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Speech Perception Benefits of Sequential Bilateral Cochlear Implantation in Children and Adults: A Retrospective Analysis

Zeitler, Daniel M.*; Kessler, Megan A.; Terushkin, Vitaly*; Roland, J. Thomas Jr.*; Svirsky, Mario A.*; Lalwani, Anil K.*; Waltzman, Susan B.*

doi: 10.1097/MAO.0b013e3181662cb5
Cochlear Implants

Objective: To examine speech perception outcomes and determine the impact of length of deafness and time between implants on performance in the sequentially bilateral implanted population.

Study Design: Retrospective review.

Setting: Tertiary academic referral center.

Patients: Forty-three children (age, <18 yr) and 22 adults underwent sequential bilateral implantation with at least 6 months between surgeries. The mean age at the time of the second implant in children was 7.83 years, and mean time between implants was 5.16 years. Five children received the first side implant (C1) below 12 months of age; 16, at 12 to 23 months; 9, between the ages of 24 and 35 months; and 11, at 36 to 59 months; 2 were implanted above the age of 5 years. In adults, mean age at second implant was 46.6 years, and mean time between implants was 5.6 years.

Intervention: Sequential implantation with 6 months or more between implantations.

Main Outcome Measures: Speech perception tests were performed preoperatively before the second implantation and at 3 months postoperatively.

Results: Results revealed significant improvement in the second implanted ear and in the bilateral condition, despite time between implantations or length of deafness; however, age of first-side implantation was a contributing factor to second ear outcome in the pediatric population.

Conclusion: Sequential bilateral implantation leads to significantly better speech understanding. On average, patients improved, despite length of deafness, time between implants, or age at implantation.

*New York University School of Medicine, New York, New York; and †Cochlear Americas, Englewood, Colorado, U.S.A.

Address correspondence and reprint requests to Susan B. Waltzman, Ph.D., New York University Cochlear Implant Center, 660 First Avenue, 7th Floor, New York, NY 10016; E-mail:

This research was supported by the Rienzi Foundation.

Presented at the Annual Meeting of the American Neurotology Society, San Diego, California, April 27 to 28, 2007.

© 2008 Otology & Neurotology, Inc.