Authors' objectives:

To assess the extension of the field of application of cochlear implants to congenitally and prelingually deaf children and to define points concerning its efficacy and/or safety requiring further investigation. Evaluation conducted at the request of the French Ministry of Health.

Authors' results and conclusions: The incidence of congenital deafness in France is 1 per 1,000.77% of these children benefit from an external hearing aid. Approximately 40% of the remaining children would be unsuitable for cochlear implants, leaving about 130-150 congenitally and prelingually deaf children per year eligible for cochlear implants. The preferential indications are: profound neurosensory perception deafness unsuitable for any other prosthetic alternative. Chronic electrical stimulation may maintain the neuronal population and prevent degeneration of central auditory structures, suggesting that implantation should be performed before the age of 4 years, but, in the current state of knowledge, cannot be performed before the age of 2 years. Preliminary results concerning speech perception are encouraging and appear to improve with time. Results of language acquisition cannot yet be assessed. Apart from immediate operative and postoperative complications, long-term complications are related to the foreign body or to functioning of the implant, which can be prevented by respecting the characteristics of electrical stimulation. Further follow-up is required.

Authors' recommendations: The multielectrode cochlear implant is the only technique currently available which allows acquisition of hearing in congenitally and prelingually deaf children. Parents should be informed about the technique and principle, the potential short-term and long-term complications and expected benefits. There are no objective arguments concerning the success of oral language development, psychoaffective equilibrium and social integration. Long-term follow-up of children implanted in France is recommended: monitoring of complications, all centers must collect results using universally accepted objective criteria, followed by assessment of all children implanted, including family, school and social integration, psychoaffective equilibrium, parents' satisfaction, etc. Other output or dissemination activity: Cochlear implants are currently approved for use only in accredited centers.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 1994

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: Agence Nationale pour le Developpement de l'Evaluation Medicale