The effect of device use after sequential bilateral cochlear implantation in children: An electrophysiological approach.
OBJECTIVE
In many studies evaluating the effect of sequential bilateral cochlear implantation in congenitally deaf children, device use is not taken into account. In this study, however, device use was analyzed in relation to auditory brainstem maturation and speech recognition, which were measured in children with early-onset deafness, 5-6 years after bilateral cochlear implantation. We hypothesized that auditory brainstem maturation is mostly functionally driven by auditory stimulation and is therefore influenced by device use and not mainly by inter-implant delay.


METHODS
Twenty-one children participated and had inter-implant delays between 1.2 and 7.2 years. The electrically-evoked auditory brainstem response was measured for both implants separately. The difference in interaural wave V latency and speech recognition between both implants were used in the analyses. Device use was measured with a Likert scale.


RESULTS
Results showed that the less the second device is used, the larger the difference in interaural wave V latencies is, which consequently leads to larger differences in interaural speech recognition.


CONCLUSIONS
In children with early-onset deafness, after various periods of unilateral deprivation, full-time device use can lead to similar auditory brainstem responses and speech recognition between both ears. Therefore, device use should be considered as a relevant factor contributing to outcomes after sequential bilateral cochlear implantation. These results are indicative for a longer window between implantations in children with early-onset deafness to obtain symmetrical auditory pathway maturation than is mentioned in the literature. Results, however, must be interpreted as preliminary findings as actual device use with data logging was not yet available at the time of the study.
Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Centre Nijmegen, The Netherlands. Electronic address: Marloes.Sparreboom@Radboudumc.nl.
Marloes
M
Sparreboom
Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Centre Nijmegen, The Netherlands.
Andy J
AJ
Beynon
Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Centre Nijmegen, The Netherlands.
Ad F M
AF
Snik
Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Centre Nijmegen, The Netherlands.
Emmanuel A M
EA
Mylanus
D000161:Acoustic Stimulation; D001306:Auditory Pathways / Q000254:growth & development / Q000503:physiopathology; D001933:Brain Stem / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods; D003054:Cochlear Implants; D015331:Cohort Studies; D003638:Deafness / Q000151:congenital / Q000503:physiopathology* / Q000628:therapy*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D013067:Speech Perception / Q000502:physiology
Bilateral cochlear implants; Device use; Electrically evoked auditory brainstem response; Pediatric; Speech recognition