An Umbrella Review of Cochlear Implant Outcomes in Children With Auditory Neuropathy

Purpose: The objective of this overview of systematic reviews (SRs; umbrella review) was to systematically summarize and critically appraise current evidence of cochlear implant (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). Method: This study was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. The methodological quality and the risk of bias in the included SRs were assessed using A MeaSurement Tool to Assess systematic Reviews 2 checklist and the Risk of Bias in Systematic Reviews tool, respectively.Results: According to eight included SRs, children with ANSD achieve CI out-comes (speech perception performance) similar to their peers with sensorineural hearing loss. In children with postsynaptic ANSD (cochlear nerve deficiency), cochlear nerve hypoplasia is associated with better speech recognition out-comes compared with cochlear nerve aplasia, especially in the absence of addi-tional disabilities. Except for one study, the overall quality of the included SRs was critically low, and except for three studies, evidence of a high risk of bias was identified in other included SRs. Conclusions: Current evidence supports CI benefits for children with ANSD. To improve the quality of evidence, well-designed, prospective studies with appro-priate sample sizes, using valid outcome measures, clarifying matching criteria, and taking into account the role of confounding factors are essential.