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Implant cochléaire

Bilateral implantation

Mots clefs

bilateral, implantation, "second cochlear implant", "two cochlear implants"

Description

Français


Since 2012 in Quebec, the bilateral implantation (a cochlear implant in each ear) is now funded by the Ministry of Health and Social Services, according to certain criteria and in limited numbers. The Centre québécois d'expertise en implant cochléaire (CQEIC) must therefore establish priorities among the requests received for bilateral implantation.

The CQEIC recommends two sequential surgeries for bilateral implantation. These two surgeries can also be performed simultaneously, especially in the case of meningitis.


It is important to recognize that bilateral implantation is not appropriate for everyone. Based on clinical experience and current research, the CQEIC has determined that individuals with the following characteristics will not be considered for a 2nd cochlear implant at this time :

  • Persons over 70 years old, notably due to the overly high risk of serious balance disorders.
  • Children over 13 years old with profound deafness from birth who have never had the non-implanted ear stimulated by a hearing aid.
  • Adults who are profoundly deaf in the non-implanted ear and have not had that ear stimulated by a hearing aid over the past 30 years.
  • People with a permanent balance disorder.


If you proceed with a second cochlear implantation, the equipment you already own for the 1st implant cannot be replaced with a newer model. It is therefore likely you will be wearing two different processors.

Potential Benefits

  • Possible improvement in sound localization. 

  • Possible improvement in speech comprehension under challenging conditions such as in the presence of background noise (e.g., in a car, restaurant, classroom, etc.).

  • The benefits of a 2nd cochlear implant vary depending on the patient’s age when they received the 1st implant and the length of time between the two implantation procedures.

  • Research shows that the benefits are greatest in younger children who have had both procedures done no more than a few years apart.


Limitations

Speech comprehension in quiet surroundings is rarely improved with a second implant.

  • In children, the 2nd cochlear implant does not further enhance language development.

  • For some people, the use of a hearing aid on the non-implanted ear may be preferable to a bilateral cochlear implantation.

  • For children who are born deaf, there seems to be a critical period following the 1st cochlear implant beyond which the addition of a 2nd implant is unlikely to bring about functional speech perception in the second ear.

  • In adults, the benefits of a 2nd implant may be very limited or non-existent, especially among those with long-term deafness and whose non-implanted ear has rarely or never been stimulated by a hearing aid.


Other Considerations

Medical factors :
  • Medically speaking, bilateral implantation may be inappropriate, inadvisable, or even contraindicated in certain people.
  • The procedure is not without risk, and the same complications associated with the 1st cochlear implant may occur.
  • The 2nd implant may also lead to other complications such as balance disorders. It is a good idea to talk to your surgeon about any concerns you might have.

Motivation :
  • The second implantation requires the same post-surgical process as the first, namely a period of programming followed by intensive rehabilitation, so you need to be very motivated !


Technical factors :
  • Patients must also consider that the cost of batteries and certain accessories will be double with two cochlear implants.

  • Please remember that if you proceed with a second cochlear implantation, the equipment you already own for the 1st implant cannot be replaced with a newer model. It is therefore very likely you will be wearing two different sound processors.


Procedure

To apply for an evaluation of your application for a 2nd cochlear implant :

 

Documents to send for the analysis of your file :

In order for us to follow up on your request for a 2nd cochlear implant, please send us the most recent of the following documents (if you have had a consultation or a follow-up appointment) : 

  • Reply slip
  • ​Audiology report (auditory skills assessment).
  • Audiogram (done in the last 6 months) for the non-implanted ear.

  • Speech therapy report.

  • Psychological assessment.

  • Any other relevant assessment.

  • If you are using  a hearing aid in the non-implanted ear, have your audiologist or hearing aid specialist complete the Professional Opinion on the Hearing Aid (done in the last 6 months).


A copy of these reports must be sent to each of the following facilities : 


CHU de Québec-UL, L'Hôtel-Dieu de Québec 
Audiology service (Cochlear implant) 
11 côte du Palais, 
Québec City, Québec G1R 2J6 

Institut de réadaptation en déficience physique de Québec 
Secrétariat du programme en déficience auditive 
Enfants/Adolescents et Implant cochléaire tous âges 
2975 chemin Saint-Louis 
Québec City, Québec G1W 1P9 


What will be the next steps ?
  • We will only analyze your application after receiving complete documentation.

  • Once we have all the necessary information, we will contact you as soon as possible to set an appointment date, taking into account our established priorities.

  • You must come to the CHU de Québec (Hôtel-Dieu de Québec) and the IRDPQ to meet with specialists of various fields. You must also undergo medical tests (e.g., radiology exam; vertigo tests if possible, depending on your age; etc.). We will then be able to determine the feasibility of a 2nd implantation and establish your prognosis.

Dernière révision du contenu : le 8 octobre 2019

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