Key words: Bilateral cochlear implant- unilateral cochlear implant – sequential implantation- localization- speech and language acquisition

Cochlear implantation for those persons suffering from profound, irreversible sensorineural hearing loss is well established beneficial treatment modality. Cochlear Implants are highly effective for the restoration of hearing in these situations.

It is equally effective in children as well as adults.

(A) What are the benefits of inserting cochlear implants versus that in one ear alone?

Insertion of bilateral cochlear implants in both ears gives the benefits of

1. (a) Greatly improved clarity of hearing.
2. (b) Ability to localize direction from where the sound/ sounds are emanating.
3. (c) Greatly improved clarity of hearing in a busy (noisy) environment.
4. (d) This leads to improved speech and language acquisition skills, better integration with society and fewer behavioral problems.

(B) What is the evidence that bilateral cochlear implantation is more beneficial that unilateral insertion?

1. The cochlear implants were simultaneously inserted before / at the age of 2.
2. Therapy was given as per the protocols (twice a week audio verbal therapy for a minimum period of 2 years),
3. No other disability was present concurrently.

(B) Audiologically their performance was far superior than those with a unilateral cochlear implant.

(C) Psychosocially Bilateral Cochlear Child Implantees were found to be better adjusted to their surroundings than those with unilateral cochlear implants.

(C) Should cochlear implants be inserted bilaterally in the same sitting or should they be inserted sequentially ( the second implant inserted later)?

There is substantial evidence that both cochlear implants should be inserted at the same sitting. This is because the hard and soft ware of both devices can be matched and synchronized. Since the technology of both the devices is the same it is easier to match and synchronize.

(D) Sequential Cochlear implantation:

Having a second cochlear implant inserted even if it is delayed is better than not having the second implant inserted. However, the second device should be inserted at the soonest. The problem associated with sequential cochlear implant insertion is that the technology of the second device may not match the technology of the first device. It has been shown that a one year delay in second cochlear implant surgery caused a delay of 1.3 years delay in receptive vocabulary.

(E) Can cochlear implants from another company be inserted as the second device?

(D) Are Bilateral Cochlear Implantation beneficial in adults?

For adults who have gone deaf in both ears they experience significant improvement in conducting their daily lives once they undergo bilateral cochlear implantation. Since adults have already acquired speech and language therapy is much easier and much more rewarding. Cochlear Implantation, especially bilateral cochlear implants allow adults to hear better and respond meaningfully to conversations. This in turn results in active social integration which results in lessening depression and quick adjustments that were impaired with deafness.

Recent reports have shown that the restoration of hearing through cochlear implantation has helped prevent Alzheimer’s disease and on occasion reverse early dementia.