This research focused on the identification and description of predictors of pediatric and
adult cochlear implantation outcomes in a South African cohort and the depiction of
profound childhood hearing loss in terms of risk and intervention profiles.
Study I described profound childhood hearing loss in a South African cohort of pediatric
cochlear implant (CI) recipients in terms of risk profile and age of diagnosis and intervention.
A retrospective review of patient files for 264 pediatric CI recipients from five CI programs
was conducted. For all subjects, permanent congenital and early onset hearing loss (PCEHL)
was confirmed under the age of five years old.
The most prevalent risks for profound PCEHL were neonatal intesive care unit (NICU)
admittance (28.1%), family history of childhood hearing loss (19.6%) and prematurity
(15.1%). An associated syndrome was diagnosed in 10% of children and 23.5% had at least
one additional developmental condition. Hearing loss for most (77.6%) children was
confirmed as congenital or early onset, while 20.3% presented with postnatal onset of
hearing loss. Auditory Neuropathy Spectrum Disorder (ANSD) was diagnosed in 5% of
children, with admittance to NICU (80%) and hyperbilirubinemia (50%) being the most
prevalent risk factors for these cases. Hearing loss was typically diagnosed late (15.3
months), resulting in delayed initial hearing aid fitting (18.8 months), enrollment in early
intervention services (19.5 months), and eventual cochlear implantation (43.6 months).
Delayed diagnosis and intervention predispose this population to poorer outcomes.