Evidence map›Paper›PMID 42162288›Full record

SynthesisEuropean 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 Surgery2026

Benefits of bilateral cochlear implantation in children: a systematic review and meta-analysis.

Anastasia Zhuchkova, Joan Remacha, Marta Sandoval, Alberto Codina, Francesc Larrosa, Manuel Bernal-Sprekelsen

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anastasia ZhuchkovaDept. of Surgical Specialties, University of Barcelona Medical School, Casanova 143, Barcelona, 08036, Spain.
Joan RemachaFaculty of Medicine, Departament d´Especialitats Quirùrgiques, Hospital Clinic, University of Barcelona, c/Casanova 143, Barcelona, 08036, Spain.
Marta SandovalFaculty of Medicine, Departament d´Especialitats Quirùrgiques, Hospital Clinic, University of Barcelona, c/Casanova 143, Barcelona, 08036, Spain.
Alberto CodinaFaculty of Medicine, Departament d´Especialitats Quirùrgiques, Hospital Clinic, University of Barcelona, c/Casanova 143, Barcelona, 08036, Spain.
Francesc LarrosaFaculty of Medicine, Departament d´Especialitats Quirùrgiques, Hospital Clinic, University of Barcelona, c/Casanova 143, Barcelona, 08036, Spain.
Manuel Bernal-SprekelsenFaculty of Medicine, Departament d´Especialitats Quirùrgiques, Hospital Clinic, University of Barcelona, c/Casanova 143, Barcelona, 08036, Spain. mbernal@clinic.cat.ORCID http://orcid.org/0000-0001-8191-9833

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo systematically evaluate the benefits and risks of bilateral cochlear implantation (BiCI) in children compared with unilateral cochlear implantation (UniCI), with a focus on auditory outcomes, language development, and potential complications.

methodsA systematic review and meta-analysis was conducted following PRISMA guidelines and registered in PROSPERO (1128982). Searches were performed in PubMed, ScienceDirect, Scopus, and the Cochrane Library for studies published between 2015 and June 2025, with selective inclusion of earlier high-quality pediatric studies. Eligible studies included children with congenital or early-onset bilateral deafness who received BiCI or UniCI. Primary outcomes were speech perception (especially in noise), sound localisation, and spoken language development. Secondary outcomes included quality of life and adverse effects. Random-effects meta-analyses were performed using standardised mean differences (SMD).

resultsFifty studies were included in the qualitative synthesis and 20 in the meta-analyses. BiCI provided significantly better outcomes in speech perception in noise (SMD = + 0.70, p < 0.001) and sound localisation (SMD = + 0.74, p < 0.001), with consistent benefits across study designs and populations. Language development also favoured BiCI (SMD = + 0.65 for receptive vocabulary). Earlier implantation and shorter inter-implant intervals were associated with larger benefits. Surgical and vestibular complications were infrequent and did not exceed those reported for UniCI. Quality-of-life ratings were consistently higher in BiCI users.

conclusionBilateral cochlear implantation offers a significant but variable advantage over unilateral implantation in children, particularly in noisy environments, spatial hearing, and language acquisition. While language outcomes generally favour BiCI, results show greater heterogeneity compared to auditory measures. Benefits are most robust with early and simultaneous implantation. Although BiCI is a safe and effective intervention, the observed methodological and clinical heterogeneity underscores the need for standardized longitudinal assessments.

Indexed as

Cochlear ImplantationCochlear ImplantsHearing Loss, BilateralChildHumansLanguage DevelopmentQuality of LifeSound LocalizationSpeech PerceptionTreatment OutcomeBilateral cochlear implantationHearing outcomesLanguage developmentMeta-analysisPediatric cochlear implantsSound localisationSpeech perception in noiseSystematic review

Identifiers

PMID42162288
PMCPMC13615015

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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.