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Cochlear Implants in Both Ears Enables Better Hearing

children who received a second implant one to seven years after being fitted with their first. When the research began, it appeared the group of 5 to 14 year-olds couldn't localize sounds at all, Litovsky says.

The result prompted her to launch a longitudinal study designed not only to test their prowess at this task, but also how it changed over time. In the 'listening game' she has devised with her team, children face a semicircle of loudspeakers arranged at regular intervals, each with a picture attached. When speech or other kinds of sounds emit from a speaker, the children are scored on their ability to identify the correct one by pointing to its picture.

In addition to completing the task while wearing both implants, the children were asked to remove the microphone and other external parts of one, rendering them deaf again in that ear. 'That turns out to be an interesting experience, because they don't like to remove an implant,' says Litovsky. 'We have to barter for that, with M&Ms or something else that motivates them.'

Although variability existed among the children, the study indicates that most did develop the ability to locate speech and other sounds more accurately when using two cochlear implants versus one. This capability also increased with experience. 'We're now seeing that the ability to localize sounds takes time to emerge,' says Litovsky. 'What seems to get better is the integration of the information from the two ears in the brain.'

Another crucial question is whether children should receive both implants simultaneously, at the same time, or sequentially, at different times, she says. The study's results have implications here, as well.

'The children we're looking at received their implants sequentially,' says Litovsky, 'and we think that their brains took a very long time to combine the inputs from the two ears.' Yet, the fact they learned to do so points to the brain's adaptability
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