Adapting to bilateral cochlear implants: early post-operative device use by children receiving sequential or simultaneous implants at or before 3.5 years

Abstract

Objective

To classify adaptation difficulties, or lack thereof, experienced by a clinical population of young bilateral cochlear implant recipients.

Method

Forty-six of the first 48 children sequentially or simultaneously implanted at ≤3.5 years at the Melbourne Clinic participated. Classification into categories was based on daily use of both implants at 2 months post-switch-on, with follow-up information obtained at 12 months.

Results

The 37 Category 1 children wore both implants full time at 2 months, and 35 still did so at 12 months. The two Category 2 children used both implants 4 hours daily at 2 months, but achieved full-time use within 12 months. The five Category 3 children used both implants for ≤1 hour, with only three achieving full-time use within 12 months. The two Category 4 children did not use two implants at 2 months, and one still did not wear both implants at 12 months. There were weak/modest but significant relationships between category and each of time between implants and age at bilateral implantation.

Discussion

Ninety-five percent of simultaneously and 70% of sequentially implanted children demonstrated full-time use within 2 months, and nearly all continued to do so at 12 months. Full-time use maximizes opportunities to develop listening skills. Monitoring device use is necessary for all children, especially when significant change occurs. For those experiencing difficulty in adapting, bilateral implant use usually increased over 12 months. Pre-operative counselling must include discussion of possible adaptation difficulties and raise the potential negative influence of age at bilateral implantation and time between implants.

Keywords:

• Bilateral cochlear implants
• Children
• Clinical practice
• Pre-operative counselling

Acknowledgements

The authors are very grateful to the families and to the staff of the Royal Victorian Eye and Ear Hospital/The University of Melbourne Cochlear Implant Clinic, who provided information for this project. The authors also thank Meredith Prain, Colleen Holt, Alexandra Tomov, Mansze Mok, and Marie-Chantal Moll-Vignes for their contribution to data collection. Financial support for this work was provided by the National Health and Medical Research Council (Project Grant No. 454318) and Audiology, Hearing and Speech Science, Department of Otolaryngology, The University of Melbourne.