Supplementary Material for: Comparative Outcomes of Cochlear Implantation in Children with Auditory Neuropathy Spectrum Disorder and Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis

Background:
Cochlear implantation (CI) has emerged as a promising intervention for children
with auditory neuropathy spectrum disorder (ANSD). Several studies have investigated the
efficacy of cochlear implants in children with ANSD, demonstrating improvements in auditory
performance and language skills following implantation. Whether the benefits and outcomes of
CIs in children with ANSD are comparable to children with sensorineural hearing loss (SNHL) is
still debatable. The present updated systematic review and meta-analysis evaluated the outcomes
of CI for children with ANSD compared to children with SNHL.

Methods:
A meta-analysis was conducted on studies that included pediatric patients and the
outcomes of CI in patients with ANSD versus SNHL were compared. A comprehensive search
was performed using the following electronic databases: PubMed, Scopus, Web of Science,
EBSCOhost, and Cochrane Central Register of Controlled Trials (CENTRAL).

Results:.
Fourteen studies (no. of patients =722 patients) were included. The total number of patients in the
ANSD and SNHL groups in the present systematic review was 212 and 520, respectively. The
most utilized assessment tests were the Speech Intelligibility Rating (SIR) and Categories of
Auditory Performance (CAP) scores. The pooled estimate showed that patients with ANSD had
comparable CAP scores compared to patients with SNHL (MD -0.52, 95% CI [-1.34, 0.29], P
=0.21,). Likewise, three studies reported the SIR after CI and showed comparable findings between
ANSD and SNHL patients. The pooled estimate showed that patients with ANSD had comparable
SIR scores compared to patients with SNHL (MD -0.26, 95% CI [-0.65, 0.13], P =0.19).

Conclusion: While the results show mixed findings across various outcome measures, the overall
impact of CI on speech recognition and language development appears to be positive and
comparable between ANSD and SNHL.