Cochlear implantation in children: current status

Cochlear implantation provides useful hearing for those too deaf to benefit from conventional hearing aids. About 370 such children are born each year in the England, and another 100 each year become deaf early in life and need an implant. Over the past 20 years, cochlear implantation has now become standard management for severe to profoundly deaf children, making the attainment of intelligible, age-appropriate spoken language an achievable goal for many. With earlier diagnosis of deafness as a consequence of newborn hearing screening, implantation is increasingly being undertaken in the first year of life, with proven additional benefits. A growing number of children with significant additional difficulties are also being implanted, although expectations for the intervention in this group are different. Recent NICE guidelines recommend simultaneous bilateral implantation for children, with sequential bilateral implantation for those who were already unilaterally implanted at the time the guidelines were issued and who are considered clinically appropriate.However, there remains huge, unexplained, variation in outcomes from implantation and the challenges of ensuring life-long use and benefit remain. Professionals responsible for deaf children need to be familiar with the current criteria to ensure equitable and timely access to services as delay can compromise outcome.