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The side of cochlear implantation and speech intelligibility in pediatric and adult cochlear implantees




A cochlear implant (CI) is an auditory prosthesis that stimulates the primary auditory nerve fibers electrically to elicit sound perception in individuals with severe-to-profound sensorineural hearing impairments. Speech intelligibility is a joint product of a speaker and a listener and can provide a close approximation of an individual’s everyday communication status, and cochlear implants can facilitate the development of speech and language skills in prelingually deaf patients.


The aim of this work was to study whether there is an advantage of one ear in the improvement of speech intelligibility in pediatric and adult cochlear-implanted patients.

Study design

A cross-sectional study to assess the speech intelligibility of right and left cochlear-implanted patients.

Patients and methods

The study included 50 cochlear-implanted patients (24 male and 26 female): 25 of the patients were prelingual and 25 were postlingual. Twenty-six of the patients were implanted on the right ear and 24 were implanted on the left ear. Speech intelligibility assessment was conducted using the Arabic Speech Intelligibility test. This Arabic Speech Intelligibility test is meant to be an objective measure as the examiner does not have to evaluate how a word was said.


The results revealed that there was no significant difference between the speech intelligibility percentage regarding the onset of deafness (prelingual or postlingual), the sex and the duration of therapy, but there was a significant difference between the speech intelligibility percentage in right-ear-implanted and left-ear-implanted patients, with marked advantage for the implanted right ear.

Conclusion and recommendation

Right-ear cochlear implantation has an advantage over left-ear implantation regarding the speech intelligibility. Hence, in case of bilateral profound deafness of the same degree with no anatomical complications in either of the ears, it is recommended to choose the right ear for cochlear implantation.


  1. Tobey E, Geers A, Brenner C, Altuna D, Gabbert G. Factors associated with development of speech production skills in children implanted by age five. Ear Hear 2003; 24: 36S–45S.

    Article  Google Scholar 

  2. Chin S, Bergeson T, Phan J. Speech intelligibility and prosody production in children with cochlear implants. J Commun Disord 2012; 45: 355–366.

    Article  Google Scholar 

  3. Bunton K, Kent R, Kent J, Duffy J. The effects of flattening fundamental frequency contours on sentence intelligibility in speakers with dysarthria. Clin Linguist Phon 2001; 15: 181–193.

    Article  Google Scholar 

  4. Kent R, Miolo G, Bloedel S. The intelligibility of children’s speech: a review of evaluation procedures. Am J Speech Lang Pathol 1994; 3: 81–95.

    Article  Google Scholar 

  5. Svirsky M, Chin S. Speech production. In: Waltzman SB, Cohen NL, editors. Cochlear implants. New York: Thieme Medical; 2000. 293–309.

    Google Scholar 

  6. Loring D, Meador K, Lee G, Murro A, Smith J, Flaningin H. Cerebral language lateralization: evidence from intracarotid amobarbital testing. Neuropsychologica 1990; 28: 831–838.

    Article  CAS  Google Scholar 

  7. Breier J, Hiscock M, Jahrsdoerfer R, Gray L. Ear advantage in dichotic listening after correlation for early congenital hearing loss. Neuropsychologica 1998; 36: 209–216.

    Article  CAS  Google Scholar 

  8. Jensen J, Borre S, Jhansen P. Unilateral sensorineural hearing loss in children: cognitive abilities with respect to right/left ear differences. Br J Audiol 1989; 23: 215–220.

    Article  Google Scholar 

  9. Justice L. Communication sciences and disorders: an introduction. Upper Saddle River, New Jersey: Pearson Merrill Prentice Hall; 2006.

    Google Scholar 

  10. Kotby MN, Khairy A, Barakah M, Rifaie N, El-Shobary A. Language testing of Arabic speaking children. In: Kotby MN, editor. Proceedings of the XXIII world congress of the International Association of Logopedics and Phonetics (August 6–10). Cairo, Egypt; 1995. 263–266.

