title: Factors influencing consistent device use in pediatric recipients of bilateral cochlear implants.
abstract: OBJECTIVE
  To determine which demographic or performance variables are associated with inconsistent use of a second implant in pediatric recipients of sequential bilateral cochlear implants (CIs).
  
  
  METHODS
  A retrospective chart review was conducted on pediatric recipients of sequential bilateral CIs. Children were divided into two age groups, 5-9 and 10-17 years of age. For each group, we examined whether inconsistent use of the second implant (CI-2) was associated with a variety of demographic variables, or speech-perception scores.
  
  
  RESULTS
  In children aged 5-9 years, inconsistent use of CI-2 was not significantly associated with any demographic variable, but was related to both the word-recognition score with CI-2, and the difference in word-recognition scores between the first implant (CI-1) and CI-2. In children aged 10-17 years, these relationships were not significant due to smaller number of subjects. Finally, CI-2 word-recognition scores across all children were significantly correlated with the age of implantation for both CI-1 and CI-2, and the time between CI-1 and CI-2 surgeries.
  
  
  CONCLUSIONS
  Speech-recognition scores obtained with CI-2, and the extent to which it differs from CI-1, are most closely related with inconsistent use of CI-2 in pediatric sequential implantees. These results are consistent with similar data previously reported by other investigators. While children implanted with CI-2 at a later age generally perform more poorly, most children still use both implants, and benefit from CI-2 even when receiving the implant as an adolescent.
  
  
  CONCLUSIONS
  In pediatric recipients of sequential bilateral CIs, inconsistent use of CI-2 is related to the speech recognition scores with CI-2, and the difference in speech-recognition scores between CI-1 and CI-2. In addition, speech-recognition scores with CI-2 are related to the amount of time between CI-1 and CI-2 surgeries, and the age of implantation for both CI-1 and CI-2.
authors.affiliation: New York University School of Medicine, New York, NY, USA.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Fitzgerald
authors.forename: Janet E
authors.initials: JE
authors.lastname: Green
authors.forename: Yixin
authors.initials: Y
authors.lastname: Fang
authors.forename: Susan B
authors.initials: SB
authors.lastname: Waltzman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000534:rehabilitation*; D003054:Cochlear Implants; D005260:Female; D006312:Hearing Loss, Bilateral / Q000534:rehabilitation* / Q000601:surgery*; D006801:Humans; D008297:Male; D010700:Phonetics; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D013067:Speech Perception