Sequential bilateral cochlear implantation in children

Abstract

Binaural hearing offers several advantages over monaural hearing including improved speech understanding in the presence of background noise and the ability to localize the source of sounds. Patients who have undergone unilateral cochlear implantation perform poorly at these binaural tasks despite their improved hearing capabilities. Bilateral cochlear implants have restored these abilities in many adult patients. This study is designed to evaluate the degree to which similar benefits are realized by children who receive a second cochlear implant after successful experience with a first device. Twenty-five children aged 3–13 years underwent sequential bilateral cochlear implantation followed by a series of age appropriate speech reception tasks administered in quiet and in background noise. Some also underwent sound localization testing. The children demonstrated improved speech understanding in quiet and in noise using two cochlear implants when compared with either implant alone. Sound localization ability was poor in all subjects even after 9 months of bilateral implant use. We conclude that bilateral cochlear implantation offers potential benefits to children, especially with regard to hearing speech in noise.