Bilateral Cochlear Implantation - Our Experience
Introduction. Cochlear implantation is a widely used method of auditory rehabilitation in patients with sensorineural deafness. One of the most progressive directions in cochlear implantation is bilateral cochlear implantation, which involves placing cochlear implants in both ears. The effectiveness of cochlear implantation in the second ear depends on the duration of the hearing loss, the time of the first operation, the experience of using the hearing aid on the untreated ear, and the interval between the implantation of the first and the second ear. Purpose. Evaluation of the effectiveness of bilateral cochlear implantation in the Republic of Belarus. Materials and methods. The study included 16 patients (8 boys and 8 girls) at the age from 8 months to 15 years diagnosed with WHO chronic sensorineural deafness. All patients underwent bilateral cochlear implantation at the Republican Center for Research and Practice in Otolaryngology from 2008 to 2019. Fourteen of the mentioned patients received sequential bilateral cochlear implantation and 2 patients received instantaneous implantation. All patients underwent telemetry of the nervous response, registering the brainstem auditory evoked response at the apical and central sections, programming the speech processor based on subjective responses, and tone audiometry in the free sound field. The effectiveness of auditory rehabilitation was analysed according to the level of speech development of patients, their ability to learn on the program of public pre-school and school institutions, and social adaptation of children. Results. Speech intelligibility after monaural CI was not more than 90 %, after bilateral CI - up to 95%. In six months after the completion of the bilateral cochlear implantation, one patient (6.25 %) had unsatisfactory auditory rehabilitation result, two patients (12.5 %) had a satisfactory one, nine patients (56.25 %) had a good one, and the results of four patients (25 %) were rated as excellent. No unsatisfactory results of rehabilitation were recorded in infants. Conclusions. The period of rehabilitation after bilateral cochlear implantation in children depends on the following: the period of deafness, the age at which the surgery was performed, the quantity and quality of the training carried out by specialists and parents, the time elapsed from connecting the voice processor. Instantaneous bilateral implantation has significant advantages: reduced operational risk, reduced narcosis time, symmetrical development of the structures of auditory conductive pathways and cortical centers, rapid development of genuinely binaural hearing.