A Within-Subject Comparison of Bimodal Hearing, Bilateral Cochlear Implantation, and Bilateral Cochlear Implantation With Bilateral Hearing Preservation. Issue 8 (September 2015)

• Record Type: Journal Article
• Authors: Gifford, René H.; Driscoll, Colin L. W.; Davis, Timothy J.; Fiebig, Pam; Micco, Alan; Dorman, Michael F.
• Is Part Of: Otology & neurotology. Volume 36:Issue 8(2015)
• Publication Date: 2015-09
• Subjects: Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000000804
• Languages: English
• ISSNs: 1531-7129

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>To compare speech understanding with bimodal hearing and bilateral cochlear implants (CIs).</p> </sec> <sec> <title>Study Design</title> <p>Within-subjects, repeated-measures.</p> </sec> <sec> <title>Methods</title> <p>Speech understanding was assessed in the following conditions: unilateral hearing aid (HA) in the non-implanted ear, unilateral CI, bimodal (CI + HA), and bilateral CI. In addition, three participants had bilateral hearing preservation and were also tested with bilateral CIs and bilateral HAs (BiBi).</p> </sec> <sec> <title>Setting</title> <p>Tertiary academic CI center.</p> </sec> <sec> <title>Patients</title> <p>Eight adult sequential bilateral recipients who, despite achieving incredibly high performance with the first CI, self-selected for bilateral cochlear implantation.</p> </sec> <sec> <title>Intervention(s)</title> <p>Bilateral cochlear implantation.</p> </sec> <sec> <title>Main Outcome Measure(s)</title> <p>Speech understanding for the adult minimum speech test battery as well as sentences in semidiffuse noise using the R-SPACE system.</p> </sec> <sec> <title>Results</title> <p>Bilateral CIs afforded significant individual improvement in a complex listening environment even for individuals demonstrating near perfect sentence scores with both the first CI alone as well as the bimodal condition. The 3 BiBi participants demonstrated additional significant benefit over the bilateral CI condition–presumably because of the availability of interaural time difference cues.</p> </sec> <sec> <title>Conclusions</title> <p>These data suggest that, for noisy environments, adding a second implant can significantly improve speech understanding—even for high-performing unilateral CI with bimodal hearing. In diffuse noise conditions, bilateral acoustic hearing can yield even greater benefits beyond that offered by bilateral implantation.</p> </sec> </abstract>