Chronology of hearing rehabilitation in simultaneous vs. sequentially implanted cochlear implant patients
23 April 2019 (online)
In cochlear implantation (CI) of adults, even with bilateral indication, the poorer hearing ear is often supplied first on request of the patient. Only about 1 in 10 patients chooses simultaneous bilateral care. In the present study, the course in time of the hearing rehabilitation of both groups will be compared.
Material and methods:
From the audiological and clinical documentation, all simultaneous or sequentially bilateral CI-implanted adults, without reimplantation or revision surgery, were extracted. 227 patients were included, 22 of them simultaneous (group 1) and 205 sequentially implanted (group 2). The temporal course of speech intelligibility (monosyllables in quiet at 65 dB) was analyzed.
Despite different group sizes, both groups were demographically comparable. Both groups achieved identical peak scores with bilateral CI coverage (78.6 ± 19.2% vs. 77.8 ± 20.7%). However, 70.9% of patients in group 2 already had a clear CI indication from the contralateral side at the time of the first OP. As a result, mean speech intelligibility during the bimodal supply phase was only 71.2 ± 28.9%. Patients achieved their individual maximum after 1.4 ± 0.9 (group 1) and 4.1 ± 4.4 years (group 2).
CI patients, who receive simultaneous bilateral care, gain their individual best hearing performance significantly earlier than the sequentially implanted patients. About 70% of the sequentially implanted patients already had an indication for surgery of the opposite side when the first ear was implanted. In patient counseling, it is therefore recommended to provide the second side as early as possible.