Bilateral Cochlear Implants in Children

ABSTRACT

This article provides a brief overview of the advantages of two-ear hearing in children and discusses the limitations, from a psychophysical and a technical perspective, which may constrain the ability of cochlear implant users to gain these benefits. The latest outcomes for children using bilateral cochlear implants are discussed, which suggest that results are more favorable for children who receive both devices before the age of 3.5 to 4 years. The available studies that have investigated electrophysiological responses for children receiving bilateral implants are discussed. These also support the notion that optimum development of binaural auditory skills may be more difficult after the age of 3.5 to 4 years. Studies that investigate the alternative for some children of using a hearing aid on the opposite ear to the cochlear implant are briefly discussed. These indicate that advantages for speech perception in noise and localization can be obtained consistently for children with significant residual hearing in the nonimplanted ear. The article concludes with an attempt to bring the available scientific evidence into the practical clinical context with suggestions that may assist clinicians in making recommendations for families considering bilateral cochlear implantation. Although the evidence remains limited at this time, it is reasonable to suggest that bilateral cochlear implantation can provide improved auditory skills over a single implant for children with severe and profound bilateral hearing loss. The available data suggest that the benefit may be maximized by introducing both implants as early as possible, at least before 3.5 to 4 years of age.

KEYWORDS

Bilateral cochlear implants - children - hearing loss - speech perception - localization

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