Sequential bilateral cochlear implant: long-term speech perception results in children first implanted at an early age

Abstract

Purpose The study aims to assess the benefit of sequential bilateral cochlear implantation in children with congenital bilateral profound hearing loss, submitted to the first implant at an early age. Methods We enrolled all the bilateral sequential cochlear implanted children who received the first implant within 48 months and the second within 12 years of age at our Institution. The children were submitted to disyllabic word recognition tests and Speech Reception Threshold (SRT) assessment using the OLSA matrix sentence test with the first implanted device (CI1), with the second implanted device (CI2), and with both devices (CIbil). Furthermore, we measured the datalogging of both devices. Then we calculated the binaural SRT gain (b-SRTgain) and checked the correlations between speech perception results and the b-SRTgain with the child’s age at CI1 and CI2, DELTA and the datalogging reports. Results With the bilateral electric stimulation, we found a significant improvement in disyllabic word recognition scores and in SRT. Moreover, the datalogging showed no significant differences in the time of use of CI1 and CI2. We found significant negative correlations between speech perception abilities with CI2 and age at CI2 and DELTA, and between the SRT with CI1 and the b-SRTgain. Conclusions From this study we can conclude that in a sequential CI procedure, even if a short inter-implant delay and lower ages at the second surgery can lead to better speech perception with CI2, children can benefit from bilateral stimulation independently of age at the second surgery and the DELTA.

Language, cognitive, and speech in noise perception abilities of children with cochlear ımplants: a comparative analysis by implantation period and bilateral versus unilateral cochlear implants

“…Easwar et al [ 41 ] stated that early simultaneous bilateral implantation promotes normal-like symmetry in auditory pathways. In addition, it is now widely accepted that in children with bilateral SPHL unilaterally implanted, the lack of an early implantation of the second ear would lead to the the hearing deprivation of one ear, due to a reorganization of the central auditory areas [ 42 ]. In this regard, the inter-implant delay seems to be a major factor of these findings, since early simultaneous bilateral cochlear implantation is the best option to promote oral language development for infants with SPHL [ 7 , 42 ].…”

A Journey to Hear: The Evolution of Cochlear Implants

“…Decisions should be individualized, and although a short inter-implant delay and lower age at the second surgery are preferable, benefits can still be realized even with delayed procedures. Older age at the second implant or extended inter-implant delays do not necessarily negate the potential advantages of bilateral electrical stimulation [27]. While simultaneous procedures have been shown to be advantageous and resource-efficient in children, comprehensive data on adults remain limited.…”