Long term results after cochlear implantation: Schooling and social insertion of teenagers and young adults

Introduction: To analyse the long-term impact of cochlear implantation (CI) in deaf patients on perception and language, and on schooling and social insertion.

Method: A total of 131 profoundly deaf patients that had unilateral CI, aged at follow up 16 to 26 years old and with 5 years minimum of follow up were included for the study. 84 of them had profound congenital deafness (Gc) and 47 had progressive deafness (Gp). In Gc, the mean age at CI was 5 years (3-16), the mean FU was 15 years. In Gp, the mean age at CI was 9 years (3-17 years), the mean FU was 11 years. The perceptive scores (open set sentences (OSS), word in open set sentences (WSS)), the intelligibility rate (SIR), the lexical scores (EVIP) were analysed and compared to the Schooling Status (SS) & Social Insertion (SSSI) (University/Working/Handicapped environment) and Classified as (Mainstream or Specialized). Both groups were compared.

Results: The mean results for Gc and Gp respectively were for the OSS score: 67.1% and 80.7% (P=0.009) and the SIR: 4.5 and 4.8 (P=0.049). EVIP scores were: in Gc, 56% of patients had normal or≥+1 SD; in Gp 72% of patients had normal or≥+1 SD. The SSSI: 63% in Gc and 83% in Gp were in Mainstream Schooling. Low level of EVIP scores were linked to Specialized environment in both groups (P=0.01, P=0.04).

Discussion: Long-term results show that differences have to be expected whether implanted children had congenital or progressive deafness. In both groups, strong correlations remain between perceptive results, lexical scores and the SSSI.

Conclusion: On the long term the lexical level remains a relevant tool to assess the evolution of implantees. For those who do not reach a near to normal lexical level, impact on the schooling and the social insertion has to be expected.