A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance Purpose Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities. ... Research Article
Research Article  |   January 01, 2017
A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance
 
Author Affiliations & Notes
  • Ruth M. Reeder
    Washington University School of Medicine, St. Louis, MO
  • Jill B. Firszt
    Washington University School of Medicine, St. Louis, MO
  • Jamie H. Cadieux
    St. Louis Children's Hospital, MO
  • Michael J. Strube
    Washington University School of Medicine, St. Louis, MO
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Ruth M. Reeder: reederr@ent.wustl.edu
  • Editor: Nancy Tye-Murray
    Editor: Nancy Tye-Murray×
  • Associate Editor: Richard Dowell
    Associate Editor: Richard Dowell×
Article Information
Hearing & Speech Perception / Hearing Aids, Cochlear Implants & Assistive Technology / Hearing / Research Articles
Research Article   |   January 01, 2017
A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance
Journal of Speech, Language, and Hearing Research, January 2017, Vol. 60, 276-287. doi:10.1044/2016_JSLHR-H-16-0175
History: Received May 2, 2016 , Revised July 21, 2016 , Accepted August 4, 2016
 
Journal of Speech, Language, and Hearing Research, January 2017, Vol. 60, 276-287. doi:10.1044/2016_JSLHR-H-16-0175
History: Received May 2, 2016; Revised July 21, 2016; Accepted August 4, 2016

Purpose Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Method A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3–6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.

Results Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.

Conclusions Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

Acknowledgments
This work was supported by R01DC009010 from the National Institute on Deafness and Other Communication Disorders. We acknowledge and thank the following: The St. Louis Children's Hospital Cochlear Implant Team, particularly Janet Vance, Jerrica Kettle, Heather Strader, and Rose Wright for assistance with data collection; Beverly Fears formerly at St. Joseph Institute for the Deaf for assistance with data collection; Tim Holden for test equipment and stimuli calibration; and our patients for their time and participation in this study.
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