Evidence map›Paper›PMID 25668423›Full record

ArticlePloS one2015

Binaural fusion and listening effort in children who use bilateral cochlear implants: a psychoacoustic and pupillometric study.

Morrison M Steel, Blake C Papsin, Karen A Gordon

Erratum issued Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03212924 (Evaluation of Listening Effort With Pupillometry in Cochlear Implant Users), which is not on this map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03212924 nacompletednot on this mapstarted 2017, after this paper: background citation

Evaluation of Listening Effort With Pupillometry in Cochlear Implant Users

TypeinterventionalSponsorOticon MedicalRan2017 to 2018Enrolled16ConditionsSensorineural Hearing Loss, Cochlear Hearing LossArmsPupillometry, Evaluation of speech comprehension in quiet, Evaluation of speech comprehension in noise, MOCA, auto evaluation of listening effort in quiet
3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Human Auditory Detection and Discrimination Measured with the Pupil Dilation Response.Journal of the Association for Research in Otolaryngology : JARO · 2020
    Trial
  3. How does otitis media with effusion history affect spatial auditory processing and listening effort?European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  4. Article
  5. Binaural fusion: Complexities in definition and measurement.The Journal of the Acoustical Society of America · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Morrison M SteelCollege of Medicine, Central Michigan University, Mount Pleasant, MI, United States of America; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Blake C PapsinInstitute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Karen A GordonInstitute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Communication Disorders, The Hospital for Sick Children, Toronto, Ontario, Canada.

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

Bilateral cochlear implants aim to provide hearing to both ears for children who are deaf and promote binaural/spatial hearing. Benefits are limited by mismatched devices and unilaterally-driven development which could compromise the normal integration of left and right ear input. We thus asked whether children hear a fused image (ie. 1 vs 2 sounds) from their bilateral implants and if this "binaural fusion" reduces listening effort. Binaural fusion was assessed by asking 25 deaf children with cochlear implants and 24 peers with normal hearing whether they heard one or two sounds when listening to bilaterally presented acoustic click-trains/electric pulses (250 Hz trains of 36 ms presented at 1 Hz). Reaction times and pupillary changes were recorded simultaneously to measure listening effort. Bilaterally implanted children heard one image of bilateral input less frequently than normal hearing peers, particularly when intensity levels on each side were balanced. Binaural fusion declined as brainstem asymmetries increased and age at implantation decreased. Children implanted later had access to acoustic input prior to implantation due to progressive deterioration of hearing. Increases in both pupil diameter and reaction time occurred as perception of binaural fusion decreased. Results indicate that, without binaural level cues, children have difficulty fusing input from their bilateral implants to perceive one sound which costs them increased listening effort. Brainstem asymmetries exacerbate this issue. By contrast, later implantation, reflecting longer access to bilateral acoustic hearing, may have supported development of auditory pathways underlying binaural fusion. Improved integration of bilateral cochlear implant signals for children is required to improve their binaural hearing.

Indexed as

Acoustic StimulationAdolescentAuditory PathwaysAuditory PerceptionCase-Control StudiesChildChild, PreschoolCochlear ImplantsCuesDeafnessEarElectric StimulationHearingHearing Loss, BilateralHumansInfant

Identifiers

PMID25668423
PMCPMC4323344

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.