{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:47:48Z","timestamp":1790700468299,"version":"4.1.0"},"reference-count":103,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trends in Hearing"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.<\/jats:p>","DOI":"10.1177\/23312165211031751","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:32:22Z","timestamp":1626741142000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Cochlear Implantation in Infants: Why and How"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3474-5572","authenticated-orcid":false,"given":"Patricia L.","family":"Purcell","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2445-7454","authenticated-orcid":false,"given":"Nicholas L.","family":"Deep","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan B.","family":"Waltzman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"J. Thomas","family":"Roland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Cushing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake C.","family":"Papsin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2491-3125","authenticated-orcid":false,"given":"Karen A.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"bibr1-23312165211031751","unstructured":"American Academy of Otolaryngology\u2013Head & Neck Surgery. (2020).\n                      Position statement: Pediatric cochlear implants\n                      . https:\/\/www.entnet.org\/content\/position-statement-pediatric-cochlear-implants"},{"key":"bibr2-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181b4e904"},{"key":"bibr3-23312165211031751","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.24.3.6"},{"key":"bibr4-23312165211031751","doi-asserted-by":"publisher","DOI":"10.3390\/life11030239"},{"key":"bibr5-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1159\/000443363"},{"key":"bibr6-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0219600"},{"key":"bibr7-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.01.029"},{"key":"bibr8-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1080\/14670100.2019.1669291"},{"key":"bibr9-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4274"},{"key":"bibr10-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-0941-8"},{"key":"bibr11-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.07.002"},{"key":"bibr12-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.01.005"},{"key":"bibr13-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1177\/1084713810370039"},{"key":"bibr14-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2010.10.003"},{"key":"bibr15-23312165211031751","first-page":"1","volume":"505","author":"Dahm M. C.","year":"1993","journal-title":"Acta Otolaryngology Supplement"},{"key":"bibr16-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20204"},{"key":"bibr17-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001972"},{"key":"bibr18-23312165211031751","doi-asserted-by":"crossref","unstructured":"Deep N. L., Purcell P. L., Gordon K. A., Papsin B. C., Roland J. T., Jr., Waltzman S. B. (2021). Cochlear implantation in infants: Evidence of Safety.\n                      Trends in Hearing\n                      . Advance online publication.","DOI":"10.1177\/23312165211014695"},{"key":"bibr19-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2016.1174890"},{"key":"bibr20-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000915"},{"key":"bibr21-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1044\/2019_AJSLP-18-0161"},{"key":"bibr22-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1044\/2017_AJA-16-0116"},{"key":"bibr23-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199605001-00001"},{"key":"bibr24-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300209"},{"key":"bibr25-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-018-0304-9"},{"key":"bibr26-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000184"},{"key":"bibr27-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000821"},{"key":"bibr28-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-3489"},{"key":"bibr29-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1179\/146701011X13074645127199"},{"key":"bibr30-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/01.AUD.0000100203.65990.D4"},{"key":"bibr31-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2005.01.003"},{"key":"bibr32-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1159\/000088851"},{"key":"bibr33-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2008.06.013"},{"key":"bibr34-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.01.002"},{"key":"bibr35-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328359eea4"},{"key":"bibr36-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002156"},{"key":"bibr37-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000852"},{"key":"bibr38-23312165211031751","unstructured":"Houston K. T., Bradham T. S. (2021). Chapter 15: Cochlear implants for children who are deaf or hard of hearing. In L. Schmeltz (Eds.),\n                      The NCHAM eBook\n                      (pp. 15-1, 15\u201330). Early Hearing Detection & Intervention National Technical Resource Center. https:\/\/www.infanthearing.org\/ehdi-ebook\/"},{"key":"bibr39-23312165211031751","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.080010"},{"key":"bibr40-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9861(19971020)387:2<167::AID-CNE1>3.0.CO;2-Z"},{"key":"bibr41-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2017.10.010"},{"key":"bibr42-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000149456.75758.4c"},{"key":"bibr43-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2004.03.007"},{"key":"bibr44-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24426"},{"key":"bibr45-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2333"},{"key":"bibr46-23312165211031751","unstructured":"Joint Committee on Infant Hearing. (2019).