title: Bilateral cochlear implants should be the standard for children with bilateral sensorineural deafness.
abstract: OBJECTIVE
  Bilateral cochlear implants are provided to children in an attempt to establish binaural processing and allow hearing with greater ease. Arguments against implantation, which prevailed for many years, are countered by some of the findings reported over the past 1-2 years.
  
  
  RESULTS
  Behavioral and electrophysiological outcomes in children receiving cochlear implants suggest that two issues are most important when considering bilateral cochlear implants for any child: the duration of deafness prior to the first implantation affecting development of oral speech and language skills and the inter-stage interval (between implantation of the first and second ears) likely affecting development of binaural processing.
  
  
  CONCLUSIONS
  Based on the data reported to date, both the interval between onset of deafness and cochlear implantation and the interval between implantation of the first and second ears should be narrow in children. We recommend that simultaneous bilateral implantation be provided when possible and, if not, the inter-stage interval should be limited. We further recommend continued exploration of outcomes in children with longer inter-stage intervals with a view to defining a point at which bilateral cochlear implantation provides so little benefit that it is not cost-effective.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, University of Toronto, Canada. blake.papsin@utoronto.ca
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
mesh_terms: D001307:Auditory Perception; D002648:Child; D019929:Cochlear Implantation / Q000592:standards*; D003054:Cochlear Implants; D006319:Hearing Loss, Sensorineural / Q000534:rehabilitation*; D006801:Humans; D018579:Patient Selection; D013065:Speech Intelligibility