Bilateral and Unilateral Cochlear Implant Users Compared on Speech Perception in Noise

Dunn, Camille; Noble, William; Tyler, Richard S.; Kordus, Monika; Gantz, Bruce J.; Ji, Haihong

doi:10.1097/aud.0b013e3181c12383

Cited by 85 publications

(63 citation statements)

References 7 publications

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“…2 and 5). These results from retrospective data confirmed that binaural listening provides better outcome than listening monaurally with one CI (Most et al 2012), especially in noise (Ching et al 2004;Ricketts et al 2006;Dunn et al 2010). It was also confirmed that the benefit of binaural listening compared with one CI alone was greater with a second CI than with an HA on average , especially in noise in the present study (+6% for the CI/HA group versus +11% for the CI/ CI group in quiet, and +9% for the CI/HA group versus +16% for the CI/CI group in noise).…”

Section: Bimodal Versus Bilateral: Slight But Significant Advantage Osupporting

confidence: 73%

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

et al. 2015

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OBJECTIVES: To compare speech perception outcomes between bilateral implantation (cochlear implants [CIs]) and bimodal rehabilitation (one CI on one side plus one hearing aid [HA] on the other side) and to explore the clinical factors that may cause asymmetric performances in speech intelligibility between the two ears in case of bilateral implantation. DESIGN: Retrospective data from 2247 patients implanted since 2003 in 15 international centers were collected. Intelligibility scores, measured in quiet and in noise, were converted into percentile ranks to remove differences between centers. The influence of the listening mode among three independent groups, one CI alone (n = 1572), bimodal listening (CI/HA, n = 589), and bilateral CIs (CI/CI, n = 86), was compared in an analysis taking into account the influence of other factors such as duration of profound hearing loss, age, etiology, and duration of CI experience. No within-subject comparison (i.e., monitoring outcome modifications in CI/HA subjects becoming CI/CI) was possible from this dataset. Further analyses were conducted on the CI/CI subgroup to investigate a number of factors, such as implantation side, duration of hearing loss, amount of residual hearing, and use of HAs that may explain asymmetric performances of this subgroup. RESULTS: Intelligibility ranked scores in quiet and in noise were significantly greater with both CI/CI and CI/HA than with a CI-alone group, and improvement with CI/CI (+11% and +16% in quiet and in noise, respectively) was significantly better than with CI/HA (+6% and +9% in quiet and in noise, respectively). From the CI/HA group, only subjects with ranked preoperative aided speech scores >60% performed as well as CI/CI participants. Furthermore, CI/CI subjects displayed significantly lower preoperative aided speech scores on average compared with that displayed by CI/HA subjects. Routine clinical data available from the present database did not explain the asymmetrical results of bilateral implantation. CONCLUSIONS: This retrospective study, based on basic speech audiometry (no lateralization cues), indicates that, on average, a second CI is likely to provide slightly better postoperative speech outcome than an additional HA for people with very low preoperative performance. These results may be taken into consideration to refine surgical indications for CIs. Design: Retrospective data from 2247 patients implanted since 2003 in 15 international centers were collected. Intelligibility scores, measured in quiet and in noise, were converted into percentile ranks to remove differences between centers. The influence of the listening mode among three independent groups, one CI alone (n = 1572), bimodal listening (CI/HA, n = 589), and bilateral CIs (CI/CI, n = 86), was compared in an analysis taking into account the influence of other factors such as duration of profound hearing loss, age, etiology, and duration of CI experience. No within-subject comparison (i.e., monitoring outcome modifications in CI/HA subjects bec...

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Section: Bimodal Versus Bilateral: Slight But Significant Advantage Osupporting

confidence: 73%

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

et al. 2015

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“…We identified 15 studies (published in 19 articles) assessing communication-related health outcomes in patients who received bilateral cochlear implants simultaneously, [28][29][30][31][32][33][34][35][36] sequentially, 21,[37][38][39][40][41][42][43] or both 44,45 ( Table 2). All but 2 studies 28,33 of simultaneous bilateral implantation showed a statistically significant improvement in communication-related outcome scores compared with unilateral implantation; in most studies, unilateral implantation was tested by temporarily deactivating 1 implant.…”

Section: Communication-related Outcomes In Bilateral Implantationmentioning

confidence: 99%

Cochlear Implantation in Adults

Gaylor

Raman²,

Chung³

et al. 2013

JAMA Otolaryngol Head Neck Surg

207

101

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Importance: Sensorineural hearing loss is the third leading cause of years lived with disability worldwide. Cochlear implants may provide a viable alternative to hearing aids for this type of hearing loss. The Coverage and Analysis Group at the Centers for Medicare & Medicaid Services was interested in an evaluation of recently published literature on this topic. In addition, this metaanalysis is to our knowledge the first to evaluate qualityof-life (QOL) outcomes in adults with cochlear implants.Objective: To evaluate the communication-related outcomes and health-related QOL outcomes after unilateral or bilateral cochlear implantation in adults with sensorineural hearing loss. Study Selection: Published studies of adult patients undergoing unilateral or bilateral procedures with multichannel cochlear implants and assessments using openset sentence tests, multisyllable word tests, or QOL measures.Data Extraction: Five researchers extracted information on population characteristics, outcomes of interest, and study design and assessed the studies for risk of bias. Discrepancies were resolved by consensus.Results: A total of 42 studies met the inclusion criteria. Most unilateral implant studies showed a statistically significant improvement in mean speech scores as measured by open-set sentence or multisyllable word tests; meta-analysis revealed a significant improvement in QOL after unilateral implantation. Results from studies assessing bilateral implantation showed improvement in communication-related outcomes compared with unilateral implantation and additional improvements in sound localization compared with unilateral device use or implantation only. Based on a few studies, the QOL outcomes varied across tests after bilateral implantation. Conclusions and Relevance:Unilateral cochlear implants provide improved hearing and significantly improve QOL, and improvements in sound localization are noted for bilateral implantation. Future studies of longer duration, higher-quality reporting, and large databases or registries of patients with long-term follow-up data are needed to yield stronger evidence.

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“…Bilateral cochlear implants (CIs) can improve speech understanding in noisy environments as well as improve sound localization (Dunn et al, 2010;van Hoesel, 2004;Litovsky et al, 2012). Patients with bilateral CIs receive some of the benefits that come with binaural hearing, but they often still have difficulty with binaural fusion, i.e., fusing sounds from the two ears together into a unitary percept .…”

Section: Introductionmentioning

confidence: 99%

Localization performance correlates with binaural fusion for interaurally mismatched vocoded speech

Suneel¹,

Staisloff²,

Shayman³

et al. 2017

The Journal of the Acoustical Society of America

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Bilateral cochlear implant users often have difficulty fusing sounds from the two ears into a single percept. However, measuring fusion can be difficult, particularly with cochlear implant users who may have no reference for a fully fused percept. As a first step to address this, this study examined how localization performance of normal hearing subjects relates to binaural fusion. The stimuli were vocoded speech tokens with various interaural mismatches. The results reveal that the percentage of stimuli perceived as fused was correlated with localization performance, suggesting that changes in localization performance can serve as an indicator for binaural fusion changes.

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Bilateral and Unilateral Cochlear Implant Users Compared on Speech Perception in Noise

Cited by 85 publications

References 7 publications

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

Cochlear Implantation in Adults

Localization performance correlates with binaural fusion for interaurally mismatched vocoded speech

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