Spatial hearing in adults with sequential bilateral cochlear implants: a longitudinal prospective cohort study
- 1Department of Psychology and Cognitive Sciences, University of Trento, Italy
Abstract
Bilateral cochlear implantation (BCI) can improve spatial hearing in adults with bilateral hearing loss, but the early development of spatial hearing following sequential BCI remains poorly understood. This prospective longitudinal study investigated changes in spatial hearing experience in 23 adults undergoing sequential BCI, assessed before and at [~]1, 3, and 8 months after bilateral implantation under two conditions: spontaneous and restrained head movements. Using a motion-tracking system combined with virtual reality, sound localization was assessed through absolute and signed errors, along with self-reported localization confidence and listening effort. Subjective spatial hearing was also assessed using the Speech, Spatial and Qualities of Hearing Scale (SSQ). Localization performance improved by 1 month after bilateral implantation, as evidenced by a reduction of absolute error and in the bias toward the first-implanted ear. Participants reported greater localization confidence and lower listening effort at 1 month, although these changes were not consistently maintained at later follow-ups. SSQ scores showed improved spatial hearing at 1 month, speech perception at 3 months, and sound clarity and discriminability at 8 months. Compared with head-restrained condition, accuracy and confidence improved when spontaneous head rotations were allowed. The temporal trajectories of localization bias, confidence, and effort were modulated by the duration of experience with the first CI. These findings indicate that changes in spatial hearing can emerge soon after second CI activation. They further highlight the contribution of spontaneous head movements and previous CI experience, and support the use of complementary measures to monitor the early development of bilateral listening.
Related
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BibTeX
@misc{valzolgher2026spatial,
title = {{Spatial hearing in adults with sequential bilateral cochlear implants: a longitudinal prospective cohort study}},
author = {C. Valzolgher and S. Ghiselli and M. O. Epifania and J. Gullotta and D. Zanetti and G. Lilli and F. Di Berardino and M. Pozzi and A. Ciorba and M. Borin and N. Brunelli and L. B. Musumano and G. N. Frau and G. Tromballi and A. Chini and T. Rosi and P. Malerba and D. Cuda and F. Pavani},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364332},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364332v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Spatial hearing in adults with sequential bilateral cochlear implants: a longitudinal prospective cohort study
AU - C. Valzolgher
AU - S. Ghiselli
AU - M. O. Epifania
AU - J. Gullotta
AU - D. Zanetti
AU - G. Lilli
AU - F. Di Berardino
AU - M. Pozzi
AU - A. Ciorba
AU - M. Borin
AU - N. Brunelli
AU - L. B. Musumano
AU - G. N. Frau
AU - G. Tromballi
AU - A. Chini
AU - T. Rosi
AU - P. Malerba
AU - D. Cuda
AU - F. Pavani
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364332
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364332v1
AB - Bilateral cochlear implantation (BCI) can improve spatial hearing in adults with bilateral hearing loss, but the early development of spatial hearing following sequential BCI remains poorly understood. This prospective longitudinal study investigated changes in spatial hearing experience in 23 adults undergoing sequential BCI, assessed before and at [~]1, 3, and 8 months after bilateral implantation under two conditions: spontaneous and restrained head movements. Using a motion-tracking system combined with virtual reality, sound localization was assessed through absolute and signed errors, along with self-reported localization confidence and listening effort. Subjective spatial hearing was also assessed using the Speech, Spatial and Qualities of Hearing Scale (SSQ). Localization performance improved by 1 month after bilateral implantation, as evidenced by a reduction of absolute error and in the bias toward the first-implanted ear. Participants reported greater localization confidence and lower listening effort at 1 month, although these changes were not consistently maintained at later follow-ups. SSQ scores showed improved spatial hearing at 1 month, speech perception at 3 months, and sound clarity and discriminability at 8 months. Compared with head-restrained condition, accuracy and confidence improved when spontaneous head rotations were allowed. The temporal trajectories of localization bias, confidence, and effort were modulated by the duration of experience with the first CI. These findings indicate that changes in spatial hearing can emerge soon after second CI activation. They further highlight the contribution of spontaneous head movements and previous CI experience, and support the use of complementary measures to monitor the early development of bilateral listening.
ER -