Parental and program's decision making in paediatric simultaneous bilateral cochlear implantation: who says no and why?

Autor: Ramsden JD; Cochlear Implant Program, The Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada. james.ramsden@orh.nhs.uk, Papaioannou V, Gordon KA, James AL, Papsin BC
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2009 Oct; Vol. 73 (10), pp. 1325-8. Date of Electronic Publication: 2009 Jul 17.
DOI: 10.1016/j.ijporl.2009.05.001
Abstrakt: Objective: To evaluate initial candidacy for bilateral simultaneous cochlear implantation in children.
Design: Prospective case series.
Setting: Tertiary academic pediatric hospital.
Participants: As part of our research protocol all children eligible for cochlear implantation were assessed for suitability to receive a simultaneous bilateral implant. Over a 12-month period (January to December 2007) 78 children received a total of 95 cochlear implants. Children with sequential second implants (24), revision cases (4), and out of province recipients (4) were excluded. The remaining 46 patients were assessed for bilateral simultaneous implantation.
Main Outcome Measures: Team/parental decision to proceed with bilateral simultaneous implantation.
Results: 17 children (37%) received simultaneous bilateral implants. 29 children (63%) were not considered suitable for simultaneous bilateral implantation. Reasons included developmental delay (10), residual borderline hearing in the second ear (9), parental/patient refusal (6), abnormally poor speech development for age (2), and abnormal cochlear anatomy precluding implantation (2). None were considered unsuitable for the more prolonged operative procedure on medical grounds.
Conclusions: Although bilateral implantation is thought to produce the optimal auditory outcome, not all patients are suitable, nor do all parents wish to proceed, when assessed for simultaneous implantation. Some of these patients are likely to be candidates for sequential bilateral implantation in due course.
Databáze: MEDLINE
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