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United Kingdom national paediatric bilateral project: Demographics and results of localization and speech perception
H E Cullington1, D Bele1, J C Brinton1
1a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK.
Insights
Bilateral cochlear implants improve sound localization and speech recognition in noise for children. Sequential implants show benefits, with shorter intervals aiding speech perception more.
Area of Science:
- Audiology
- Pediatric Medicine
- Biomedical Engineering
Background:
- Bilateral cochlear implantation (BCI) is increasingly common in children.
- Understanding longitudinal outcomes in a diverse pediatric population is crucial.
Purpose of the Study:
- To assess long-term outcomes of simultaneous versus sequential bilateral cochlear implants in children.
- To evaluate the impact of implant timing and interval on auditory performance.
Main Methods:
- Observational, non-randomized service evaluation of 1001 children receiving BCIs in the UK.
- Data collected at four time points: pre-implantation, and 1, 2, and 3 years post-BCI.
- Included children with diverse backgrounds, additional needs, and varying device usage.
Main Results:
- Simultaneously implanted children demonstrated better localization than unilaterally implanted children.
- Sequentially implanted children showed improved localization and speech recognition in noise after 1 year of bilateral listening.
- Shorter intervals between sequential implants correlated with greater speech recognition improvement.
Conclusions:
- Bilateral cochlear implants offer significant improvements in sound localization and speech perception in noise for children.
- Children with sequential implants, even with long intervals, can achieve substantial auditory benefits.
- These findings support offering bilateral cochlear implants to a wide range of pediatric candidates.
Objectives:
To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially.
Methods:
This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included.
Results:
1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants.
Conclusion:
These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
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