More than 80 %  of sequentially bilaterally implanted CI-patients are not treated sufficiently during the bimodal phase

Introduction In the bimodal phase between the two implantations, patients with sequential bilateral CI had shown a worse speech intelligibility than expected according to the literature. Therefore, the course of rehabilitation of this patient group was analyzed in more detail.

Material and methods From the 2,355 cochlear implantations of the years 1988 to 2017, sequentially implanted adults without reimplantations or revision procedures were identified and divided into two groups: Group A patients (n=35) had a hearing aid indication on the non-implanted ear at the time of the first implantation; while the 169 group B patients had not. Binaural monosyllabic speech intelligibility in quiet at 65dB was evaluated at different times of treatment.

Results Right after the initial fitting of the first implant, there is no significant difference between the two groups. At 0.5-2 years postoperatively, group A (79.8  ±  26.5dB) performs highly significantly better than group B and can maintain this result during subsequent bilateral CI treatment (87.0  ±  15.2dB). Group B underperforms during bimodal care (66.5  ±  29.0dB) and does not achieve good results until the contralateral side has been implanted (78.4  ±  20.4dB). However, the results of group B show significantly poorer performance compared to group A over the entire course of treatment.

Conclusion: It is understandable that patients with bilateral CI indication initially receive their implant on the worse performing ear. However, 82.8 %  are not treated adequately during bimodal care and they also show poorer results than other bilateral CI users. For this reason, the suitability of hearing aids should be critically reviewed on a regular basis and the implantation of the second side should be recommended at an early stage

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Publication History

Article published online:
13 May 2021