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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Richard C DowellPh.D.
Professor of Audiology and Speech Science, The University of Melbourne, Director of
Audiological Services, Royal Victorian Eye and Ear Hospital
550 Swanston Street, Parkville, Victoria 3010, Australia
Email: rcd@unimelb.edu.au