\n                      Year 2019 position statement: Principles and guidelines for early hearing detection and intervention programs \u2013 Executive Summary\n                      . http:\/\/jcih.org\/JCIH_2019_Executive_Summary.pdf"},{"key":"bibr47-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000092"},{"key":"bibr48-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14954"},{"key":"bibr49-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054915"},{"key":"bibr50-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-019-00259-2"},{"key":"bibr51-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhr282"},{"key":"bibr52-23312165211031751","doi-asserted-by":"crossref","unstructured":"Leigh J. R., Dettman S. J., Dowell R. C. (2016). Evidence-based guidelines for recommending cochlear implantation for young children: Audiological criteria and optimizing age at implantation.\n                      55\n                      (Suppl 2), S9\u2013S18. https:\/\/doi.org\/10.3109\/14992027.2016.1157268","DOI":"10.3109\/14992027.2016.1157268"},{"key":"bibr53-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.17647"},{"key":"bibr54-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ics.2004.07.044"},{"key":"bibr55-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32485-1"},{"key":"bibr56-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000400"},{"key":"bibr57-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0557"},{"key":"bibr58-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28061"},{"key":"bibr59-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2017.12.001"},{"issue":"1","key":"bibr60-23312165211031751","first-page":"1","volume":"11","author":"National Institutes of Health Consensus Development Conference","year":"1993","journal-title":". National Institutes of Health Consensus Statement"},{"key":"bibr61-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1422"},{"key":"bibr62-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001777"},{"key":"bibr63-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25570"},{"key":"bibr64-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200211000-00014"},{"key":"bibr65-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2011.01.019"},{"key":"bibr66-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.77.6.16"},{"key":"bibr67-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200501001-00001"},{"key":"bibr68-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25502"},{"key":"bibr69-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct0706268"},{"key":"bibr70-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.12.006"},{"key":"bibr71-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1080\/14670100.2017.1389020"},{"key":"bibr72-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-31546-8"},{"key":"bibr73-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1179\/1754762814Y.0000000064"},{"key":"bibr74-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000915"},{"key":"bibr75-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20489"},{"key":"bibr76-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815575276"},{"key":"bibr77-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.156"},{"key":"bibr78-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2013.04.008"},{"key":"bibr79-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.conb.2009.05.014"},{"key":"bibr80-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1080\/00016480601075456"},{"key":"bibr81-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002342"},{"key":"bibr82-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2013.11.003"},{"key":"bibr83-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2004.12.010"},{"key":"bibr84-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.109984"},{"key":"bibr85-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002617"},{"key":"bibr86-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27666"},{"key":"bibr87-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181f2f475"},{"key":"bibr88-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001566"},{"key":"bibr89-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1080\/14670100.2019.1655868"},{"key":"bibr90-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002405"},{"key":"bibr91-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.16.2000"},{"key":"bibr92-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000253285.40995.91"},{"key":"bibr93-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002177"},{"key":"bibr94-23312165211031751","unstructured":"U.S. Food and Drug Administration. (2020).\n                      \n                        Nucleus 24 cochlear implant system. Recently-approved devices\n                        : 2020\n                        device approvals\n                      \n                      . https:\/\/www.fda.gov\/medical-devices\/recently-approved-devices\/nucleus-24-cochlear-implant-system-p970051s172"},{"key":"bibr95-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2008.02.009"},{"key":"bibr96-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2014.09.002"},{"key":"bibr97-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000461"},{"key":"bibr98-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1002\/dev.20060"},{"key":"bibr99-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05349-0"},{"key":"bibr100-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32834618ec"},{"key":"bibr101-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200438"},{"key":"bibr102-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1148\/rg.345130083"},{"key":"bibr103-23312165211031751","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.2877"}],"container-title":["Trends in Hearing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23312165211031751","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23312165211031751","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23312165211031751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:46:22Z","timestamp":1777596382000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23312165211031751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":103,"alternative-id":["10.1177\/23312165211031751"],"URL":"https:\/\/doi.org\/10.1177\/23312165211031751","relation":{},"ISSN":["2331-2165","2331-2165"],"issn-type":[{"value":"2331-2165","type":"print"},{"value":"2331-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"23312165211031751"}}