“Aural Patching” After Bilateral Cochlear Implantation Is Challenging for Children With Prior Long-Term Unilateral Implant Experience

Objectives: To assess the use of “aural patching” as a strategy to potentially reduce the known persistence of aural preference in children receiving bilateral cochlear implants (CIs) with long inter-implant delays by removing the first device to increase stimulation to the second implanted side. Design: Children/adolescents who received a second CI at 12.8 ± 3.5 years of age after 9.4 ± 2.9 years of unilateral CI use were asked to remove their first CI for regular periods daily (aural patching). Their compliance was monitored, and asymmetries in speech perception were measured at the end of the study period. Results: Partial adherence to aural patching over the first few months of bilateral hearing use markedly declined with time. As expected, the group demonstrated asymmetries in speech perception that were not significantly affected by the limited aural patching. Conclusions: The aural patching protocol was a challenge to maintain for most children and families studied, reflecting both the expected aural preference for the first implanted ear and their challenges to reverse it.