title: United Kingdom national paediatric bilateral project: Demographics and results of localization and speech perception testing.
abstract: To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially.
  
  
  
  This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included.
  
  
  
  1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants.
  
  
  
  These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
authors.affiliation: a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Cullington
authors.affiliation: a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK.
authors.forename: D
authors.initials: D
authors.lastname: Bele
authors.affiliation: a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Brinton
authors.affiliation: b St. Thomas' Hospital Hearing Implant Centre , London , UK.
authors.forename: S
authors.initials: S
authors.lastname: Cooper
authors.affiliation: c Nottingham Auditory Implant Programme , Nottingham , UK.
authors.forename: M
authors.initials: M
authors.lastname: Daft
authors.affiliation: d Cardiff Paediatric Cochlear Implant Programme , London , UK.
authors.forename: J
authors.initials: J
authors.lastname: Harding
authors.affiliation: e Emmeline Centre , Cambridge , UK.
authors.forename: N
authors.initials: N
authors.lastname: Hatton
authors.affiliation: f The Oxford Cochlear Implant Programme , London , UK.
authors.forename: J
authors.initials: J
authors.lastname: Humphries
authors.affiliation: g Hearing and Balance Centre , University of Southampton , Southampton , UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Lutman
authors.affiliation: h West of England Paediatric Hearing Implant Programme , Bristol , UK.
authors.forename: J
authors.initials: J
authors.lastname: Maddocks
authors.affiliation: i The Midlands Children's Hearing Implant Programme , Birmingham , UK.
authors.forename: J
authors.initials: J
authors.lastname: Maggs
authors.affiliation: j The Richard Ramsden Centre for Hearing Implants , Manchester , UK.
authors.forename: K
authors.initials: K
authors.lastname: Millward
authors.affiliation: c Nottingham Auditory Implant Programme , Nottingham , UK.
authors.forename: G
authors.initials: G
authors.lastname: O'Donoghue
authors.affiliation: k St George's Hospital Auditory Implant Service , London , UK.
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.affiliation: l Great Ormond Street Cochlear Implant Programme , London , UK.
authors.forename: K
authors.initials: K
authors.lastname: Rajput
authors.affiliation: m North East Cochlear Implant Programme , Middlesbrough , UK.
authors.forename: V
authors.initials: V
authors.lastname: Salmon
authors.affiliation: n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK.
authors.forename: T
authors.initials: T
authors.lastname: Sear
authors.affiliation: o Belfast Regional Cochlear Implant Centre , Belfast , UK.
authors.forename: A
authors.initials: A
authors.lastname: Speers
authors.affiliation: n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK.
authors.forename: A
authors.initials: A
authors.lastname: Wheeler
authors.affiliation: b St. Thomas' Hospital Hearing Implant Centre , London , UK.
authors.forename: K
authors.initials: K
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003710:Demography; D005260:Female; D006312:Hearing Loss, Bilateral / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009622:Noise; D065228:Non-Randomized Controlled Trials as Topic; D011184:Postoperative Period; D013017:Sound Localization; D013067:Speech Perception; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Bilateral cochlear implant; Binaural hearing; Cochlear implant; Localization; Paediatric service evaluation