speech perception test outcomes showed no statistical significance, though the ANSD group showed higher and stronger electrocochleography waveform amplitudes (1 study).</span></li>
<li><span style="color: #333333;">Children with ANSD showed rapid improvements in auditory perception in the first 3 months and in verbal skills in the first 9 months post-CI; however, the level of benefit differed from the control group over time (1 study).</span></li>
</ul>
<span style="color: #333333;">Additional research is needed to investigate ideal rehabilitation strategies for cochlear implantation in children with ANSD.</span>
