title: From hearing with a cochlear implant and a contralateral hearing aid (CI/HA) to hearing with two cochlear implants (CI/CI): a within-subject design comparison.
abstract: OBJECTIVE
  To compare within-subject bilateral-binaural and bimodal complementary abilities between bimodal (cochlear implant and hearing aid; CI/HA) and bilateral CI hearing (CI/CI), thereby enabling better-informed counseling of experienced CI/HA users contemplating contralateral implantation.
  
  
  METHODS
  Comparative within-subject case review.
  
  
  METHODS
  Outpatient hearing clinic.
  
  
  METHODS
  Ten experienced adult CI/HA users with severe-to-profound hearing loss in the HA ear, who converted to CI/CI between 2 and 11 years after initial implantation.
  
  
  METHODS
  Task-specific testing of bilateral-binaural hearing (sound lateralization, binaural summation/redundancy/unmasking, head-shadow effect), bimodal complementary benefit (contribution of low-frequency information), and a self-report Speech, Spatial, and Qualities of Hearing (SSQ) questionnaire, all before and 1 year after contralateral cochlear implantation.
  
  
  METHODS
  Test result differences between CI/HA and CI/CI conditions.
  
  
  RESULTS
  CI/CI hearing was better than CI/HA for speech lateralization and for perception of semantically unpredictable sentences in speech noise with speech at 0 degrees and noise at +90 degrees azimuth on the old CI side. CI/HA was better than CI/CI only for differences between perception of natural prosody speech and of speech with flattened fundamental frequency (F0) contour with speech and noise in front (at 0 degrees azimuth). Total scores on the SSQ questionnaire were higher in CI/CI than in CI/HA users.
  
  
  CONCLUSIONS
  Counseling regarding contralateral implantation for CI/HA users with severe-to-profound hearing loss in the HA ear, though generally positive, should consider individual functional needs, and cover expectations about the expected trade-off between gaining improved understanding and speech lateralization in challenging listening conditions and losing some low-frequency cues still available with CI/HA hearing.
authors.affiliation: *Ear and Hearing Program, Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Technion-Bruce Rappaport Faculty of Medicine, Haifa, Israel; †Department of Communication Sciences and Disorders, Haifa University, Haifa, Israel; and ‡School of Education, Department of Communication Disorders, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Luntz
authors.forename: Dana
authors.initials: D
authors.lastname: Egra-Dagan
authors.forename: Joseph
authors.initials: J
authors.lastname: Attias
authors.forename: Noam
authors.initials: N
authors.lastname: Yehudai
authors.forename: Tova
authors.initials: T
authors.lastname: Most
authors.forename: Talma
authors.initials: T
authors.lastname: Shpak
mesh_terms: D000328:Adult; D000368:Aged; D019929:Cochlear Implantation; D003054:Cochlear Implants; D005260:Female; D006309:Hearing / Q000502:physiology*; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D013067:Speech Perception / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome