Reading outcomes following cochlear implantation are extremely variable. Understanding the factors underlying this variability is of clinical importance, and research has concentrated on how children with cochlear implants encode and process information. Existing research has focussed on younger children; the present study investigated the relationship between short-term and working memory and reading outcomes in adolescents with cochlear implants. A cross-sectional comparative design was selected. 18 adolescents with cochlear implants were recruited from a cochlear implant programme in London. All participants completed neuropsycho- logical measures of reading, phonological and visual working memory and non-verbal IQ, and scores were compared with normative data for hearing children: Significantly more adolescents with cochlear implants had below average reading outcomes than would be expected. Reading Composite scores were positively correlated with performance on a phonological working memory task (WISe-IV Digit Span). This correlation was not significantly different from manual norms for normal-hearing children. These findings show that the difference in reading attainment between children with cochlear implants and their hearing peers continues into adolescence. In keeping with previous research, outcomes were highly variable. Reading scores in adolescents are significantly correlated with Digit Span scores, consistent with findings in younger children. The size of this correlation did not differ significantly from normative data for hearing children. The results of this study stress the importance of careful, individualized assessments of reading for children with cochlear implants, and indicate that monitoring should continue into adolescence. The effect of interventions designed to improve or compensate for limited working memory capacity on reading outcomes is an important area for future research.

La surdité de perception est généralement la conséquence de la mort des cellules ciliées et de la dégénérescence supplémentaire des innervations afférentes induite par une absence de stimulation. Les indications de l’implant cochléaire se sont élargies en direction des patients sourds qui présentent un reliquat d’audition exploitable dans les fréquences graves. La persistance d’un reliquat auditif suffisant après l’intervention permet parfois une stimulation électrique acoustique, amplifiée acoustique sur les fréquences graves préservées, et électrique sur les fréquences aiguës. Actuellement, plusieurs protocoles de préservation de l’audition sont en investigation. Chaque protocole vise à appliquer des procédures qui minimisent les deux mécanismes du traumatisme, à savoir trauma immédiat et trauma différé. En particulier, une insertion atraumatique du porte-électrode (Flex EAS et Flex Soft ; Med-El) a été proposée pour minimiser le traumatisme chirurgical intracochléaire. L’application local et concomitante de médicament devrait améliorer la tolérance du tissu et donc réduire les dommages intracochléaire au niveau cellulaire. Un cathéter (Med-El) intra cochléaire pour la délivrance de médicaments intracochléaire a été développé, destiné à l’utilisation d’agents pharmacologiques in situ avant l'insertion du porte-électrode. Les propriétés mécaniques de ce cathéter n’induit pas de traumatisme dans la cochlée. Une insertion séquentielle de cathéter et de porte-électrodes est réalisable et souvent atraumatique / Sensorineural deafness is generaly the result of hair cell death and additional degeneration of afferent innervation. In recent years the candidacy criteria for cochlear implantation have been expanding, and now include patients with severe to profound high-frequency hearing loss along with mild to moderate low-frequency loss. The single most important prerequisite for providing both electric and acoustic stimulation in the same ear is the preservation of acoustic hearing following the surgical procedure. Currently, several hearing preservation protocols are under investigation. Each protocol attempts to implement procedures that minimize both immediate and delayed mechanisms. Specifically, atraumatic approaches and electrode insertions (Flex EAS and Flex Soft) have been proposed that aim at minimizing the surgical aspect of intracochlear trauma. The concomitant application local of drugs should enhance tissue tolerability and thus reduce intracochlear damage on a cellular level. Acute and topical, intracochlear drug delivery prior to electrode array insertion with a disposable single-use catheter (Med-El) has been evaluated and developed. The flexible properties of this catheter are enough to be inserted without trauma in the cochlea. Sequential insertion of intracochlear catheters and electrode arrays is feasible and often atraumatic