The Value Of Gesell Score In Predicting The Outcome Of Cochlear Implantation In Children

Backgound: Cochlear implant(CI)is the most important intervention for children with severe to profound sensorineural hearing loss.There are great individual differences among the postoperative outcomes of CI patients,so the factors of impact on postoperative outcomes has always been a hot research.In fact there are many factors influencing the outcomes after CI.In recent years,more and more studies began to focus on the developmental levels in children prepared to CI.Fully understanding these factors will be helpful to make a personalized surgical program,improve the postoperative outcomes and establish reasonable expectations for the surgeon and the patient's parents before the CI operation.Objective: To evaluate the preoperative developmental levels of children who was prepared to CI by Gesell scale and to determine the relationship between preoperative Gesell score and the change of postoperative hearing and speech ability in pediatric CI patients.To explore the value of Gesell scale in predicting the postoperative outcomes for CI patients before the operation if there is a correlation between the above factors.Methods: The preoperative development levels evaluation for CI candidates was performed by Gesell development scale as a starting point of this study.At the same time the developmental characteristics of CI candidates before the operation were obtained and analysed.The auditory speech ability of CI children was assessed by auditory performance rating scale(CAP)and speech intelligibility rating scale(SIR).To determine the correlation between the preoperative Gesell development scale and the improvement of CAP and SIR in three months,six months and one year after CI.Littl EARS auditory questionnaire(LEAQ)was used to assess the prelinguistic and early auditory behavior and speech perception of infants younger than 2 years of age,and to determine the correlation the results of preoperative Gesell developmental scale and the improvement of LEAQ score in CI patients in three months,six months and one year after operation.Results: Preoperative developmental evaluation of CI candidates suggested that the developmental delay was prevalent in children with profound hearing loss,and the most significant one was speech backwardness.There was a significant difference in the mean of DQ among different age groups.The older the population are,the lower the DQ quotient are.Age and adaptability DQ and children with postoperative oneyear CAP and SIR improvement are related.Age and adaptability of DQ and LEAQ scores in children with one year after surgery were associated with improvement.Age is negative correlation with the CI outcome and adaptability of DQ is positive correlation with the CI outcome.Conclusion: The older children are,more serious developmental delay occur,so the CI operation should be planned as soon as possible at the early time of the patient's life.Adaptive DQ has predictive effect on the postoperative outcome of children,and its predictive value has nothing to do with the postoperative evaluation methods.