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Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory
Merve Ozbal Batuk1, Betul Cicek Cinar1, Mehmet Yarali1
1Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.
Insights
Children with cochlear nerve deficiency (CND) benefit from combined cochlear implant (CI) and auditory brainstem implant (ABI) use. Bimodal stimulation significantly improved auditory perception and word recognition in these children.
Area of Science:
- Audiology
- Neurosurgery
- Pediatrics
Background:
- Cochlear nerve deficiency (CND) presents unique challenges for hearing restoration.
- Children with CND often have limited progress with cochlear implants (CI) alone.
Purpose of the Study:
- To evaluate audiological outcomes in children using a CI in one ear and an auditory brainstem implant (ABI) in the contralateral ear.
- To assess the effectiveness of bimodal electrical stimulation in children with CND.
Main Methods:
- Retrospective case review of twelve children with CND.
- Children received a CI in one ear and an ABI in the contralateral ear.
- Audiological performance and auditory perception skills were analyzed.
Main Results:
- Hearing thresholds with CI or ABI alone showed no significant difference.
- Auditory perception scores significantly improved with bimodal stimulation (CI + ABI).
- MAIS scores, pattern perception, and word recognition were significantly higher with bimodal stimulation.
Conclusions:
- Children with CND demonstrate enhanced performance with combined CI and ABI.
- Bimodal stimulation is recommended for children with CND based on audiological and radiological findings.
Objective:
To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear.
Design:
Retrospective case review.
Setting:
Tertiary referral hospital.
Participants:
Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects.
Main Outcome Measures:
Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI.
Results:
Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P = .002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions.
Conclusion:
Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.
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