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Reduced Cochlear Implant Performance After the Use of Growth Hormone With Regain of Function After Cessation of Growth Hormone Therapy

Lafer, Marissa P.*; Green, Janet E.*; Heman-Ackah, Selena E.; Roland, J. Thomas Jr.*; Waltzman, Susan B.*

doi: 10.1097/MAO.0000000000000734
Cochlear Implants
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Objective To assess whether recombinant growth factor (hGH) therapy has an effect on cochlear implant (CI) performance.

Patients Two pediatric CI recipients (S1, S2) who underwent treatment with hGH for short stature were identified for review. S1 has bilateral labyrinthine dysplasia and received implants at ages 10 months (right) and 4 years 3 months (left). S2 was diagnosed with severe to progressive sensorineural hearing loss bilaterally and received a CI at age 9 years 10 months (left).

Intervention(s) Case series.

Main Outcome Measure(s) Cochlear implant, hGH, and speech perception data were collected. Phonetically Balanced Kindergarten (PBK) and Consonant Nucleus Consonant (CNC) word recognition scores were reviewed to assess auditory perception. Electrode impedances, threshold levels, and comfort levels were also reviewed.

Results After 4 months of hGH, word recognition scores for S1 were observed to decrease from 90 to 72% (right) and were stable at 40% (left). Despite troubleshooting, performance continued to decline bilaterally to 52% (right) and 28% (left), and the decision was made to discontinue hGH. One month after cessation of hGH, word recognition scores began improving to 74% (right) and 68% (left). Word recognition scores for S2 were observed to have decreased from 92% the previous year to 82% after taking hGH for 2 months. Given both our previous experience with S1 and discussions with S2’s parents, hGH was discontinued after 10 months of therapy. Two months after cessation of hGH, S2’s word recognition had improved to 86% (left).

Conclusions Our case studies illustrate that implanted children undergoing treatment with hGH may experience a decrease in speech perception, which recovers after the cessation of treatment. Since hGH use has become more prevalent in recent years, it is important to inquire whether children undergoing, or who have undergone, implantation are receiving hGH so that they may be appropriately monitored.

*NYU Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York; and †Otology, Neurotology and Skull Base Surgery, Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.

Address correspondence and reprint requests to Susan B. Waltzman, Ph.D., NYU Cochlear Implant Center, NYU Langone Medical Center, 660 First Avenue, 7th floor, New York, NY 10016, U.S.A.; E-mail: susan.waltzman@nyumc.org

The authors disclose no conflicts of interest.

Copyright © 2015 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company