Clin Exp Otorhinolaryngol.  2012 Apr;5(Suppl 1):S24-S31.

Bilateral Cochlear Implantation for Children in Nagasaki, Japan

• Kanda Y
• Kumagami H
• Hara M
• Sainoo Y
• Sato C
• Yamamoto-Fukuda T
• Yoshida H
• Ito A
• Tanaka C
• Baba K
• Nakata A
• Tanaka H
• Takahashi

Abstract

OBJECTIVES
The number of patients with bilateral cochlear implant (CI) has gradually increased as patients and/or parents recognize its effectiveness. The purpose of this report is to evaluate the efficacy of 29 bilateral CI out of 169 pediatric CI users, who received auditory-verbal/oral habilitation at our hearing center.
METHODS
We evaluated the audiological abilities 29 Japanese children with bilateral CIs including wearing threshold, word recognition score, speech discrimination score at 1 m from front speaker (SP), 1 m from second CI side SP, speech discrimination score under the noise (S/N ratio=80 dB sound pressure level [SPL]/70 dB SPL, 10 dB) at 1 m from front SP, word recognition score under the noise (S/N ratio=80 dB SPL/70 dB SPL, 10 dB) at 1 m from front SP.
RESULTS
Binaural hearing using bilateral CI is better than first CI in all speech understanding tests. Especially, there were significant differences between the results of first CI and bilateral CI on SDS at 70 dB SPL (P=0.02), SDS at 1 m from second CI side SP at 60 dB SPL (P=0.02), word recognition score (WRS) at 1 m from second CI side SP at 60 dB SPL (P=0.02), speech discrimination score (SDS) at 1 m from front SP under the noise (S/N=80/70; P=0.01) and WRS at 1 m from front SP under the noise (S/N=80/70; P=0.002). At every age, a second CI is very effective. However, the results of under 9 years old were better than of over 9 years old on the mean SDS under the noise (S/N=80/70) on second CI (P=0.04). About use of a hearing aid (HA) in their opposite side of first CI, on the WRS and SDS under the noise, there were significant differences between the group of over 3 years and the group of under 10 months of HA non user before second CI.
CONCLUSION
These results may show important binaural effectiveness such as binaural summation and head shadow effect. Bilateral CI is very useful medical intervention for many children with severe-to-profound hearing loss in Japan as well as elsewhere.

Keyword

Cochlear implant; Children; Bilateral; Binaural; Binaural summation; Head shadow effect; Japan

MeSH Terms

Asian Continental Ancestry Group
Child
Cochlear Implantation
Cochlear Implants
Head
Hearing
Hearing Aids
Hearing Loss
Humans
Japan
Noise
Parents
Speech Perception

Figure

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  Fig. 1 Age at operation of first cochlear implantation (CI) and second CI (year).

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  Fig. 2 Interval between first and second cochlear implantation (month).

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  Fig. 3 Number of months child discontinued hearing aid use before second cochlear implantation.

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  Fig. 4 Causes for deafness.

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  Fig. 5 Device of first cochlear implantation (CI) (A) and second CI (B).

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  Fig. 6 The mean wearing threshold using first cochlear implantation (CI), second CI, and bilateral CI.

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  Fig. 7 The mean wearing threshold of their hearing aid (HA) before second cochlear implantation (CI) and second CI.

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  Fig. 8 Mean word recognition score at 1 m from front speaker at 70 dB SPL (0.13). CI, cochlear implantation; SPL, sound pressure level.

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  Fig. 9 Mean word recognition score at 1 m from front speaker at 60 dB SPL (P=0.05). CI, cochlear implantation; SPL, sound pressure level.

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  Fig. 10 Mean speech discrimination score at 70 dB SPL (P=0.02*). CI, cochlear implantation; SPL, sound pressure level.

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  Fig. 11 Mean speech discrimination score at 60 dB SPL (P=0.24). CI, cochlear implantation; SPL, sound pressure level.

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  Fig. 12 Mean speech discrimination score at 1 m from second cochlear implantation (CI) side speaker at 70 dB SPL (P=0.25). SPL, sound pressure level.

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  Fig. 13 Mean speech discrimination score at 1 m from second cochlear implantation (CI) side speaker at 60 dB SPL (P=0.02*). SPL, sound pressure level.

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  Fig. 14 Mean word recognition score at 1 m from second cochlear implantation (CI) side speaker at 60 dB SPL (P=0.02*). SPL, sound pressure level.

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  Fig. 15 Mean speech discrimination score at 1 m from front speaker under the noise (S/N=80/70, +10; P=0.01*). CI, cochlear implantation.

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  Fig. 16 Mean word recognition score at 1 m from front speaker under the noise (S/N=80/70, +10; (P=0.002**). CI, cochlear implantation.

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  Fig. 17 Comparison of the mean word recognition score (WRS) and speech discrimination score (SDS), at 70 dB SPL at 1 m from front speaker, the mean SDS and WRS under the noise (S/N=80/70) on second cochlear implantation for over and under 9 years old. SPL, sound pressure level.

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  Fig. 18 Comparison of the mean word recognition score (WRS) and speech discrimination score (SDS) at 70 dB SPL at 1 m from front speaker, the mean SDS and WRS under the noise (S/N=80/70) on second cochlear implantation (CI) for those that had not used their hearing aid (HA) for over 3 years before second CI with those that had used their HA within 10 months before second CI. SPL, sound pressure level.

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