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EBP Compendium: Summary of Systematic Review

A Meta-Analytic Comparison of Binaural Benefits between Bilateral Cochlear Implants and Bimodal Stimulation

Schafer, E. C., Amlani, A. M., et al. (2007).
Journal of the American Academy of Audiology, 18(9), 760–776.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication No
Included studies are assessed for study quality No
Quality assessments are reproducible No

Description: This is a meta-analysis of studies investigating the outcomes for individuals using bilateral cochlear implants or bimodal stimulation.

Question(s) Addressed:

Question not specifically stated.

Population: Subjects with bilateral cochlear implants (CI) or bimodal input

Intervention/Assessment: Bilateral cochlear implants or bimodal input compared to monaural cochlear implant or hearing aid.

Number of Studies Included: 16

Years Included: January 2000–December 2005



  • Hearing/Balance Treatment 
    • "The general findings of this study indicate that cochlear implant users who are stimulated binaurally—either bilateral or bimodal—will perform significantly better at fixed levels of noise than a listener having a monaural cochlear implant or hearing aid. In fact, bilateral and bimodal stimulation was found to provide listeners with an overall average improvement ranging from 15.3 to 30.7 percentage points across the combined effects of binaural summation, binaural squelch, and the head-shadow effects compared to a monaural cochlear implant or hearing aid. The binaural-listening improvements were similar between users of bilateral implants and bimodal stimulation" (pp. 770–771). 
    • "Given the results of the meta-analysis and the consistent reports of subjective benefits in the literature, clinical recommendations regarding the use of bimodal or bilateral listening arrangements are supported" (p. 774).  

Keywords: Hearing Loss; Deafness; Cochlear Implants

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Added to Compendium: August 2010

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