title: Self-reported benefits from successive bilateral cochlear implantation in post-lingually deafened adults: randomised controlled trial.
abstract: Adult users of unilateral Nucleus CI24 cochlear implants with the SPEAK processing strategy were randomised either to receive a second identical implant in the contralateral ear immediately, or to wait 12 months while they acted as controls for late-emerging benefits of the first implant. Twenty four subjects, twelve from each group, completed the study. Receipt of a second implant led to improvements in self-reported abilities in spatial hearing, quality of hearing, and hearing for speech, but to generally non-significant changes in measures of quality of life. Multivariate analyses showed that positive changes in quality of life were associated with improvements in hearing, but were offset by negative changes associated with worsening tinnitus. Even in a best-case scenario, in which no worsening of tinnitus was assumed to occur, the gain in quality of life was too small to achieve an acceptable cost-effectiveness ratio. The most promising strategies for improving the cost-effectiveness of bilateral implantation are to increase effectiveness through enhanced signal processing in binaural processors, and to reduce the cost of implant hardware.
authors.affiliation: MRC Institute of Hearing Research, Nottingham, UK. aqs1@york.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Quentin Summerfield
authors.forename: G R
authors.initials: GR
authors.lastname: Barton
authors.forename: J
authors.initials: J
authors.lastname: Toner
authors.forename: C
authors.initials: C
authors.lastname: McAnallen
authors.forename: D
authors.initials: D
authors.lastname: Proops
authors.forename: C
authors.initials: C
authors.lastname: Harries
authors.forename: H
authors.initials: H
authors.lastname: Cooper
authors.forename: I
authors.initials: I
authors.lastname: Court
authors.forename: R
authors.initials: R
authors.lastname: Gray
authors.forename: J
authors.initials: J
authors.lastname: Osborne
authors.forename: M
authors.initials: M
authors.lastname: Doran
authors.forename: R
authors.initials: R
authors.lastname: Ramsden
authors.forename: D
authors.initials: D
authors.lastname: Mawman
authors.forename: M
authors.initials: M
authors.lastname: O'Driscoll
authors.forename: J
authors.initials: J
authors.lastname: Graham
authors.forename: W
authors.initials: W
authors.lastname: Aleksy
authors.forename: L
authors.initials: L
authors.lastname: Meerton
authors.forename: C
authors.initials: C
authors.lastname: Verschure
authors.forename: P
authors.initials: P
authors.lastname: Ashcroft
authors.forename: M
authors.initials: M
authors.lastname: Pringle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation; D003638:Deafness / Q000601:surgery*; D005260:Female; D006312:Hearing Loss, Bilateral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D011795:Surveys and Questionnaires