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Background <p>Among all sensory deficiencies, hearing impairment is thought to be the most common. Communication in hearing-impaired persons depends on the amount of residual hearing, type of deafness, language skills, age of onset of hearing difficulty, speech-reading skills and educational background (J Speech Lang Hear Res 65:3539–3547, 2022). The objective of this work was to compare the language and speech acquisition and perception in children with bimodal fitting and those with unilateral cochlear implantation. This study was carried out on 30 patients with pre-lingual hearing impairment who underwent unilateral cochlear implantation surgery—15 with unilateral cochlear implant and 15 with bimodal fitting—to evaluate the outcome after language and speech therapy with bimodal fitting and unilateral cochlear implant CI. Complete pre-operative and post-operative phoniatric evaluation was done 6&#xa0;months after finishing programming of the cochlear implant device with intensive language and speech therapy for 12&#xa0;months through applying the Modified Preschool Language Scale (PLS4) (Ain Shams Med J 14:10–18, 2011) and Articulation Test (Kotby et al., Standardization of an articulation test, 1986) and The Auditory Skills Checklist (ASC) (Ann Otol Rhinol Laryngol 116:812–818, 2007).</p> Results <p>The results suggested that the bimodal fitting improved total language age over the unilateral cochlear implantation as there is a statistically significant difference between mean of total language age in bimodal group (28 ± 6&#xa0;months) than mean of total language age in bimodal group (34.47 ± 6.34&#xa0;months) as (<i>t</i> = −&#xa0;2.24, <i>p</i> = 0.006). As regards receptive language age there was a highly statistically significant difference between mean of receptive language age in unilateral group (29.87 ± 7.8&#xa0;months) versus mean of receptive language age in bimodal group (37.6 ± 6.3&#xa0;months) as (<i>t</i> = −&#xa0;2.9, <i>p</i> = 0.006).</p> Conclusion <p>Bimodal stimulation demonstrated superior language outcomes compared with unilateral cochlear implantation in children with pre-lingual hearing loss. Significant improvements were seen in both expressive and receptive language domains following 12&#xa0;months of treatment, and articulatory results were similar across groups. In order to maximize early language development in children with aidable residual hearing, our results recommend the use of bimodal fitting.</p>

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Bimodal versus unilateral cochlear implantation in early childhood: impacts on language and speech-perception outcomes

  • 期刊论文

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  • 发表日期：

    2026年3月19日

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  • Nehal Adel Lotfy Ahmed,
  • Mona Abd El-Fattah Hegazi,
  • Amal El Sayed Saber,
  • Mohamed El Said Darweesh,
  • Yomna Hassan Elfiky

摘要

Background

Among all sensory deficiencies, hearing impairment is thought to be the most common. Communication in hearing-impaired persons depends on the amount of residual hearing, type of deafness, language skills, age of onset of hearing difficulty, speech-reading skills and educational background (J Speech Lang Hear Res 65:3539–3547, 2022). The objective of this work was to compare the language and speech acquisition and perception in children with bimodal fitting and those with unilateral cochlear implantation. This study was carried out on 30 patients with pre-lingual hearing impairment who underwent unilateral cochlear implantation surgery—15 with unilateral cochlear implant and 15 with bimodal fitting—to evaluate the outcome after language and speech therapy with bimodal fitting and unilateral cochlear implant CI. Complete pre-operative and post-operative phoniatric evaluation was done 6 months after finishing programming of the cochlear implant device with intensive language and speech therapy for 12 months through applying the Modified Preschool Language Scale (PLS4) (Ain Shams Med J 14:10–18, 2011) and Articulation Test (Kotby et al., Standardization of an articulation test, 1986) and The Auditory Skills Checklist (ASC) (Ann Otol Rhinol Laryngol 116:812–818, 2007).

Results

The results suggested that the bimodal fitting improved total language age over the unilateral cochlear implantation as there is a statistically significant difference between mean of total language age in bimodal group (28 ± 6 months) than mean of total language age in bimodal group (34.47 ± 6.34 months) as (t = − 2.24, p = 0.006). As regards receptive language age there was a highly statistically significant difference between mean of receptive language age in unilateral group (29.87 ± 7.8 months) versus mean of receptive language age in bimodal group (37.6 ± 6.3 months) as (t = − 2.9, p = 0.006).

Conclusion

Bimodal stimulation demonstrated superior language outcomes compared with unilateral cochlear implantation in children with pre-lingual hearing loss. Significant improvements were seen in both expressive and receptive language domains following 12 months of treatment, and articulatory results were similar across groups. In order to maximize early language development in children with aidable residual hearing, our results recommend the use of bimodal fitting.