title: A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance.
abstract: Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.
  
  
  
  A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3-6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.
  
  
  
  Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.
  
  
  
  Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.
authors.affiliation: Washington University School of Medicine, St. Louis, MO.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Reeder
authors.affiliation: Washington University School of Medicine, St. Louis, MO.
authors.forename: Jill B
authors.initials: JB
authors.lastname: Firszt
authors.affiliation: St. Louis Children's Hospital, MO.
authors.forename: Jamie H
authors.initials: JH
authors.lastname: Cadieux
authors.affiliation: Washington University School of Medicine, St. Louis, MO.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Strube
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D006312:Hearing Loss, Bilateral / Q000534:rehabilitation*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D009622:Noise; D011446:Prospective Studies; D013067:Speech Perception; D013997:Time Factors; D016896:Treatment Outcome