[Bilateral cochlea implantation in varying duration of deafness]

The effectiveness of cochlear implants in profoundly deaf patients could be demonstrated in the last years. One of the problems of these patients is the decreased speech understanding in noise. Therefore bilateral cochlear implantation seems to be obvious. Another problem of unilateral cochlear implantation is to predict the better side for implantation concerning speech understanding. Only a few factors seem to help for the choice of the side for implantation. One of these is duration of deafness. In other studies short duration of deafness is a significant predictor of good word recognition. We present a case of a deaf patient with a time gap of 23 years for deafness between both ears. The patient underwent bilateral cochlear implantation (Med-el Combi 40+) as one stage procedure. After activation of the speech processor he shows better speech understanding on that ear, which is deaf for more than 25 years. In addition he has further improvement of speech understanding in noise by using both implants compared to one. In unilateral cochlear implantation selection of the side might still be difficult. In bilateral cochlear implantation the better side is always implanted, which is an other advantage of bilateral cochlear implantation.