To compare behavioral speech perception
performance of children
with right versus left cochlear implants (CIs).
A retrospective cohort study.
Academic university medical center.
Seventy-one prelingually deafened children
that obtained a CI device at 48 months or younger.
Cochlear implantation with Cochlear, Advanced Bionics, and Med-El devices.
Main Outcome Measurements:
Patients were divided into 2 groups according to ear of implant (right, n = 30; left, n = 41) and matched in age at implantation
and preoperative audiologic results. Multivariate analysis of variance was used to evaluate the effects of 1) side of CI, 2) age at implantation
, 3) time with CI (T1, 18-24 mo; T2, 36-42 mo), and 4) dominance (i.e., compatibility between CI side and handedness) on performance in a monosyllabic open-set test scored for words and phonemes.
A small yet significant "right CI advantage" was evident throughout the study follow-up and was independent of age at implantation
. The performance of children
implanted at 24 months or younger was significantly higher than that of children
implanted between 25 and 48 months. Regardless of CI side and age at implantation
, all children
exhibited improvement in speech perception
with continuous use.
The present study provides first-time evidence for a right CI advantage for speech perception
in prelingually deafened children
that can be taken into account when selecting side of CI in candidates with similar residual hearing in both ears and no anatomic constraints. The present data lend further support to the notions that greater gains in speech perception
are associated with earlier age at implantation
and continuous use.