title: Bilateral cochlear implantation in children: a systematic review and best-evidence synthesis.
abstract: OBJECTIVE
  To evaluate the effectiveness of bilateral cochlear implantation over unilateral implantation in children with sensorineural hearing loss.
  
  
  METHODS
  Pubmed, Embase, and Web of Science.
  
  
  METHODS
  All studies comparing a bilateral cochlear implant group with a unilateral implant group were included.
  
  
  RESULTS
  Twenty-one studies compared a bilateral cochlear implant group with a unilateral group. No randomized trials were identified. Due to the clinical heterogeneity, statistical pooling was not feasible and a best-evidence synthesis was performed. The results of this best-evidence synthesis indicate the positive effect of the second implant for especially sound localization and possibly for preverbal communication and language development. There was insufficient evidence to make a valid comparison between bilateral implantation and a bimodal fitting.
  
  
  CONCLUSIONS
  Although randomized trials are lacking, the results of our best-evidence synthesis indicate that the second cochlear implant might be especially useful in sound localization and possibly also in language development.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht.
authors.forename: Marc J W
authors.initials: MJ
authors.lastname: Lammers
authors.forename: Geert J M G
authors.initials: GJ
authors.lastname: van der Heijden
authors.forename: Vanessa E C
authors.initials: VE
authors.lastname: Pourier
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D002648:Child; D019929:Cochlear Implantation / Q000379:methods*; D003638:Deafness / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007804:Language Development; D013067:Speech Perception; D016896:Treatment Outcome
keywords: Cochlear implantation; best-evidence synthesis; bilateral; bimodal; deafness; hearing loss; systematic review; unilateral