New approach in programming sequentially implanted children: Towards balanced dynamic ranges (DR)

Abstract

There is a tendency for children undergoing sequential cochlear implant after a long period of unilateral implant use to have a smaller dynamic range in their second implant compared to their first implant. This study aimed to investigate if balancing the dynamic ranges between the two implants influenced functional outcomes in sequentially implanted children. Nineteen participants with long inter-implant time delays were randomly assigned to a study group or a control group. Children in the study group received progressive minimal changes to both first and second implants over a period of nine months to achieve balanced dynamic ranges, while the children in the control group received only changes to their sequential implant. Functional outcomes were collected 24-months after sequential implantation and consisted of speech discrimination scores, spatial localisation, device use and quality of life measures. Results show that spatial discrimination skills improved over time for both groups of children; however children in the study group had smaller localisation errors compared with the children in the control group. No other differences between the two groups were observed. Balanced dynamic ranges in sequentially implanted children can contribute to better performance, particularly in spatial discrimination tasks that rely in inter-aural level differences.

Keywords:

• Cochlear implant
• Dynamic Range (DR)
• Sequential programming
• Spatial discrimination
• Inter implant delay

Additional information

Notes on contributors

Piumi Chathurika Kosgallana

Piumi Chathurika Kosgallana is an Audiological Scientist at the National Hearing Implant and Research Centre, Beaumont Hospital in Dublin.

Dylan Viani Walsh

Dylan Viani Walsh is currently an intern at the Mater Misericordiae University Hospital and former medical student of the Royal College of Surgeons Ireland.

Cristina Simões-Franklin

Cristina Simões-Franklin is a Senior Medical Physicist in the National Hearing Implant and Research Centre, Beaumont Hospital, Dublin.

Jyoti Thapa

Jyoti Thapa is an Audiological Scientist and the Paediatric Programme Co-Ordinator at the National Hearing Implant and Research Centre, Beaumont Hospital in Dublin.

Peter Walshe

Peter Walshe is a Consultant Otolaryngologist Surgeon in Beaumont Hospital and Temple Street Children's University Hospital, Dublin, Ireland.

Fergal Glynn

Fergal Glynn is a Consultant Otolaryngologist Surgeon in Beaumont Hospital and Temple Street Children's University Hospital, Dublin Ireland.

Richard B. Reilly

Richard B. Reilly is a Professor of Neural Engineering at Trinity College, The University of Dublin.

Laura Viani

Laura Viani is the Director of the National Cochlear Implant Programme in Ireland and a Consultant Otolaryngologist Surgeon in Beaumont Hospital and Temple Street Children's University Hospital.