|
Bilateral Cochlear Implantation In 27 Patients
Baumgartner, WD, Hamzavi, JS,
Jappel, A, Pok, SM,
Eckl-Dorna, J, Frei K, Stach, M, Franz, P
Since 1995 we performed 27 nonsimultaneous bilateral
cochlear implantations in 13 adults and 14 children. Prior to bilateral
implantation all patients were sucessful monoaural cochlear implant
users. The decision of bilateral cochlear implantation was made together
with the patients (in children additionally with parents) and reevaluation
concerning audiological and anatomical data of the contralateral
ear.
The time periode between the two surgeries was within 3 months up to 7 years.
The age at the time of bilateral cochlear implantation was between 3 and 59 years
old.
We observed no surgical or psychological complications. In adult bilateral implantees
we have following implant data:
A: |
analog system/ multichannel
CIS stimulator |
B: |
nucleus mini
22 / med el combi 40+ |
C: |
same implanttype
but different fitting parameter, because of etiology or surgical
circumstances |
D: |
nucleus mini
22/ nucleus contour |
E: |
med el combi
40/ med el combi 40+ |
F: |
med el combi
40+/med el combi 40+ |
As a result, significant superior speech
understanding (especially in noise) and acoustic orientation, can only
be achieved by bilateral cochlear implantation in "group D, E,
F patients". To obtain a subjective (and in performance evident)
benefit of a bilateral cochlear implantation, two multichannel fast
stimulators in quite symetric fitting parameters are mandatory. Otherwise
the "better" ear remains dominant. For the intended benefit
of bilateral implantation, we recommend bilateral cochlear implantation
in a "group D, E, F" situation only.
All 14 implanted children are group E or F and wear both implants with behind
the ear speech processors all over the day.
Seven school age children (100%) attend regular mainstream school sucessfully.
Children and parents report about a superior life quality, which is correlated
to enhanced speech understanding (especially in noise) and increased acoustical
orientation. Parents and teachers report directional hearing and enhanced "ease” in
speech understanding and speech production. All (n=14) children and families
are doing well, in every day life these children appear like nearly "normal” hearing
kids.
Our data and experience with these families suggest, that bilateral cochlear
implantation should be at least considered, even in younger children, or performed,
whenever audiologically, anatomically and/or financially possible.
Contact Information
ENT University Department Vienna
Waehringer Guertel 18-20
1097 Vienna, Austria
Phone: +43-664 302 36 88 fax: +43-1 40400 3332
E-mail: wolf-dieter.baumgartner@akh-wien.ac.at
Web: www.univie.ac.at/cochlear
|
