Objective: The aim of the study was to evaluate the validity, clinical applicability, and developmental sensitivity of the Romanian LEESPQ in children with cochlear implants (CIs), by analyzing its association with age at implantation, duration of auditory experience, and implantation laterality, and by comparing the developmental trajectory with that of normal-hearing (NH) children. Methods: The study assesses the validity, reliability, and clinical sensitivity of the LEESPQ in pediatric cochlear implant users. Furthermore, it investigates the associations between total questionnaire scores and key clinical variables, including implantation laterality (unilateral versus bilateral), age at device activation, and duration of implant use. Forty-seven children with CIs (26 boys, 21 girls) were included, with implantation ages ranging from 9 months to 5 years. Of these, 21 received unilateral implants and 26 bilateral implants. Responses were analyzed both in relation to clinical variables and in comparison with available normative data from NH children, in order to delineate potential differences in linguistic developmental trajectories. Results: Findings suggest that the LEESPQ is a reliable and clinically valuable instrument for monitoring post-implant linguistic progress. It provides relevant insights into early auditory access, the linguistic environment within the family, and the development of early verbal production. Scores were significantly influenced by age at implantation and duration of auditory experience, confirming the role of early stimulation and neural plasticity in shaping speech development after cochlear implantation. Conclusions: The LEESPQ demonstrates strong clinical utility as a sensitive tool for monitoring early preverbal and verbal development in children with CIs. By capturing score variations associated with age at implantation, auditory experience, and implantation laterality, the questionnaire provides meaningful insights into early post-implant outcomes and supports individualized rehabilitation planning. These findings highlight the value of the LEESPQ for early outcome assessment in pediatric cochlear implant users.

Introduction Cochlear implants are a modern approach for the treatment of multiple cases of profound sensorineural hearing loss. Factors such as the ethiology of hearing loss and the potential for achieving good postoperative outcomes are considered in cochlear implantation. Additionally, surgical strategies, protocols, the experience of the surgeon and audiologist, and the presence of postoperative issues and risks that may require revision surgery should also be taken into account. The surgeon specialized in cochlear implantation must inform the patient and his relatives not only about the surgical technique but also about possible complications. The literature shows different rates of complications evaluated both in adults and in children. An evaluation of adverse events in order to prevent complications can be made if the definition of medical complications and mistakes is strictly approached based on the CLAVIEN-DINDO classification system. The rate of complications can be compared with existing literature. Studies demonstrate the need for preoperative vaccination for pneumococcus, which can prevent complications, especially in patients with inner ear malformations who present an increased postoperative risk Relevant Sections This review is structured around the collection of specialized literature from PubMed, organized into subchapters related to intraoperative complications such as Gusher syndrome, foreign body reaction, endocochlear inflammation phenomena, issues related to electrode positioning and associated complications, vestibular phenomena related to cochlear implantation, as well as late complications related to the surgical wound and cochlear implant extrusion. The important sections in this review are: Inner Ear Malformations and Gusher Syndrome: Intraoperative Complication Risks, Electrode Insertion and Positioning Issues, Intracochlear Inflammation, Foreign Body Reaction, and Intracochlear Fibrosis: Phenomena That Can Occur with Cochlear Implantation, Vestibular Disorders, Tardive Postoperative Complications: Wound Injuries and Cochlear Implant Extrusion and Otitis Media and Cholesteatoma as Complications of Cochlear Implantation Conclusions: Postoperative complications, although considered quite rare. The surgical limits and long-term evolution of cochlear implants cannot be concretely established, despite the fact that this intervention is considered safe in the medium and long term. Future directions Given that cochlear implants represent the most modern surgical technique for auditory rehabilitation in adults and children, with massive implications for quality of life, there is a tendency to extend surgical indications in the future, and especially to inform doctors in related specialties about the benefits of this medical device. Surgeons must be knowledgeable about cochlear implantation methods, as well as the methods for managing complications that can arise immediately postoperatively, as well as in the medium and long term.

