“Bilateral CI offers additional advantages over unilateral implantation including improved localisation of sound, improved speech understanding in quiet, improved speech understanding in background noise, stimulation of both auditory pathways, a guarantee that the better performing ear has been implanted, improvements in speech and language development in children, potential for normal central auditory development in children, music appreciation, subjective reports of improved sound quality and in the event that one device fails, the patient is not left without hearing.”

Cochlear implants for deafness in children and adults, a joint submission to NICE on behalf of: British Academy of Audiology, British Cochlear Implant Group, ENT UK. March 2007

“BCIG supports bilateral implantation:

• For all profoundly deaf children in order to stimulate both auditory pathways and optimise speech, language and auditory development and maximise potential academic achievement.
• For all profoundly deaf adults, unable to benefit from bimodal hearing
• For patients following meningitis or other risk of ossification, where failure to implant may result in obliteration of the cochlea, preventing future auditory stimulation.
• For patients with additional sensory handicap e.g. the deaf-blind, where there is a greater reliance on binaural hearing. Bilateral implantation offers this patient group improved speech understanding in quiet and in noise, the ability to localise sounds, essential for personal safety, and the important potential to more effectively monitor their environment through hearing.
• For patients who experience a loss of performance in the first implanted ear or deterioration of device function in the first ear but re-implantation in the same ear is contra-indicated. This may be because some residual function remains in the first device that would contribute to performance with a second implant. Other medical, surgical or anatomical factors may also preclude revision surgery in the first ear.
• For patients who agree to participate in research studies into bilateral implantation.”

(British Cochlear Implant Group policy statement on bilateral CI, 2007).

“Given the success of unilateral implantation, and the fact that hearing people use two ears, logic would indicate that two implants will provide even more benefit than one. We have over 20 children in our Group who have already benefited from bilateral implantation. They and their families are reporting that listening with a bilateral as opposed to a unilateral implant improves directional hearing and hearing in background noise, and that listening with two is easier than with one and is, therefore, less tiring”

Cochlear Implanted Children’s Support Group (CICS) submission to NICE, 2007.

“With regard to education; we have commented on the effect of a unilateral hearing loss; Bess (1986) showed that children with a unilateral hearing loss were ten times more likely to fail a grade, and twice as likely to have behavioural difficulties in the classroom. In the noisy classroom environment, the benefits of bilateral implantation are likely to become more apparent over time. Where bilateral implantation is more widely available, in Belgium, De Raeve (2007) reported that 100% of children with bilateral implants were in mainstream schools, compared with 54% of those with unilateral implants thus greatly increasing the potential for mainstream education, and hence for further educational cost savings, maximising the benefit of implantation for these children”

Ear Foundation submission to NICE, 2007.

“The quantitative benefits of bilateral hearing are clear: improved signal to noise ratios, binaural summation, binaural squelch and localisation of sounds. Qualitative benefits are externalisation by the user, a balanced 3D effect and restoration of the feel of “normal hearing”

National Cochlear Implant Users Association submission to NICE, 2007.

Canadian TV report on the Canadian version of the postcode lottery (some states in Canada fund bilateral CIs, some do not) canadian TV report