No Difference in Behavioral and Self-Reported Outcomes for Simultaneous and Sequential Bilateral Cochlear...

Area of Science:

• Audiology
• Neuroscience
• Otolaryngology

Background:

• Severe-to-profound postlingual sensorineural hearing loss impacts quality of life.
• Bilateral cochlear implantation (BiCI) aims to restore hearing in both ears.
• Simultaneous (simBiCI) and sequential (seqBiCI) approaches exist, with differing outcomes.

Purpose of the Study:

• To longitudinally compare behavioral and self-reported outcomes of simBiCI versus seqBiCI in adults.
• To assess speech perception in noise, localization, and quality of life.
• To evaluate outcomes over a 4-year follow-up period.

Main Methods:

• Multicenter randomized controlled trial with 4-year follow-up.
• Adults with severe-to-profound hearing loss randomized to simBiCI or seqBiCI (2-year interval).
• Annual assessments of speech perception (in quiet and noise), localization, quality of life, and hearing questionnaires.

Main Results:

• Both groups performed equally on speech perception in noise directly in front.
• SeqBiCI group showed significantly worse spatial speech perception and localization during unilateral use.
• SeqBiCI outcomes matched simBiCI after the second cochlear implant activation; no differences in tinnitus.
• Complications included infection, CI dysfunction, facial nerve palsy, tinnitus, and vertigo.

Conclusions:

• SimBiCI demonstrates superior longitudinal performance in spatial speech perception and localization compared to seqBiCI.
• The initial performance gap in seqBiCI is attributed to the period of unilateral cochlear implant use.
• Full bilateral benefit is achieved in seqBiCI once the second implant is activated, matching simBiCI outcomes.