A 14-month-old child with bilateral severe-to-profound congenital sensorineural hearing loss confirmed by ABR is being counselled for cochlear implantation. The parents ask whether delaying surgery until school age would change the outcome. What is the key reason early implantation is preferred?

• A Surgical anaesthesia risk increases with age
• B Electrode insertion is technically easier in a smaller cochlea
• C Central auditory pathways show maximal plasticity in the first few years of life ✓
• D Implant battery life matches the school years better

Explanation

There is a sensitive period for development of the central auditory cortex, roughly the first three and a half years. Auditory deprivation during this window leads to irreversible cortical reorganisation and poor speech perception even with later amplification. Implantation within this period yields markedly better speech and language outcomes than implantation after it. Electrode insertion and anaesthesia considerations are minor compared with this neurodevelopmental argument.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.