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Updated: May 13, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Factors influencing consistent device use in pediatric recipients of bilateral cochlear implants
Matthew B Fitzgerald1, Janet E Green, Yixin Fang
1New York University School of Medicine, New York, NY, USA.
Insights
Speech recognition scores with the second cochlear implant (CI-2) and the difference between the two implants (CI-1 vs. CI-2) are linked to inconsistent CI-2 use in children. Later implantation ages also correlate with CI-2 scores.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Biomedical Engineering
Background:
- Sequential bilateral cochlear implantation (CI) is a common procedure for pediatric hearing loss.
- Understanding factors influencing consistent use of both implants is crucial for optimizing auditory rehabilitation outcomes.
Purpose of the Study:
- To identify demographic and performance variables associated with inconsistent use of the second cochlear implant (CI-2) in pediatric recipients.
- To analyze the relationship between speech-perception scores and CI-2 usage patterns.
Main Methods:
- Retrospective chart review of pediatric sequential bilateral cochlear implant recipients.
- Division of participants into two age groups: 5-9 years and 10-17 years.
- Examination of associations between inconsistent CI-2 use, demographic data, and speech-perception scores.
Main Results:
- In younger children (5-9 years), inconsistent CI-2 use correlated with CI-2 word-recognition scores and the difference between CI-1 and CI-2 scores.
- In older children (10-17 years), these associations were not statistically significant due to a limited sample size.
- Across all participants, CI-2 word-recognition scores were significantly correlated with implantation ages for both CI-1 and CI-2, and the interval between surgeries.
Conclusions:
- Speech-recognition performance with CI-2 and the performance disparity between CI-1 and CI-2 are key factors in inconsistent CI-2 use among pediatric sequential bilateral cochlear implant recipients.
- While later implantation ages may be associated with poorer performance, most children utilize both implants, demonstrating benefit even when implanted as adolescents.
Objectives:
To determine which demographic or performance variables are associated with inconsistent use of a second implant in pediatric recipients of sequential bilateral cochlear implants (CIs).
Methods:
A retrospective chart review was conducted on pediatric recipients of sequential bilateral CIs. Children were divided into two age groups, 5-9 and 10-17 years of age. For each group, we examined whether inconsistent use of the second implant (CI-2) was associated with a variety of demographic variables, or speech-perception scores.
Results:
In children aged 5-9 years, inconsistent use of CI-2 was not significantly associated with any demographic variable, but was related to both the word-recognition score with CI-2, and the difference in word-recognition scores between the first implant (CI-1) and CI-2. In children aged 10-17 years, these relationships were not significant due to smaller number of subjects. Finally, CI-2 word-recognition scores across all children were significantly correlated with the age of implantation for both CI-1 and CI-2, and the time between CI-1 and CI-2 surgeries.
Discussion:
Speech-recognition scores obtained with CI-2, and the extent to which it differs from CI-1, are most closely related with inconsistent use of CI-2 in pediatric sequential implantees. These results are consistent with similar data previously reported by other investigators. While children implanted with CI-2 at a later age generally perform more poorly, most children still use both implants, and benefit from CI-2 even when receiving the implant as an adolescent.
Conclusion:
In pediatric recipients of sequential bilateral CIs, inconsistent use of CI-2 is related to the speech recognition scores with CI-2, and the difference in speech-recognition scores between CI-1 and CI-2. In addition, speech-recognition scores with CI-2 are related to the amount of time between CI-1 and CI-2 surgeries, and the age of implantation for both CI-1 and CI-2.