title: The effectiveness of bilateral cochlear implants for severe-to-profound deafness in adults: a systematic review.
abstract: OBJECTIVE
  Assessment of the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation or bimodal stimulation, in adults with severe-to-profound hearing loss. In 2007, the National Institute for Health and Clinical Excellence (NICE) in the U.K. conducted a systematic review on cochlear implantation. This study forms an update of the adult part of the NICE review.
  
  
  METHODS
  The electronic databases MEDLINE and Embase were searched for English language studies published between October 2006 and March 2011.
  
  
  METHODS
  Studies were included that compared bilateral cochlear implantation with unilateral cochlear implantation and/or with bimodal stimulation, in adults with severe-to-profound sensorineural hearing loss. Speech perception in quiet and in noise, sound localization and lateralization, speech production, health-related quality of life, and functional outcomes were analyzed.
  
  
  METHODS
  Data extraction forms were used to describe study characteristics and the level of evidence.
  
  
  RESULTS
  The effect size was calculated to compare different outcome measures.
  
  
  CONCLUSIONS
  Pooling of data was not possible because of the heterogeneity of the studies. As in the NICE review, the level of evidence of the included studies was low, although some of the additional studies showed less risk of bias. All studies showed a significant bilateral benefit in localization over unilateral cochlear implantation. Bilateral cochlear implants were beneficial for speech perception in noise under certain conditions and several self-reported measures. Most speech perception in quiet outcomes did not show a bilateral benefit. The current review provides additional evidence in favor of bilateral cochlear implantation, even in complex listening situations.
authors: Department of Clinical and Experimental Audiology, Academic Medical Center, Amsterdam, The Netherlands. jvanschoonhoven@amc.nl
authors: Jelmer
authors: J
authors: van Schoonhoven
authors: Marloes
authors: M
authors: Sparreboom
authors: Bert G A
authors: BG
authors: van Zanten
authors: Rob J P M
authors: RJ
authors: Scholten
authors: Emmanuel A M
authors: EA
authors: Mylanus
authors: Wouter A
authors: WA
authors: Dreschler
authors: Wilko
authors: W
authors: Grolman
authors: Bert
authors: B
authors: Maat
mesh_terms: D000328:Adult; D000465:Algorithms; D002648:Child; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation*; D019317:Evidence-Based Medicine; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D009622:Noise; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D013067:Speech Perception; D016896:Treatment Outcome