Sequential pediatric bilateral cochlear implantation: The effect of time interval between implants

To examine speech intelligibility in children subjected to sequential bilateral cochlear implants
(CI) surgery and to assess the influence of the inter-stage interval duration.
Introduction: Binaural hearing recovery can have additional benefits, especially in speech and language
development in patients with congenital profound sensorineural hearing loss; so recently there has been
an increase in the number of children receiving bilateral CI.
Methods: Twenty-seven children who underwent sequential bilateral cochlear implant (SBCI) with a
short (1e3 yrs), medium (4e6 yrs) and long (7e12 yrs) range interval between both implantations,
respectively, were evaluated. All patients underwent periodic speech perception test in quiet and noise
after second implant activation in three conditions: with the first or second implant alone and with both
implants. Results were examined according to the inter-stage interval.
Results: Speech intelligibility in noise was significantly better under bilateral conditions than either ear
alone, in all three groups. Small improvements were seen in quiet, especially in the third group (6
e12 yrs).
Conclusion: Benefits of second implant in the early-implanted children and after a short inter-implant
delay are more evident. However our study support that, even after a long period of deafness and
despite a prolonged inter-stage interval, sequential bilateral cochlear implantation should be considered.
Level of Evidence: Level 4.