Bilateral Cochlear Implantation in Children: A Systematic Review and Best-Evidence Synthesis

Objectives/Hypothesis: To evaluate the effectiveness of bilateral cochlear implantation over unilateral implantation in children with sensorineural hearing loss. Data Sources: Pubmed, Embase, and Web of Science. Review Methods: All studies comparing a bilateral cochlear implant group with a unilateral implant group were included. Results: Twenty-one studies compared a bilateral cochlear implant group with a unilateral group. No randomized trials were identified. Due to the clinical heterogeneity, statistical pooling was not feasible and a best-evidence synthesis was performed. The results of this best-evidence synthesis indicate the positive effect of the second implant for especially sound localization and possibly for preverbal communication and language development. There was insufficient evidence to make a valid comparison between bilateral implantation and a bimodal fitting. Conclusion: Although randomized trials are lacking, the results of our best-evidence synthesis indicate that the second cochlear implant might be especially useful in sound localization and possibly also in language development.