72 Journal of Rhinolaryngo-Otologies, 2013, 1, 72-77 E-ISSN: 2308-7978/13 © 2013 Synergy Publishers Evaluation of Speech Production Skills After Unilateral Cochlear Implantation in 45 Prelingual Deaf Patients Neha Shah * , Rajesh Vishwakarma, Amit Kumar and Rupali Mathur Department of E.N.T., B.J. Medical College, Civil Hospital, Ahmedabad-380016, Gujarat, India Abstract: Objectives: To determine speech production skills in everyday situations following unilateral Cochlear Implantation. Methods: 45 prelingual deaf patients who underwent unilateral Cochlear Implantation under B.J. Medical College Cochlear and Hearing Implant Programme from April 2007 to August 2010 were included in the study. Participants were divided into five groups on basis of age at which participants underwent implantation: 3 years, 3 to 6 years, 6 to 9 years, 9 to 12 years, 12 to 15 years. MUSS Questionnaire was administered before implantation unaided and at three post-implant switch-on time periods 6 months, 1 year and 2 years with Cochlear Implant alone. The study was retrospective and prospective comparative interventional type with quantitative approach. The study was based on individual children evaluated with repeated measures, each child serving as his own control. The significance of the difference between the individual preoperative and postoperative scores was evaluated using the post hoc test of repeated measure analysis. Results: Pre-op average MUSS Questionnaire score was  4/40 in all implanted age groups with scores increasing over time to attain average score ranging from 27.5 to 34.78/40 in all implanted age groups after two years of implantation. The score increased significantly (p<0.05) in all implanted age groups from pre- to post- CI. Improved ratings were found for those implanted at younger age ( 3 years) than those implanted later. Discussion: There is significant improvement in speech production skills after cochlear implantation which continues to improve over time, highlighting the need for continuous auditory-verbal training. This study highlights the importance of age of implantation. Better results seen in those implanted at younger age. Keywords: Unilateral Cochlear Implantation, Prelingual Deaf Patients, Speech Production Skills, MUSS Questionnaire. INTRODUCTION In the past thirty years, Cochlear Implants have evolved from a single-channel device, providing little or no speech understanding, to multi-channel implants using advanced signal processing strategies. Cochlear Implantation is a well-established intervention for both adults and children with severe to profound bilateral sensorineural hearing loss, who receive no useful benefit from hearing aids (HAs) [1, 2]. As of December 2010, approximately 219,000 people worldwide have received Cochlear Implants; in the United States, roughly 42,600 adults and 28,400 children are recipients [3]. Hearing loss interferes with a person’s ability to communicate effectively. Profound or severe hearing impairments in young children often result in poor speech perception and production skills. Multichannel Cochlear Implantation of profoundly hearing impaired children unable to benefit from hearing aids results in significant improvements in speech production following implantation [4-8]. *Address correspondence to this author at the Department of E.N.T., B.J. Medical College, Civil Hospital, Ahmedabad-380016, Gujarat, India; Tel: +91 9591518338; E-mail: drnehalalashah@gmail.com METHOD A total of 45 prelingual deaf patients (satisfying the inclusion criteria) who underwent unilateral Cochlear Implantation under B.J. Medical College Cochlear Implant Programme from April 2007 to August 2010 were included in the study. 18 patients who did not meet the inclsion criteria were excluded from study. All participants underwent Cochlear Implantation by Transcanal “Veria” Technique. Full insertion of the active electrode array was accomplished in all subjects. Tempo+ speech processor was used in these subjects. All participants used the CIS speech processing strategy with a stimulation rate of 1500 pulses per second. All participants underwent Auditory-Verbal training and had strong family support systems. Study Design The study was retrospective and prospective comparative interventional type. In this study a quantitative approach was used to collect, analyze and interpret the data. The quantitative approach allows the researcher to describe and objectively assess the outcomes [9]. Inclusion Criteria Inclusion criteria for the study were: