Qusai Tawakkul

Background: Cochlear implantation (CI) has emerged as a promising intervention for children with auditory neuropathy spectrum disorder (ANSD). Several studies have investigated the efficacy of CIs in children with ANSD, demonstrating improvements in auditory performance and language skills following implantation. Whether the benefits and outcomes of CIs in children with ANSD are comparable to children with sensorineural hearing loss (SNHL) is still debatable. The present updated systematic review and meta-analysis evaluated the outcomes of CI for children with ANSD compared to children with SNHL. Methods: A meta-analysis was conducted on studies that included pediatric patients and the outcomes of CI in patients with ANSD versus SNHL were compared. A comprehensive search was performed using the following electronic databases: PubMed, Scopus, Web of Science, EBSCOhost, and Cochrane Central Register of Controlled Trials (CENTRAL). Results: Fourteen studies (number of patients = 722 patients) were included. The total number of patients in the ANSD and SNHL groups in the present systematic review was 212 and 520, respectively. The most utilized assessment tests were the Speech Intelligibility Rating (SIR) and Categories of Auditory Performance (CAP) scores. The pooled estimate showed that patients with ANSD had comparable CAP scores compared to patients with SNHL (MD: −0.52, 95% CI [−1.34, 0.29], p = 0.21). Likewise, three studies reported the SIR after CI and showed comparable findings between ANSD and SNHL patients. The pooled estimate showed that patients with ANSD had comparable SIR scores compared to patients with SNHL (MD: −0.26, 95% CI [−0.65, 0.13], p = 0.19). Conclusion: While the results show mixed findings across various outcome measures, the overall impact of CI on speech recognition and language development appears to be positive and comparable between ANSD and SNHL.

Background/Objectives: Cochlear implantation (CI) is a transformative intervention for individuals with sensorineural hearing loss, providing auditory and speech perception improvements. Traditional CI activation occurs 4–6 weeks post-surgery; however, recent advancements allow for early activation within 1–2 days. The integration of data logging in modern CI systems offers objective insights into processor usage and auditory exposure, which are crucial for optimizing rehabilitation outcomes. Methods: A retrospective study was conducted on 63 patients with bilateral simultaneous CIs using MED-EL SONNET2/RONDO3 devices. Patients were classified into early activation (n = 30, activation within 1–2 days) and classical activation groups (n = 33, activation after day 2). Data logging metrics, patient demographics, and implant details were analyzed using the Wilcoxon rank-sum test and Poisson regression. Results: Daily processor usage did not significantly differ between groups (9.5 ± 3.0 h/day for classical vs. 9.4 ± 3.7 h/day for early activation, p = 0.927). Subgroup analysis showed a significant 18% increase in processor usage with each additional year of patient age (IRR = 1.18, p < 0.001) and a 15% decrease in usage with each year delay in implantation age (IRR = 0.85, p < 0.001) among early activation users. Switch-on frequencies were comparable between groups, with no significant differences observed (p = 1.0). Conclusions: Early activation is feasible and associated with consistent CI usage, providing potential benefits in auditory rehabilitation. Future research should explore its impact on long-term speech and language outcomes to inform evidence-based practices.