In an ideal world, if you could increase the clinical use of bilateral cochlear implant (CI) treatment, would you? If you’re interested in exploring the clinical benefits of bilateral CIs, or how reviews can directly inform patient care, this systematic review and meta-analysis is worth reading. Since the first bilateral CI translational research studies were conducted in 1998, use of bilateral CIs has increased, particularly in children. Recognised benefits of bilateral implantation for bilateral sensorineural hearing loss (SNHL) encompass improved sound localisation and speech comprehension. Despite this, there is variability in adult bilateral CI indication guidelines and reimbursement among health systems. In contrast, unilateral implantation is widely utilised and accepted as being an effective intervention in adults with moderate-to-profound SNHL. In order to inform bilateral CI indication and funding guidelines, review of the literature on binaural hearing benefits of bilateral CIs is vital. Due to variation in magnitude and direction of benefit, the authors of this review focused on comparing hearing and quality of life (QOL) benefits between bilateral CIs and any other treatment modality, in adults with bilateral moderate-to-profound SNHL. The key aim was to compare bilateral and unilateral CIs, and to conduct a meta-analysis to estimate magnitude of change with bilateral implantation. In keeping with PRISMA guidelines, this review identified 35 studies published between 2005 and 2022, presenting comparative data between bilateral versus unilateral CIs in terms of sound localisation, speech perception and QOL. Most studies identified significant improvements in sound localisation and binaural redundancy with bilateral CIs. The meta-analysis identified statistically significant benefits in speech perception. General trends regarding head-shadow effect and binaural release from masking in bilateral CIs demonstrated improvement. Finally, significant improvements in hearing-specific QOL were observed. These findings highlight that bilateral CIs offer audiological benefits over unilateral implantation, and can improve hearing-specific QOL.
Benefits of bilateral cochlear implants
Reviewed by Sirat Lodhi
The benefit of bilateral cochlear implants in adults with bilateral sensorineural hearing loss: a systematic review and meta-analysis.
CONTRIBUTOR
Sirat Lodhi
Mersey and West Lancashire Teaching Hospitals NHS Trust, Aintree University Hospital, UK.
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