Pediatric cochlear implantation: A quarter century in review.

Objective: To review the growth of a pediatric cochlear implant (CI) program at one large tertiary care medical center over a 25-year period in order to (1) describe the population of pediatric cochlear implant recipients, (2) document word recognition outcomes, and (3) describe changes in candidacy criteria over time. Design: A retrospective review of population demographics and trends included etiology of hearing loss, device use and type, expansion of inclusion criteria, and word recognition outcomes. Results: Ninety-one percent of the children studied were from North Carolina and reflect the ethnic distribution of the state. The population is heterogeneous for etiology and the presence of syndromes and/or co-morbidities. A trend of lower age of implant and greater residual hearing was documented overtime. As a single metric, monosyllable word recognition for the children assessed is good with the mean CNC test word score of 76.13% (range 0-100, S.D = 19.94). Conclusions: Pediatric cochlear implant candidacy criteria have evolved despite no change in FDA-approved regulations since 2000. There is great diversity among recipients but word recognition outcomes are generally good in this population and have improved over time. Professionals who may refer children for cochlear implantation should be aware of current clinical practices and general outcomes.