  11. Abdel Hamid A, Bassiouny S, Hegazi M, Saber A, Nassar G, Ibrahim A. Development of Arabic Speech Intelligibility test for children [MD thesis]. Cairo: Unit of Phoniatrics, Faculty of Medicine, Ain Shams University; 2010.

    Google Scholar 

  12. Popelar J, Erre J, Aran J, Cazals Y. Plastic changes in ipsi-contralateral differences of auditory cortex and inferior colliculus evoked potentials after injury to one ear in the adult guinea pig. Hear Res 1994; 72: 125–134.

    Article  CAS  Google Scholar 

  13. Hartvig Jensen J, Borre S, Johansen P. Unilateral sensorineural hearing loss in children: cognitive abilities with respect to right/left ear differences. Br J Audiol 1989; 23:215–222.

    Article  CAS  Google Scholar 

  14. Niedzielski A, Humeniuk E, Blaziak P, Gwizda G. Intellectual efficiency of children with unilateral hearing loss. Int J Pediatr Otorhinolaryngol 2006; 70: 1529–1532.

    Article  Google Scholar 

  15. Henkin Y, Taitelbaum-Swead R, Hildesheimer M, Migirov L, Kronenberg J, Kishon-Rabin L. Is there a right cochlear implant advantage. Otol Neurotol 2008; 29: 489–494.

    Article  Google Scholar 

  16. Buarque L, Brazorotto J, Cavalcanti H, Lima L Jr, Lima D, Ferreira M. Auditory performance during a period of time in cochlear implant users with postlingual hearing loss. Audiol Commun Res 2013; 18: 120–125.

    Article  Google Scholar 

  17. Morris L, Mallur P, Roland J, Waltzman S, Lalwani A. Implication of central asymmetry speech processing on selecting the ear for cochlear implantation. Otol Neurotol 2007; 28: 25–30.

    Article  Google Scholar 

  18. Deguine O, Garcia de Quevedo S, Fraysse B, Cormary X, Uziel A, Demonet J. Criteria for selecting the side for cochlear implantation. Ann Otol Rhinol Laryngol Suppl 1995; 166: 403–406.

    PubMed  CAS  Google Scholar 

  19. Allen M, Nikolopoulos T, O’Donoghue G. Speech intelligibility in children after cochlear implantation. Am J Otol 1998; 19: 742–746.

    PubMed  CAS  Google Scholar 

  20. Calmels M, Saliba I, Wanna G, Cochard N, Fillaux J, Deguine O, et al. Speech perception and speech intelligibility in children after cochlear implantation. Int J Pediatr Otorhinolaryngol 2004; 68: 347–351.

    Article  Google Scholar 

  21. Lenarz M, Sonmez H, Joseph G, Buchner A, Lenarz T. Long-term performance of cochlear implants in postlingually deafened adults. Otolaryngol Head Neck Surg 2012; 147: 112–118.

    Article  Google Scholar 

  22. Manrique M, Espinosa J, Huarte A, Molina M, Garcia-Tapia R, Artieda J. Cochlear implants in postlingual persons: results during the first five years of the clinical course. Acta Otorrinolaringol Esp 1998; 49: 19–24.

    PubMed  CAS  Google Scholar 

  23. Manrique M, Ramos A, Morera C, Cenjor C, Lavilla M, Boleas M, et al. Analysis of the cochlear implant as a treatment technique for profound hearing loss in pre and postlocutive patients. Acta Otorrinolaringol Esp 2006; 57: 2–23.

    Article  CAS  Google Scholar 

  24. Klop W, Boermans P, Ferrier M, Van den Hout W, Stiggelbout A, Frijns J. Clinical relevance of quality of life outcome in cochlear implantation in postlingually deafened adults. Otol Neurotol 2008; 29: 615–621.

    Article  Google Scholar 

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Correspondence to Abdelhamid A. Mohammed MD.

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Mohammed, A.A., Sarwat, S.A. The side of cochlear implantation and speech intelligibility in pediatric and adult cochlear implantees. Egypt J Otolaryngol 30, 362–366 (2014).

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