Related Experiment Video
Updated: Jun 27, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Early-Term Effect of Bilateral Sequential Cochlear Implantation on the Audiovestibular Function of Paediatric
Federica Di Berardino1,2, Marco Pozzi1,2, Anna Maria Gasbarre1,2
1Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Insights
Sequential bilateral cochlear implantation offers early auditory benefits for children with profound hearing loss, improving speech recognition and noise perception without significant short-term vestibular issues. This approach is increasingly considered for better hearing outcomes.
Area of Science:
- Audiology
- Otolaryngology
- Neuroscience
Background:
- Sequential bilateral cochlear implantation (CI) is a growing option for pediatric patients with bilateral profound hearing loss.
- Concerns exist regarding potential vestibular impairment following surgery for a second cochlear implant (CI2).
Purpose of the Study:
- To prospectively evaluate early audiological and vestibular outcomes in children after sequential bilateral CI.
- To investigate the influence of implantation age and inter-implant interval on outcomes.
Main Methods:
- Ten children with prelingual bilateral profound sensorineural hearing loss underwent sequential bilateral CI.
- Audiological (speech recognition, speech-in-noise) and vestibular (stabilometry, video head impulse testing) assessments were conducted up to 12 months post-CI2.
- Longitudinal changes were analyzed using mixed-effects models.
Main Results:
- Significant improvement in unilateral speech recognition with CI2 alone was observed over 12 months.
- Speech-in-noise performance improved significantly in various configurations.
- Vestibular measures remained broadly stable, and patient-reported outcomes showed non-significant changes.
Conclusions:
- Sequential bilateral CI provides early auditory benefits, enhancing CI2 performance and speech-in-noise abilities.
- No major short-term vestibular deterioration was detected.
- Implantation age and inter-implant interval did not show consistent effects on outcomes.
Background/Objectives:
Sequential bilateral cochlear implantation is being increasingly considered in paediatric patients with bilateral profound hearing loss, particularly when the contralateral ear shows limited residual hearing or poor speech discrimination. Although auditory benefits of a second cochlear implant (CI2) have been reported, concerns remain regarding possible vestibular impairment after surgery. This study aimed to provide a preliminary prospective evaluation of early audiological and vestibular outcomes in children undergoing sequential bilateral cochlear implantation and to explore whether the age at implantation or the inter-implant interval influenced longitudinal trajectories.
Methods:
Ten children with prelingual bilateral profound sensorineural hearing loss who underwent sequential bilateral cochlear implantation were prospectively enrolled. Assessments were performed at baseline and during follow-up up to 12 months after CI2 activation. The audiological evaluation included pure-tone audiometry, speech recognition in quiet with CI2 alone and bilaterally, and speech-in-noise testing in frontal and lateralised configurations. The vestibular evaluation included static stabilometry and video head impulse testing. Patient-reported outcomes were assessed using the speech, spatial and qualities of hearing scale for children. Longitudinal changes were analysed using mixed-effects models with false discovery rate correction.
Results:
Unilateral speech recognition with CI2 improved significantly over time, with median word recognition increasing from 0% at 3 months to 60% at 12 months (p < 0.0001; q = 0.0001). The speech-in-noise performance also improved significantly in the frontal and F1C configurations. Bilateral speech recognition in quiet remained stable at high levels, consistent with a ceiling effect. The vestibular measures were broadly stable at the group level, and the SSQ scores showed modest, non-significant changes. Exploratory analyses did not identify consistent effects of the implantation age or inter-implant interval on longitudinal trajectories.
Conclusions:
Sequential bilateral cochlear implantation was associated with early auditory benefit, particularly for CI2 unilateral performance and speech perception in noise, without evidence of major short-term vestibular deterioration.
