Should a hearing aid in the contralateral ear be recommended for children with a unilateral cochlear implant?

Objectives: To predict bimodal benefit before cochlear implantation, we compared the performances of participants with bimodal fitting and with a cochlear implant alone on speech perception tests. Methods: Twenty-two children with a cochlear implant in one ear and a hearing aid in the other (bimodal fitting) were included. Several aided and unaided average hearing thresholds and the aided word recognition score of the hearing aid ear were related to the bimodal benefit on a phoneme recognition test in quiet and in noise. Results with bimodal fitting were compared to results with the cochlear implant alone on a phoneme recognition test in quiet and in noise. Results: No relationship was found between any of the hearing thresholds or the aided phoneme recognition score of the hearing aid ear and the bimodal benefit on the phoneme recognition tests. At the group level, the bimodal scores on the phoneme recognition tests in quiet and in noise were significantly better than the scores with the cochlear implant alone. Conclusions: Preoperatively available audiometric parameters are not reliable predictors of bimodal benefit in candidates for cochlear implantation. Children with unilateral implants benefit from bimodal fitting on speech tests. This improvement in performance warrants the recommendation of bimodal fitting even when bimodal benefit cannot be predicted.