Bilateral CI research findings

I will post my findings on the issue of bilateral CI on my blog. Hopefully it helps someone else too…

I want to collect the data concerning this debate, in order to get an oversight of what the medical community discover, as well as what they are writing and thinking about this issue.

Papers found in PubMed:

Patients fitted with one (CI) versus two (CI+CI) cochlear implants, and those fitted with one implant who retain a hearing aid in the non-implanted ear (CI+HA), were compared using the speech, spatial, and qualities of hearing scale (SSQ) (Gatehouse & Noble, 2004). The CI+CI profile yielded significantly higher ability ratings than the CI profile in the spatial hearing domain, and on most aspects of other qualities of hearing (segregation, naturalness, and listening effort). A subset of patients completed the SSQ prior to implantation, and the CI+CI profile showed consistently greater improvement than the CI profile across all domains. Patients in the CI+HA group self-rated no differently from the CI group, post-implant. Measured speech perception and localization performance showed some parallels with the self-rating outcomes. Overall, a unilateral CI provided significant benefit across most hearing functions reflected in the SSQ. Bilateral implantation offered further benefit across a substantial range of those functions.
(Link to more information about this paper)

Speech perception tests were performed preoperatively before the second implantation and at 3 months postoperatively. RESULTS: Results revealed significant improvement in the second implanted ear and in the bilateral condition, despite time between implantations or length of deafness; however, age of first-side implantation was a contributing factor to second ear outcome in the pediatric population. CONCLUSION: Sequential bilateral implantation leads to significantly better speech understanding. On average, patients improved, despite length of deafness, time between implants, or age at implantation.
(Link to more information about this paper)

The average group results in this study showed significantly greater benefit on words and sentences in quiet and localization for listeners using two cochlear implants over those using only one cochlear implant. One explanation of this result might be that the same information from both sides are combined, which results in a better representation of the stimulus. A second explanation might be that CICI allow for the transfer of different neural information from two damaged peripheral auditory systems leading to different patterns of information summating centrally resulting in enhanced speech perception. A future study using similar methodology to the current one will have to be conducted to determine if listeners with two cochlear implants are able to perform better than listeners with one cochlear implant in noise.
(Link to more information about this paper)

The Let Them Hear Foundation have done their own research:

Despite many insurers’ (in the US; my comment) continued erroneous assertions to the contrary, bilateral cochlear implantation is NOT an experimental or investigational procedure, and is medically necessary.  Bilateral cochlear implantation in children has been an accepted, mainstream medical practice since 1998.  Over 3000 have been performed, including over 1600 on children.

Several studies have shown that there is a vast improvement in sound localization ability in patients with bilateral cochlear implants.  In particular, the group of subjects who received a significant amount of improvement when bilaterally implanted were those who were initially implanted at a very early age, as Andrew was.  In September 2005, an international consortium of cochlear implant specialists published an article in the widely respected journal “Acta Oto-Laryngologica” formally recommending that all children with permanent bilateral profound hearing losses receive bilateral cochlear implants.  A recent publication by industry-leading otologist Dr. Robert Peters stated that:

Provision of binaural hearing should be considered the standard of care for hearing-impaired patients whenever it can be provided without significant risks. In severe to profoundly hearing impaired individuals, this can only be provided with bilateral cochlear implantation when hearing aids are inadequate. In carefully selected candidates, the benefits derived are significant, the surgical procedures well tolerated, and negative effects infrequent in both children and adults.

A second recent paper by well-known communications disorder specialist Dr. Ruth Litovsky concluded that: Bilateral CIs can offer a combination of benefits that include better ear effects, binaural summation/redundancy effects and binaural unmasking. These effects have been illustrated in numerous patients world-wide; continued work in this field will no doubt lead to further improvements and increases in the size of each of these effects, for adults and for children.Please refer to the following publications for additional information.

Another medical benefit of bilateral cochlear implantation is that it has been shown to improve speech recognition in noisy environments.  It is expected that once that a patient’s hearing with the second cochlear implant in place is maximized, they will notice a significant improvement in understanding speech in noisy environments.  Comprehending speech amidst background noise occurs commonly in real-life situations, especially in classroom settings and learning environments, at the dinner table, or while talking in a car or on a plane.  Please refer to the following studies for more details:
read more from their conclusions here…..

