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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted

Ruth M Reeder1, Jill B Firszt1, Jamie H Cadieux2

  • 1Washington University School of Medicine, St. Louis, MO.

Journal of Speech, Language, and Hearing Research : JSLHR
|January 7, 2017
PubMed
Summary

Older children receiving a second cochlear implant showed gradual speech recognition improvement, with bilateral implants outperforming single ears in most tests. Further research into optimal timing and hearing aid use is recommended.

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Area of Science:

  • Audiology
  • Neuroscience
  • Speech-Language Pathology

Background:

  • The optimal timing for providing a second cochlear implant to older children with unilateral implantation is an unresolved clinical issue.
  • Sequential bilateral cochlear implantation in older children presents unique challenges and outcomes compared to simultaneous implantation.

Purpose of the Study:

  • To evaluate the speech recognition progress in the second implanted ear and with bilateral cochlear implants in older children who received implants sequentially.
  • To assess the development of sound localization abilities in this population.

Main Methods:

  • A prospective longitudinal study followed 24 children who received bilateral cochlear implants sequentially (mean surgery ages 5.11 and 14.25 years).
  • Speech recognition and sound localization were tested at 3-6 month intervals for up to 24 months post-bilateral implantation, under single-ear and bilateral conditions.

Main Results:

  • Speech recognition in the second implanted ear improved gradually, with gains in quiet extending through the second year of use.
  • Improvements in noise were less pronounced and plateaued within the second year; performance in the second ear was consistently lower than the first.
  • Bilateral cochlear implant use enhanced performance over single-ear use for most measures, except for sentences in quiet and sound localization.

Conclusions:

  • Older children with sequential bilateral cochlear implants can achieve speech understanding with the second implant, though progress may be slow and performance limited.
  • Continued use of hearing aids in the non-implanted ear and minimizing the time between sequential surgeries may improve outcomes.