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Bimodal Stimulation in Children With Bilateral Profound Sensorineural Hearing Loss: A Suitable Intervention Model for
Ying Chen1,2,3, Meiping Huang1,2,3, Bei Li1,2,3
1Department of Otolaryngology-Head and Neck Surgery, Ninth People's Hospital.
Insights
Bimodal stimulation, combining cochlear implants (CI) with hearing aids (HA), offers significant auditory and speech benefits for children with prelingual deafness. This approach is recommended when bilateral CIs are not feasible, enhancing overall communication skills.
Area of Science:
- Audiology
- Speech-Language Pathology
- Biomedical Engineering
Background:
- Prelingual deafness significantly impacts auditory and speech development.
- Cochlear implantation (CI) is a primary intervention for profound sensorineural hearing loss.
- Bimodal stimulation (CI in one ear, hearing aid in the other) is an alternative approach.
Purpose of the Study:
- To evaluate the auditory and speech benefits of bimodal stimulation in prelingual deafened pediatric cochlear implant recipients.
- To compare outcomes between unilateral cochlear implantation and bimodal stimulation.
Main Methods:
- A retrospective, comparative study involving 56 children with prelingual profound sensorineural hearing loss.
- Participants were divided into a unilateral cochlear implantation (CI) group (n=28) and a bimodal stimulation (BI) group (n=28) using a contralateral hearing aid (HA).
- Auditory (IT-MAIS, CAP) and speech (MUSS, SIR) assessments were conducted at multiple intervals post-implantation, analyzed using repeated measures analysis.
Main Results:
- Both groups showed auditory and speech development over time, with significant differences observed in IT-MAIS, CAP, MUSS, and SIR.
- The bimodal stimulation group demonstrated initially better IT-MAIS scores and sustained advantages in CAP, MUSS, and SIR at specific time points.
- While the BI group showed superior IT-MAIS scores early on, this difference diminished by 12 months.
Conclusions:
- Bimodal stimulation provides significant auditory and speech benefits for prelingual deafened CI recipients, especially when bilateral CIs are not an option.
- Contralateral hearing aid use in conjunction with unilateral cochlear implantation is recommended to foster auditory and speech skill development.
- This approach supports improved communication outcomes in pediatric hearing loss rehabilitation.
Objective:
To evaluate the auditory and speech benefit of bimodal stimulation for prelingual deafened cochlear implantation recipients.
Study Design:
Retrospective and comparative study.
Setting:
Tertiary referral center.
Patients:
Fifty-six children with bilateral prelingual profound sensorineural hearing loss were enrolled, including 28 consecutive children with unilateral cochlear implantation (CI group), and 28 consecutive children with bimodal stimulation (BI group) who used an additional hearing aid (HA) in the contralateral ear.
Main Outcome Measures:
Hearing assessments included the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP). Speech evaluations included the Meaningful Use of Speech Scale (MUSS), and Speech Intelligibility Rating (SIR). These measurements were evaluated at the first mapping of cochlear implants and 0.5, 1, 3, 6, 12, 18, 24 months after. Data were analyzed by repeated measures analysis.
Results:
The mean ages of BI and CI groups were similar (17.6 ± 6.87 vs 19.0 ± 8.10 months, p = 0.497). The initial scores for hearing and speech assessments showed no differences between the two groups, apart from IT-MAIS (2.46 ± 0.631 in BI group vs 0.50 ± 0.279 in CI group, p = 0.004). The auditory and speech development over time were different in the two groups as seen in IT-MAIS (p < 0.001), CAP (p = 0.029), MUSS (p < 0.001), and SIR (p < 0.001). A continuing but stable difference was observed in CAP, MUSS, and SIR at 3, 18, and 12 months after the first mapping, respectively. In addition, the BI group had better IT-MAIS scores at 3 and 6 months compared with the CI group; however, the difference was not significant after 12 months.
Conclusion:
Bimodal stimulation is beneficial for prelingually deafened CI recipients who have minimal contralateral residual hearing when bilateral CIs are not available. Hearing aid use in the contralateral ear might be recommended for children after unilateral cochlear implantation to facilitate the development of auditory and speech skills.
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