Health experts at the Second Meeting Consensus on Auditory Implants held in Valencia, Spain in February 2004 made the following recommendations:

“Bilateral cochlear implantation (CI) should be recommended in the following types of patient:

1. Those in whom the benefits obtained with one CI is poor.
2. In meningitis, that is developing cochlear ossification the implantation should be performed as soon as possible to achieve full insertion.
3. Those who want to restore binaural hearing or need it in order to remain in their chosen profession.
4. Children with permanent bilateral profound hearing loss. Special attention should be paid to young children who are in their speech and language acquisition periods.”

(E. Offeciers (Belgium), C. Morera (Spain), J. Muller (Germany), A. Huarte (Spain), J. Shllop (USA) & L. Cavelle (Spain), International consensus on bilateral cochlear implants and bimodal stimulation, 2004).

The Board of Directors of the Hearing Committee of the American Academy of Otolaryngology Head and Neck Surgeons has approved a position statement for bilateral cochlear implantation.

It reads as follows:

Position statement on bilateral cochlear implantation

“Although unilateral cochlear implantation (CI) generally provides good speech understanding in quiet, and has been highly successful in rehabilitation of deaf adults and children, patients with only one CI frequently report difficulty in every day listening conditions.

“Localization of sounds is not possible with only one implant, often creating a safety issue, and hearing in noise is very difficult. Over the past decade, a substantial literature has accumulated demonstrating improved speech intelligibility and sound localization with bilateral CIs. These findings are consistent with the psychoacoustic literature that shows the importance of bilateral hearing for normal hearing people and hearing aid recipients.

“The head shadow effect and central effects, based on integration of timing, frequency and level from the two ears, are possible only with binaural hearing and significantly improve speech understanding and sound localization compared to listening with only one CI. The literature is clear that both children and adults perform better with two CIs than with one.

“The William House Cochlear Implant Study Group acknowledges the findings reported in the literature and strongly endorses bilateral cochlear implantation in profoundly deaf adults and children. Bilateral cochlear implantation is now considered accepted medical practice.”