Early Outcomes of Cochlear Implantation for Pediatric COVID-19 Related Single Sided Deafness: Case Series and Literature Review

OBJECTIVE: Sudden sensorineural hearing loss (SSNHL) is a rare manifestation of COVID-19. Cochlear implantation (CI) has been reported for definitive management of COVID-19 related single sided deafness (SSD) in adults. We present the first cases of pediatric CI for presumed COVID-19 related SSD. METHODS: Patients under 18 years were included who underwent CI following SSNHL after COVID-19 infection via retrospective review. Literature review was performed on PubMed for "cochlear implant" and "COVID" and "deafness or hearing loss." RESULTS: A 13-year-old boy (patient A) and 6-year-old girl (patient B) met inclusion criteria; both patients underwent round window insertion of a perimodiolar electrode. For patient A, audiogram showed SNHL in the left ear; pre-operative word recognition score (WRS) and speech awareness threshold (SAT) were 20% at 100 dB HL and 90 dB HL, respectively. The patient underwent CI 9 months post-infection; SAT for patient A improved to 25 dB HL at 2.5 months after surgery. Patient B's pre-operative WRS and SAT in the affected ear were 0% at 100 dB HL and non-responsive, respectively. She underwent right CI 10 months post-infection; her SAT improved post-operatively to 20 dB HL at 2 post-operative months. Neither patient suffered from intra- or post-operative complication. Both patients and their caregivers reported subjective benefit from CI. CONCLUSION: Single-sided deafness is a rare neurological complication from COVID-19. CI is a valuable tool for restoring hearing localization and awareness in this scenario. Early success with these cases demonstrates technical feasibility and benefit with this management of pediatric COVID-19 related SSD.