Sequential bilateral cochlear implant: results in children and adolescents

Gabriela Felix Lazarini Almeida,Marcella Ferrari Martins,Lucas Bevilacqua Alves Da Costa,Orozimbo Alves Da Costa,Ana Claudia Martinho De Carvalho

doi:10.1016/j.bjorl.2018.07.008

Gabriela Felix Lazarini Almeida, Marcella Ferrari Martins + Show 3 more

Open Access

https://doi.org/10.1016/j.bjorl.2018.07.008

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Abstract

IntroductionThe use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, thus benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise. ObjectiveTo evaluate the ability of speech perception in children and adolescents using sequential bilateral cochlear implants, considering the association of these variables: age at surgery, time of device use and interval between surgeries. MethodsA total of 14 individuals between 10 and 16 years of age, who demonstrated surgical indication for the use of sequential bilateral cochlear implants as intervention in the auditory habilitation process, were assessed. The speech perception ability was assessed through sentence lists constructed in the Portuguese language, presented in two situations: in silence, with fixed intensity of 60dB SPL, and in competitive noise, with a signal-to-noise ratio of +15dB. The evaluation was performed under the following conditions: unilateral with the first activated cochlear implant, unilateral with the second activated cochlear implant and bilateral with both devices activated. ResultsThe results of the speech perception tests showed better performance in both silence and in noise for the bilateral cochlear implant condition when compared to the 1st cochlear implant and the 2nd cochlear implant alone. A worse result of speech perception was found using the 2nd cochlear implant alone. No statistically significant correlation was found between age at the surgical procedure, interval between surgeries and the time of use of the 2nd cochlear implant, and the auditory speech perception performance for all assessed conditions. The use of a hearing aid prior to the 2nd cochlear implant resulted in benefits for auditory speech perception with the 2nd cochlear implant, both in silence and in noise. ConclusionThe bilateral cochlear implant provided better speech perception in silence and in noise situations when compared to the unilateral cochlear implant, regardless of the interval between surgeries, age at the surgical procedure and the time of use of the 2nd cochlear implant. Speech perception with the 1st cochlear implant was significantly better than with the 2nd cochlear implant, both in silence and in noise. The use of the hearing aid prior to the 2nd cochlear implant influenced speech perception performance with the 2nd cochlear implant, both in silence and in noise.

Highlights

The use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise
Even considering all the technology applied to the current generation of cochlear implants and the fact that unilateral cochlear implant (CI) users show speech comprehension in silent environments and report improvements in the quality of life after the implantation, some difficulties in everyday situations have been reported by users of unilateral CI, such as sound localization and speech perception in noisy environments,[1,2] functions that require the binaural ability and may not be favored with the use of the unilateral CI.[3]
Better speech perception was observed with the use of bilateral CI, when compared to the results of the 1st CI and the 2nd CI separately, both in silence and in the presence of competitive noise (p = 0.002 and p = 0.001, respectively)

Summary

Introduction

The use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise. Objective: To evaluate the ability of speech perception in children and adolescents using sequential bilateral cochlear implants, considering the association of these variables: age at surgery, time of device use and interval between surgeries. Even considering all the technology applied to the current generation of cochlear implants and the fact that unilateral cochlear implant (CI) users show speech comprehension in silent environments and report improvements in the quality of life after the implantation, some difficulties in everyday situations have been reported by users of unilateral CI, such as sound localization and speech perception in noisy environments,[1,2] functions that require the binaural ability and may not be favored with the use of the unilateral CI.[3]. A question related to the impact of the time interval between the first and second surgeries regarding the post-surgical results has been discussed by researchers in the area.[7]

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