Objective To compare audiological, speech, and functional auditory outcomes following simultaneous bilateral cochlear implantation (SBLI) and early sequential bilateral cochlear implantation (SQLI) in children, and to explore the relationship between inter-implant interval and outcomes in sequentially implanted children. Methods This comparative cohort study included 50 children with bilateral severe-to-profound sensorineural hearing loss who underwent SBLI (n = 34) or SQLI (n = 16). First cochlear implantation was performed before 5 years of age in all children; in the SQLI group, the second implant was placed within 24 months of the first. All children completed 2 years of structured auditory-verbal therapy (AVT) before standardized outcome assessment. Primary outcomes were aided pure-tone average (PTA) and speech perception; secondary outcomes included CAP, SIR, MAIS, MUSS, LIP, and SSQ. Results Aided PTA (32.03 ± 4.17 vs 33.50 ± 3.58 dB HL; p = 0.208) and speech perception (82.74 ± 6.79% vs 82.56 ± 6.79%; p = 0.934) were comparable between SBLI and SQLI. CAP, MAIS, MUSS, LIP, and SSQ showed no significant between-group differences. SIR was higher following SBLI [median 4 (IQR 3–5) vs 3 (IQR 3–4); p = 0.009]. After adjustment for age at first implantation and daily cochlear implant use, SBLI remained associated with a higher SIR category (adjusted OR 5.15; 95% CI 1.53–17.32; p = 0.008). Conclusion SBLI and early SQLI achieved comparable aided hearing, speech perception, and most functional auditory outcomes. SBLI was associated with higher speech intelligibility; however, the wide confidence interval and potential residual confounding warrant cautious interpretation and confirmation in larger cohorts.
Objective To characterize delays in hearing loss intervention in children from infancy through adolescence and identify factors associated with delayed care and treatment adherence. Study design Retrospective cohort study with a supplemental caregiver survey. Setting Tertiary otologic referral center. Patients Patients younger than 18 years diagnosed with sensorineural hearing loss following ABR and recommended an intervention. Interventions Caregivers of all patients who experienced a delay of more than six months in receiving recommended hearing intervention or deferred treatment were contacted for a phone survey. Main outcomes and measures Delays in intervention greater than six months, treatment adherence, and caregiver-reported barriers to care. Results Among 188 patients identified over an 10-year period, 26% (n = 49) experienced delays of more than six months. Of these patients, 22 never received the recommended intervention. Within the studied interval, demographic factors showed no significant associated with delays, whereas neurological conditions (30%) and other comorbidities (40%) were associated with delays (p < 0.05). The degree of hearing loss and age at diagnosis were not associated with delays. Patients with delayed intervention had significantly lower adherence (p < 0.001). Of 49 patients eligible, 23 (47%) completed caregiver surveys, most commonly citing difficulty scheduling timely specialist appointments, provider communication, and insurance-related challenges as contributors to delay. Conclusions These exploratory findings highlight persistent challenges in timely intervention for pediatric hearing loss and underscore the need for improved communication, coordination, and access to hearing services throughout childhood.
Background Early hearing rehabilitation is critical for optimal developmental outcomes. However, children with congenital conductive hearing loss due to microtia or aural atresia often experience delays between diagnosis and intervention. This study evaluates temporal trends in the interval between diagnosis and initiation of bone-conduction hearing rehabilitation over a 14-year period in one medical center. Methods This retrospective cohort study of 47 children with congenital hearing loss associated with microtia and/or aural atresia. Children born between 2010 and 2024 and received a non-implantable bone-conduction hearing aids at a tertiary center by early September 2024 were included. Cox PH models estimated association of birth year with time from diagnosis and from birth to rehabilitation. Results The mean age at diagnosis was 2.70 ± 4.98 months, while the mean age at rehabilitation was 15.51 ± 18.05 months. Later birth year was associated with earlier observed rehabilitation, with associations in the same direction in analyses restricted to births through 2021 and in the laterality-adjusted 12-month analysis. Audiological outcomes demonstrated significant improvements in speech reception thresholds and pure-tone thresholds following device use. Conclusions In this single-center cohort, the diagnosis-to-rehabilitation interval decreased over the 14-year study period. These findings suggest improved translation of early identification into rehabilitation within this clinical setting, Selection of -rehabilitated children, unequal observation opportunity, small number of bilateral children and limitations in model diagnostics require cautious interpretation of the temporal associations. Audiological measures demonstrated benefit following rehabilitation.
Objective Allergic rhinitis (AR) is an increasingly important global public health concern, with a rising prevalence and an increasing burden among younger populations. This study aimed to systematically evaluate the association between exposure to gaseous air pollutants and the risk of AR in children and adolescents, and to investigate differences in effect estimates across pollutants and geographical regions. Methods Relevant studies published between 2006 and 2026 were systematically retrieved from PubMed, Embase, Scopus, the Cochrane Library,CNKI, and the China Hospital Knowledge Database. Two reviewers independently screened the studies, extracted data, and assessed study quality according to the eligibility criteria. Studies meeting the predefined inclusion criteria were included, and a meta-analysis was conducted using RevMan 5.4 software to pool effect sizes, assess heterogeneity, and evaluate publication bias. Results A total of 21 studies were included, comprising 13 cross-sectional studies, 6 cohort studies, and 2 case-control studies. The results indicated that exposure to air pollutants was associated with an increased risk of AR in children and adolescents.Among the exposures assessed, mold (OR = 1.45, 95% CI: 1.16–1.80), traffic-related air pollution (OR = 1.39, 95% CI: 1.21–1.59), PM2.5 (OR = 1.23, 95% CI: 1.05–1.43), O3 (OR = 1.15, 95% CI: 1.05–1.26), and NO2 (OR = 1.09, 95% CI: 1.00–1.17) were associated with an increased risk of AR in children. In contrast, the associations of PM10, SO2, and CO with AR were not statistically significant. Subgroup analyses showed that the effect estimates for PM10, NO2, and O3 were generally higher in studies conducted in China than in those conducted in other countries. Sensitivity analyses supported the robustness of the findings, and no clear evidence of publication bias was detected. Conclusion Mold exposure and traffic-related air pollution were associated with an increased risk of AR in children and adolescents. Exposure to PM2.5, O3, and NO2 was also associated with AR risk. These findings highlight the potential importance of controlling specific air pollutants to reduce the risk of AR in children and adolescents. This study provides evidence to inform the development of public health interventions targeting AR in children and adolescents.
