H E Cullington1, D Bele1, J C Brinton1, S Cooper2, M Daft3, J Harding4, N Hatton5, J Humphries6, M E Lutman7, J Maddocks8, J Maggs9, K Millward10, G O'Donoghue3, S Patel11, K Rajput12, V Salmon13, T Sear14, A Speers15, A Wheeler14, K Wilson2. 1. a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK. 2. b St. Thomas' Hospital Hearing Implant Centre , London , UK. 3. c Nottingham Auditory Implant Programme , Nottingham , UK. 4. d Cardiff Paediatric Cochlear Implant Programme , London , UK. 5. e Emmeline Centre , Cambridge , UK. 6. f The Oxford Cochlear Implant Programme , London , UK. 7. g Hearing and Balance Centre , University of Southampton , Southampton , UK. 8. h West of England Paediatric Hearing Implant Programme , Bristol , UK. 9. i The Midlands Children's Hearing Implant Programme , Birmingham , UK. 10. j The Richard Ramsden Centre for Hearing Implants , Manchester , UK. 11. k St George's Hospital Auditory Implant Service , London , UK. 12. l Great Ormond Street Cochlear Implant Programme , London , UK. 13. m North East Cochlear Implant Programme , Middlesbrough , UK. 14. n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK. 15. o Belfast Regional Cochlear Implant Centre , Belfast , UK.
Abstract
OBJECTIVES: To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially. METHODS: This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included. RESULTS: 1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants. CONCLUSION: These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
OBJECTIVES: To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially. METHODS: This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included. RESULTS: 1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants. CONCLUSION: These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
Authors: Camille C Dunn; Elizabeth A Walker; Stephanie Gogel; Tanya Van Voorst; Marlan Hansen; Bruce J Gantz Journal: Otol Neurotol Date: 2019-03 Impact factor: 2.311