title: Abnormal timing delays in auditory brainstem responses evoked by bilateral cochlear implant use in children.
abstract: OBJECTIVE
  A period of unilateral implant use before bilateral implantation affects timing of brainstem processes measured by the electrically evoked auditory brainstem response (EABR).
  
  
  BACKGROUND
  EABR latencies decrease with unilateral implant use potentially disrupting binaural timing cues important in auditory brainstem processing of bilateral input.
  
  
  METHODS
  EABRs were evoked by electrical pulses from the left, right, and both implants simultaneously in 3 groups of children. All were initially implanted at ages younger than 3 years and had the following: 1) a long delay (>2 yr [n = 16]), 2) a short delay (<1 yr [n = 15]), or 3) no delay (n = 15) between left and right ear implantation. Responses were recorded on the first day of bilateral implant use and 3 and 9 months thereafter.
  
  
  RESULTS
  Relative to responses evoked in the experienced ear, the naive ear showed prolonged latency in both the EABR peaks and the binaural difference response. After 3 and 9 months of bilateral implant use, the relative prolongation decreased in the long and short delay groups, but significant differences persisted in the former. No clear differences in latencies evoked by the left versus right implant were found at any time point in children receiving bilateral implants simultaneously.
  
  
  CONCLUSIONS
  Results suggest potential disruptions to binaural brainstem processing based on timing cues in children receiving a second cochlear implant after more than 2 years of unilateral implant use that persist through at least the first 9 months of bilateral implant use.
authors.affiliation: Cochlear Implant Laboratory, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada. karen.gordon@utoronto.ca
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
authors.forename: Jerome
authors.initials: J
authors.lastname: Valero
authors.forename: Richard
authors.initials: R
authors.lastname: van Hoesel
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
mesh_terms: D002675:Child, Preschool; D003054:Cochlear Implants; D003463:Cues; D004558:Electric Stimulation; D004594:Electrophysiology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D012000:Recruitment Detection, Audiologic