Cullington, H., Bele, D., Brinton, J., Cooper, S., Daft, M., Harding, J., Hatton, N., Humphries, J., Lutman, M., Maddocks, J., Maggs, J., Millward, K., O'Donoghue, G., Patel, S., Rajput, K., Salmon, V., Sear, T., Speers, A., Wheeler, A. and Wilson, K. (2017) United Kingdom National Paediatric Bilateral Project: demographics and results of localisation and speech perception testing. Cochlear Implants International, 18 (1), 2-22. (doi:10.1080/14670100.2016.1265055).
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-randomised service evaluation collected localisation 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, one year, two years and three 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 one year of age. In sequentially-implanted children the interval between implants ranged from 0.1 to 14.5 years.
Children with simultaneous bilateral implants localised better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localisation and listening in background noise after one year of bilateral listening. The interval between sequential implants had no effect on localisation 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 two years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localisation 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 2010-2012. 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.
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