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Research Supporting Bilateral Cochlear Implantation
Despite many insurers’ continued erroneous assertions to the contrary, bilateral cochlear implantation is NOT an experimental or investigational procedure, and is medically necessary. Bilateral cochlear implantation in children has been an accepted, mainstream medical practice since 1998. Over 3000 have been performed, including over 1600 on children.
Several studies have shown that there is a vast improvement in sound localization ability in patients with bilateral cochlear implants. In particular, the group of subjects who received a significant amount of improvement when bilaterally implanted were those who were initially implanted at a very early age, as Andrew was. In September 2005, an international consortium of cochlear implant specialists published an article in the widely respected journal “Acta Oto-Laryngologica” formally recommending that all children with permanent bilateral profound hearing losses receive bilateral cochlear implants. A recent publication by industry-leading otologist Dr. Robert Peters stated that:
Provision of binaural hearing should be considered the standard of care for hearing-impaired patients whenever it can be provided without significant risks. In severe to profoundly hearing impaired individuals, this can only be provided with bilateral cochlear implantation when hearing aids are inadequate. In carefully selected candidates, the benefits derived are significant, the surgical procedures well tolerated, and negative effects infrequent in both children and adults.
A second recent paper by well-known communications disorder specialist Dr. Ruth Litovsky concluded that:[B]ilateral CIs can offer a combination of benefits that include better ear effects, binaural summation/redundancy effects and binaural unmasking. These effects have been illustrated in numerous patients world-wide; continued work in this field will no doubt lead to further improvements and increases in the size of each of these effects, for adults and for children.Please refer to the following publications for additional information.
- Litovsky R, Binaural Hearing, March 2006 (Part 2 of Cochlear Series on Bilateral Cochlear Implantation)
- Peters BR, Rational for Bilateral Cochlear Implantation in Children and Adults, January 2006 (Part 1 of Cochlear Series on Bilateral Cochlear Implantation)
- Litovsky R, Johnstone P et al., Bilateral Cochlear Implants in Children: Localization Acuity Measured with Minimum Audible Angle, Ear & Hearing, 27(1) pp 43-59, Jan. 2006.
- Das S, Buchman CA, Bilateral cochlear implantation: current concepts, Curr Opin Otolaryngol Head Neck Surg. 13(5): 290-3, Oct 2005.
- Offeciers, E. et al., International consensus on bilateral cochlear implants and bimodal stimulation, Acta Oto-Laryngologica, Volume 125, Number 9, pp. 918-919, September 2005.
- Verschuur CA, Lutman ME, Ramsden R, Greenham P, O'Driscoll M., Auditory localization abilities in bilateral cochlear implant recipients, Otol Neurotol. 26(5): 965-71, Sept. 2005.
- Litovsky R, Speech intelligibility and spatial release from masking in young children, J. Acoust. Soc. Am. 17(5), pp. 3091-99, May 2005
- Laszig R et al., Benefits of bilateral electrical stimulation with the nucleus cochlear implant in adults: 6-month postoperative results, Otol Neurotol. 25(6): 958-68, Nov. 2004.
- Litovsky R et al., Bilateral Cochlear Implants in Adults and Children, Archives of Otolaryngology Head Neck Surgery v 130:648-655, 2004.
- Long C and Eddington D., Binaural sensitivity as a function of interaural electrode position with a bilateral cochlear implant user, J. Acoust. Soc. Am.114(3), pp 1565-74, Sept. 2003.
- D'Haese P et al., The investigation of the binaural effect in bilateral cochlear implant users, The Australian and New Zealand Journal of Audiology, Addendum, Volume 23, Number 2, 2002.
- Müller J et al., Binaural cochlear implantation: a case report discussing preliminary results. European Archives of Oto-Rhino-Laryngology, 255, 38, 1998.
- Schoen F et al., Results of bilateral cochlear implantation. European Archives of Oto-Rhino-Laryngology, 156, 106, 1999.
- Lawson D et al., Fourth Quarterly Progress Report. NIH Contract N01-DC-8-2105, 1999.
- Schön F et al., Restoration of binaural hearing by means of bilateral cochlear Implantation, Conference on Implantable audiology prostheses, Asilomar, USA. August 2001.
- Nopp P et al., Sound localization under fixed and roving level conditions in bilateral users of the MED-EL COMBI 40+ cochlear implant. 7th International Cochlear Implant Conference, Manchester, 2002.
- Baumann U et al., Electrode discrimination of ‘place-pitch’ with deeply inserted electrode arrays. Hear. Res., submitted, 2003.
- Hochmair I et al. Deep electrode insertion in cochlear implants: apical morphology, electrodes, and speech perception results. Acta Oto-Laryngologica, accepted, 2002.
- Nopp P et al., Binaural effects in bilateral users of the MED-EL COMBI 40/40+ cochlear implant. 7th International Cochlear Implant Conference, Manchester, 2002.
Another medical benefit of bilateral cochlear implantation is that it has been shown to improve speech recognition in noisy environments. It is expected that once that a patient’s hearing with the second cochlear implant in place is maximized, they will notice a significant improvement in understanding speech in noisy environments. Comprehending speech amidst background noise occurs commonly in real-life situations, especially in classroom settings and learning environments, at the dinner table, or while talking in a car or on a plane. Please refer to the following studies for more details:
- Kuhn-Inacker H, Shehata-Dieler W, Muller J, Helms J., Bilateral cochlear implants: a way to optimize auditory perception abilities in deaf children?, Int J Pediatr Otorhinolaryngol.68(10): 1257-66 Oct. 2004
- Schön F et al., Speech reception thresholds obtained in a symmetrical four-loudspeaker arrangement from bilateral users of MED-EL cochlear implants. Otology and Neurotology, in press, 2002.
- Müller J et al., Speech understanding in quiet and noise in bilateral users of the MED-EL COMBI 40/40+ cochlear implant system. Ear and Hearing, 23, 198-206, 2002
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