Background and Objectives: The Cochlear implant is the first approved cranial nerve stimulator that works by directly stimulating the cochlear nerve. Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantation. The preoperative computed tomographic examination is essential not only in assessing the anatomical aspect of the cochlea, but also in determining its dimensions to choose an appropriate electrode and obtain the best possible audiological performance. Materials and Methods: In the present paper, we aimed to carry out an observational study regarding the role of cochlear measurements in the preoperative evaluation of patients proposed for cochlear implants. The purpose of the study was to measure the cochlea and establish the existence of a correlation between the size of the cochlea and the age and gender of the patients. Results: From the group of 35 examined patients, 54% (n = 19) were male and 46% (n = 16) were female. The average length of the cochlea in the age group 0–4 years is 7.82 mm in the left ear and 7.86 mm in the right ear; in the age group 4–7 years, it is 7.82 mm and 7.94 mm, respectively; for the age group 7–14 years, the dimensions increase to 8.48 mm and 8.77 mm, respectively; and after 14 years, these dimensions reach 9.12 mm and 9.18 mm, respectively. Comparative measurements of the length of the cochlea by age groups show an increase in length with the patient’s age, but this increase does not exceed 1.5 mm for both the right and left ears. The measurements of the width of the cochlea, by age group, start from 6.84 mm in the left ear and 6.81 mm in the right ear at 0–4 years, 6.94 mm and 6.97 mm, respectively, in the group 4–7 years, 7.71 mm and 7.55 mm at 7–14 years, and reaching 8.19 mm and 8.12 mm at the age of 14 years and over. Conclusions: From the study carried out, it can be concluded that the evaluation of the dimensions of the cochlea is important for cochlear implantation. The size variables, although small, are still an element to be considered in correlation with the age of the patient and the implanted ear. This increase is statistically insignificant, but it still exists, even if, from a theoretical point of view, it is considered that the dimensions of the cochlea remain constant.

Background/Objectives: Addressing cochlear malformations in the context of cochlear implantation is particularly important because the dimensions of the cochlea can affect intraoperative surgical decisions and options as well as the postoperative outcomes of each patient. High-resolution computed tomography (CT) is routinely used to assess the dimensions of the cochlea and the presence of any structural malformations. The purpose of this paper is to evaluate the dimensions of the cochlea and its malformations by using imaging measurements and correlating the data obtained with certain types of medical devices used. Methods: A retrospective observational study was conducted, through the systematic analysis of computed tomography images, on 130 cochlear implants between 2014 and 2024 at the ENT Clinic in Târgu Mureș, Romania, analyzing 103 patients. Data related to the anatomical features of the cochlea and their dimensions were evaluated, with an emphasis on the volume of the malformed and non-malformed cochleas. The collected data were statistically analyzed, evaluating the volume of the cochlea in relation to the gender and age of the patients, as well as the presence of cochlear malformations related to the analyzed side—the right and left ear. Results: The age groups analyzed were 58% between 0 and 7 years, 14% between 8 and 17 years, and 28% between 17 and 68 years, with the minimum age for implantation being 10 months and the maximum age being 68 years. Analyzing the presence of malformations by gender, it was found that enlarged cochlear aperture occurs at a rate of 14.89% in females and 17.02% in males, while an enlarged vestibular aqueduct occurs at a rate of 4.26% in females and 8.51% in males. Incomplete partition types I and II have a frequency of 10.64% in women and 14.89% in men. Incomplete partition type I is equally present in 10.64% of women and men. Cochlear hypoplasia occurs at a low frequency of 2.13% in women and is not observed in men in our analysis. Conclusions: In this study, we analyzed cochlear volume variables between malformed and normal cochleae. Cochlear dimensions (width and height) did not show statistically significant variations between the right and left ears, both in malformed and non-malformed cochleae. The cochlear volume is consistent across the groups studied and is not influenced by malformations or the demographic variables analyzed. Cochlear malformations, according to our assessments, do not present contraindications for a cochlear implant, which nevertheless demonstrates that a preliminary imaging assessment is extremely useful for determining the type of implant that can be used.

Background and Objectives: Outcomes after cochlear implantation are usually judged using audiological measures, although recipients' everyday benefit also depends on psychological and social functioning. This study characterized post-implant quality of life (QoL) across six patient-reported domains and explored factors associated with social integration. Methods: Fifty consecutive cochlear implant recipients completed a 35-item questionnaire covering speech perception, psychological self-esteem, media and music, environmental sound, listening effort, and social integration. Negatively framed items were reverse-scored, and domain scores were transformed to a 0-100 scale. Internal consistency, subgroup comparisons, inter-domain correlations, and multivariable regression were evaluated. Results: Mean overall QoL was 65.3 (95% CI, 60.5-69.7). Media and music received the highest mean score (77.9), whereas listening effort was lowest (56.6). The full questionnaire showed excellent internal consistency (Cronbach's alpha = 0.956). QoL scores did not differ significantly by sex, age group, time since implantation, surgical approach, or SMART NAV use, although several subgroup analyses were underpowered. Psychological self-esteem showed the strongest correlation with social integration (rho = 0.56, p < 0.001) and remained the only significant independent correlate in multivariable analysis (B = 0.456, 95% CI, 0.117-0.795; p = 0.010; R2 = 0.428). Conclusions: In this cohort, post-implant QoL varied across functional domains, with listening effort remaining a relative challenge. Social integration was more closely associated with psychological self-esteem than with individual auditory domains. These findings are exploratory and require confirmation in larger longitudinal studies with pre-implant measurements.