Kühn-Inacker H, Shehata-Dieler W, Müller J, Helms J
Center for Hearing Impaired Children, Würzburg, Germany.
Int J Pediatr Otorhinolaryngol. 2004 Oct;68(10):1257-66. doi: 10.1016/j.ijporl.2004.04.029.
The Würzburg bilateral cochlear implant (CI) program was started with the aim to improve the patients' communicative abilities in complex listening situations. In this study, the auditory skills of children using bilateral cochlear implants were evaluated.
Qualitative data based on free observations in the rehabilitation setup were collected in 39 bilaterally implanted children. A speech discrimination in noise test was performed in 18 of these children; lists of bisyllabic words were presented in noise at a signal to noise ratio (SNR) of +15 dB.
Qualitative and quantitative data show clearly that bilateral CI improves the children's communicative behaviour, especially in complex listening situations. Children examined with the speech in noise test scored significantly better under the bilateral condition compared to the unilateral condition. Integration of the second implanted side and use of binaural information was observed to be easier and faster in children with a short time lag between both implants.
To be able to obtain optimal benefit from bilateral cochlear implants, an intensive rehabilitation program is necessary. The important aspects of such a program are creating realistic expectations in older children before implantation; performing the first processor fitting of the second side with the first side switched on; and separate intensive training with the new system in order to balance out the hearing competence of the second CI with that of the first.
维尔茨堡双侧人工耳蜗植入（CI）项目启动的目的是提高患者在复杂听力环境中的沟通能力。在本研究中，对使用双侧人工耳蜗的儿童的听觉技能进行了评估。
在39名接受双侧植入的儿童中，基于康复环境中的自由观察收集了定性数据。其中18名儿童进行了噪声中的语音辨别测试；以+15 dB的信噪比在噪声中呈现双音节单词列表。
定性和定量数据清楚地表明，双侧人工耳蜗植入改善了儿童的沟通行为，尤其是在复杂听力环境中。与单侧情况相比，接受噪声中语音测试的儿童在双侧情况下得分明显更高。观察到在两次植入之间时间间隔较短的儿童中，第二植入侧的整合和双耳信息的使用更容易、更快。
为了能够从双侧人工耳蜗植入中获得最佳益处，强化康复计划是必要的。该计划的重要方面包括在年龄较大的儿童植入前设定现实的期望；在第一侧处理器开启的情况下进行第二侧的首次处理器适配；以及使用新系统进行单独的强化训练，以平衡第二个人工耳蜗与第一个人工耳蜗的听力能力。