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The relief of a summer

This summer I felt better than I have in many years. Somehow I think getting away also meant that my mental self got away for a while. I did what I said before in this blog: I left it all (about my hearing and thinking about it and being tired from it) behind and “forgot” it. It was a really good summer for me with one exception: my girlfriend had to work and couldn’t join me… But with a little help from my friends….

I was really busy: Viking-festival, a little party almost every night with my friends from Poland, a bicycle-trip almost every day while in Poland, spending time with my son, and spending time with my family at our place in Sweden and fixing it up even more. I got a energy boost from getting away and doing physical work and exercise outdoor with fresh air and the beauty of nature around me.

Coming home was hard, I could feel the weight of my life right now coming down on my shoulders… I’m not complaining, but explaining the fact that psychology has a huge factor in my situation. Coming home reminded me of everything: not being able to work, waiting for the CI, missing my girlfriend badly, getting tired from spending time with friends and family in a social situation (I was really exhausted after the vacation, in a good way, and I still haven’t rested up again, it feels like.)

So now I’m almost back into the everyday routine that I have had the last two years; and it is hard. It isn’t really bad, but it is certainly a burden that requires that I keep thinking about the positive and do all I can to keep bad thoughts at bay.

I was interviewed by the Norwegian Hard Of Hearing association membership-magazine today (it is called “Din Hørsel” (Your Hearing), will get back to that when it’s published sometime in late September or early October.

It was an interview about me waiting for so long for the CI…

Also the the struggle for getting bilateral rather than unilateral CI has begun for me. I finally got into contact with Sheri Byrne from the Let them hear foundation, the US lawyer who won 325 or-so lawsuits against the insurance-companies who in the beginning declined bilateral CI stating that one was sufficient for everyone… (would you accept good sight on one eye rather than on both?)

Anyway, I’m back after a long nice summer, and will continue to write more in this blog. Keep reading, and I really appreciate all comments given, even negative ones… I’m all for freedom of speech.

Posted in hearing. 1 Comment »

Scientific proof in favor of bilateral CI

Hello, world! I’m back after long and nice vacation. Had a great time. Now I’m ready for another year of blogging about waiting for my CI. Will initially start up with a plea for help about information.

I need arguments in favor of bilateral Cochlea Implants. I wish to operate on both ears simultaneously for several reasons: one surgery and be done with it. One time recovery instead of two. I will benefit from doing the same drastic change to both ears at the same time as opposed to operating both with years between. I risk getting an imbalance between my two ears that will take long time to adjust if it will be several years between both surgeries (if I’m ever allowed a second surgery that is…)

Could my readers help me with finding research material concerning this topic?

I found this piece of information on the net:

Benefits of bilateral are much more than just the obvious cost benefit, or the sound-booth measurable difference. As I’ve investigated whether to get a bilateral for my 6-year-old son, I’ve spoken to many, many adults and parents of children with bilaterals.

Here’s what I’m being told, over and over: Science (sound-booth tests) says it’s a 10-20% benefit. However, science can’t measure how much less exhausted I (or the child) am at the end of the day – how much more I (or the child) feel willing to participate in groups, how much more conversation I’m getting. All of this eventually translates into costs, later in life.

If I ask the scientists, they say the benefits (measurable) are
* Improved distance hearing
* Improved incidental hearing
* Improved localization of sound
* Improved performance in sound-to-noise settings

Ask the recipients themselves, or their parents, they add:
* Improved enjoyment of music
* Improved hearing in group settings (isn’t life one big group setting – especially childhood?)
* Exhaustion factor, read above

Some studies show that unilaterally deaf children are ____ 10 times _____ more likely to fail a grade in school. Unilateral implant recipients seem to me to fit into this category.

 

Would it be possible to find papers and studies about these things that can count as proof in the legal or bureaucratic system?

Also I found this this name: Sheri Byrne-Haber (link to article about her work in the US). Does anybody have her email-address? I’d like to get in touch with her to see if she can share some of her arguments…