Active inhibition of the first over the second ear implanted sequentially

Area of Science:

• Audiology
• Neuroscience
• Pediatric Medicine

Background:

• Delayed sequential cochlear implantation (CI) in pediatric patients presents unique challenges.
• Understanding the influence of the first CI on the performance of the second CI is crucial for optimizing auditory rehabilitation.

Purpose of the Study:

• To investigate the impact of the first implanted ear on the auditory performance of the delayed sequentially implanted ear in children.
• To compare outcomes between unilateral sequential user groups (USG) and bilateral sequential user groups (BSG).

Main Methods:

• Retrospective case series review of pediatric patients undergoing sequential bilateral CI.
• Patients were divided into USG and BSG based on the retention or removal of the first CI.
• Speech recognition testing was conducted for two years post-second surgery, calculating the Difference Between the Ears (DBE).

Main Results:

• Both groups achieved interaural equivalence (DBE=0%) within two years post-sequential implantation.
• The USG group reached interaural equivalence faster, with 85% demonstrating it at 6 months compared to the BSG group at one year.
• A statistically significant difference in performance was observed between the groups.

Conclusions:

• The performance of a sequentially implanted ear is influenced by a potential inhibitory effect from the first implanted ear.
• Unilateral auditory deprivation duration may not be the primary factor affecting sequential CI performance.
• Findings necessitate re-evaluation of rehabilitation strategies for pediatric patients with delayed sequential cochlear implantation.