title: Sequential bilateral cochlear implantation in the adolescent population.
abstract: OBJECTIVE
  To examine the variables affecting outcomes for sequential bilateral cochlear implantation patients in the adolescent population.
  
  
  METHODS
  Retrospective chart review at tertiary care center.
  
  
  METHODS
  Main outcome measures were open set speech recognition tests at the word (Consonant-Nucleus-Consonant/Phonetically Balanced Kindergarten List Test [CNC/PBK]) and sentence levels in noise (Hearing in Noise Test-Noise [HINT-N]) in different test conditions with respect to the age at first and sequential implantation, as well as the interval between implants.
  
  
  RESULTS
  Despite a mean age at sequential implantation of 13.5 years, sequential bilateral implanted adolescents revealed significant improvement in the sequential cochlear implant (CI2) ear. The mean time interval between implants was 8.2 years. A wide range of performance was noted, and age at implantation and interval between first cochlear implant (CI1) and CI2 did not predict outcome. Mean CNC/PBK score with CI1 alone was 83.0%, with the CI2 alone was 56.5%, and with bilateral implants was 86.8%. Sentence scores (HINT-N) were 89.5% for CI1, 74.2% for CI2, and 94.4% for bilateral CI condition. The clinical relevance of these enhanced perception abilities requires attention to individual device use, performance with the first implant, and subjective benefits reported by patients.
  
  
  CONCLUSIONS
  Bilateral sequential cochlear implantation leads to improved speech perception in the adolescent population and should be considered in this population, even after a long period of deafness and despite a prolonged interval between implants. Numerous factors affect the ability to predict performance, but age at implantation and interimplant interval were not correlated with performance measures. Extensive preoperative counseling and individualized evaluation are critical to ensure that patients and families understand the range of possible outcomes.
  
  
  METHODS
  4
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: David R
authors.initials: DR
authors.lastname: Friedmann
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Janet
authors.initials: J
authors.lastname: Green
authors.affiliation: Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Ensor
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Roland
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Waltzman
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D019929:Cochlear Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006312:Hearing Loss, Bilateral / Q000503:physiopathology / Q000601:surgery*; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome
keywords: Adolescent, pediatric cochlear implants; bilateral; sequential