The Nottingham Paediatric Cochlear Implant Programme is the largest and most
experienced centre in the UK. Established in 1989, it specialises in providing
cochlear implants to deaf pre-school children, and has developed a protocol that
ensures a high degree of co-operation between all agencies.
Numbers have steadily increased from year to year. To date 193 children from all over the UK have been implanted at Nottingham. The most common age of children at implantation is 3 years, and there is a trend for younger children to be considered in their first or second year of life. Most of the children who have been provided with a cochlear implant are congenitally deaf, that is they have been deaf from birth. Complex cases are now being managed by the programme, such as children who are deaf and blind, and children with additional needs. The Nottingham programme was the first in the UK to fit the ear-level speech processor (BTE) to a child in January 1998. We are presently evaluating its use in the paediatric population.
We have recently completed an audit of complications, and this shows that the Programme has a good surgical record. There is a 2.5% major complication rate, which is very low compared with programmes elsewhere in the world
The most basic performance measure of a
sensory aid is the ability to detect stimulation. All children in the programme
have demonstrated marked improvements in their thresholds for sound field warble
tone stimuli when using implants six months after implantation, compared with
using hearing aids. The figure on the right shows that the children fitted with
the most powerful hearing aids available were unable to hear any middle to high
frequency warble tones at a level of 60 dB (filled squares). After implantation,
all children could hear warble tones at all frequencies between 0.5 and 4 kHz,
with the high frequency response being typically 35 dB (open squares).
Categories of Auditory Performance: The table below provides an overview of the hearing performance of children with cochlear implants as a function of increasing device experience. The numbers of children diminish with time since implantation because fewer children were implanted earlier. The data show that all children gain substantial hearing benefit from use of the cochlear implant, and these benefits increase steadily over a period of at least three years. After three years, 63 out of 69 children (91%) can understand common phrases without lipreading. Of these, the younger children are at implantation, the better their auditory performance following surgery.
* Excludes one child who has recently been reimplanted.
Speech Intelligibility Rating: This table shows the change in speech intelligibility of the children following provision of a cochlear implant. As children become more experienced with the cochlear implant, their speech becomes more intelligible. After five years, 28 out of 32 children (87%) had acquired intelligible speech.
The Nottingham Programme is the largest and most experienced in the UK. It provides a comprehensive service, comprising assessment, counselling, surgery, tuning and maintenance of the system for an initial period of three years. Thereafter continued maintenance and support will be provided annually. The Progress Report that documents outcomes related to those reported here has now been reprinted following demand, and we would be happy to send you a copy on request.
Page Maintained by Jonathan
Hill(jrh@npcip.org.uk)
Page Last Updated 11th October 1999
Original address of this page:
www.npcip.demon.co.uk/outcomes.html
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