[Bilateral sequential cochlear implantation in children].

INTRODUCTION: Unilateral cochlear implantation (CI) has become the standard of care for patients with severe and profound hearing loss. Most unilateral CI users achieve excellent speech understanding abilities in quiet conditions, but face extreme difficulty in noisy environment, a difficulty which can be minimized with bilateral hearing. AIM OF STUDY: To assess the added benefit from a sequential bilateral cochlear implantation in children, several years after the first CI. MATERIAL AND METHODS: Seven children who underwent sequential CI between 2006 and 2008 were included in the study. Mean age at first CI was 4.1 +/- 3.8 years. Mean age at second CI was 11.3 +/- 2.3 years. The mean interval between implantations was 7.3 +/- 2.8 years. Mean duration of experience with both implants was 11.91 +/- 12.2 months. Performance with the first implant and with the two implants was compared using speech perception tests. RESULTS: All children had significant added benefit from the second implantation. Mean word recognition score with both implants was 71% as compared to 44% with the first CI (P=0.018). Mean sentences recognition score in quiet conditions with both implants was 78% as compared to 60% with the first CI (P=0.028) and mean sentences recognition in noise with both implants was 58% as compared to 26% with the first CI (P=0.028). CONCLUSIONS: Benefit from contralateral implantation was demonstrated in the present study despite the long interval between the first and second implantation and the relatively late age at contralateral implantation. This finding raises the possibility that the window of opportunity for beneficial sequential contralateral implantation is longer than hypothesized so far.