Clinical trial NCT00784043: Bilateral Cochlear Implantation in Children With the MED-EL Cochlear Implant
Official title: Longitudinal Efficacy in Young Children Implanted Bilaterally With MED-EL COMBI 40+ / PULSARCI100/SONATATI100 Cochlear Implant Systems.
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Hearing Loss
Keywords: Cochlear implant
hearing loss
Lead sponsor: Med-El Corporation
Sponsor class: INDUSTRY
First posted: 2008-11-02
Enrollment: 37
Sex: ALL
Minimum age (years): 12
Maximum age (years): 36
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate and document longitudinal efficacy in young children implanted bilaterally with MED-EL COMBI 40+ / PULSARCI100/SONATATI100 cochlear implant systems.


Eligibility criteria: Inclusion Criteria:

* Between 12 and 36 months of age at time of implantation
* Profound bilateral sensorineural hearing loss
* English as the primary language in the home
* Realistic expectations of guardians
* Child must be enrolled in a post-operative rehabilitative/educational program that supports the use of cochlear implants and the development of auditory-based skills
* Willing and available to comply with all scheduled procedures as defined in the protocol

Audiological:

* Profound bilateral sensorineural hearing loss with average thresholds between ears of 90 dB HL or greater at 1000 Hz and above, and must demonstrate minimal functional benefit from conventional amplification
* Behavioral test measures must include unaided threshold measures for the right and left ears using insert earphones; left-alone and right-alone aided sound field threshold measurements; and aided and unaided speech-awareness / detection thresholds (for each ear individually)
* Children accepted into the study must be able to demonstrate a consistent response to sound. If a child has no measurable hearing, he/she must be able to demonstrate a consistent response to vibrotactile stimuli.
* All children must have completed an appropriate trial period with optimally fit amplification prior to inclusion in the study.

Medical:

* Good general health status, as judged by Primary Investigator
* Patent cochleae bilaterally, as indicated by radiological evaluation
* No contraindications for surgery, in general, or cochlear implant surgery in particular

Exclusion Criteria:

* Prior experience with any cochlear implant system
* Younger than 12 months or older than 36 months at time of implantation
* Audiological: Presence of otoacoustic emissions and/or cochlear microphonic, indicating possible condition of auditory neuropathy

Medical:

* Evidence of ossification that would prevent full insertion of the standard C40+ / PULSARCI100 /SONATATI100 electrode array in the cochlea(e) to be implanted, as indicated by radiological evaluation
* Abnormal or malformed cochlea(e) to be implanted
* Severed or non-functional auditory nerve in the ear(s) to be implanted
* Central auditory lesion
* Cognitive and/or neurological dysfunction
* Auditory neuropathy

Primary outcomes:
measure: Longitudinal Efficacy in Young Children Implanted Bilaterally With MED-EL COMBI 40+ / PULSARCI100/SONATATI100 Cochlear Implant Systems
timeFrame: 60 months post initial stimulation
Secondary outcomes:
measure: Language Acquisition Over Time in Bilaterally Implanted Children.
timeFrame: 60 months post initial activation
measure: Speech Production Over Time in Children Implanted Bilaterally With a MED-EL Cochlear Implant.
timeFrame: 5 years
Other outcomes:
Locations:
city: Jacksonville
country: United States
facility: Nemours Children's Clinic
state: Florida
city: Atlanta
country: United States
facility: Children's Healthcare of Atlanta
state: Georgia
city: Cleveland
country: United States
facility: Cleveland Clinic Foundation
state: Ohio
city: Dallas
country: United States
facility: Dallas Otolaryngology Associates
state: Texas
city: Dallas
country: United States
facility: Callier Center
state: Texas
city: Houston
country: United States
facility: Texas Children's Hospital
state: Texas
city: Norfolk
country: United States
facility: Eastern Virginia Medical School
state: Virginia
city: Milwaukee
country: United States
facility: Medical College of Wisconsin
state: Wisconsin
city: London
country: Canada
facility: London Health Sciences Centre
state: Ontario
Study officials:
References:
citation: Kuhn-Inacker H, Shehata-Dieler W, Muller J, Helms J. Bilateral cochlear implants: a way to optimize auditory perception abilities in deaf children? Int J Pediatr Otorhinolaryngol. 2004 Oct;68(10):1257-66. doi: 10.1016/j.ijporl.2004.04.029.
citation: Nopp P, Schleich P, D'Haese P. Sound localization in bilateral users of MED-EL COMBI 40/40+ cochlear implants. Ear Hear. 2004 Jun;25(3):205-14. doi: 10.1097/01.aud.0000130793.20444.50.
citation: Schleich P, Nopp P, D'Haese P. Head shadow, squelch, and summation effects in bilateral users of the MED-EL COMBI 40/40+ cochlear implant. Ear Hear. 2004 Jun;25(3):197-204. doi: 10.1097/01.aud.0000130792.43315.97.
citation: Muller J, Schon F, Helms J. Speech understanding in quiet and noise in bilateral users of the MED-EL COMBI 40/40+ cochlear implant system. Ear Hear. 2002 Jun;23(3):198-206. doi: 10.1097/00003446-200206000-00004.
citation: Schon F, Muller J, Helms J. Speech reception thresholds obtained in a symmetrical four-loudspeaker arrangement from bilateral users of MED-EL cochlear implants. Otol Neurotol. 2002 Sep;23(5):710-4. doi: 10.1097/00129492-200209000-00018.
citation: Tyler RS, Gantz BJ, Rubinstein JT, Wilson BS, Parkinson AJ, Wolaver A, Preece JP, Witt S, Lowder MW. Three-month results with bilateral cochlear implants. Ear Hear. 2002 Feb;23(1 Suppl):80S-89S. doi: 10.1097/00003446-200202001-00010.
citation: Winkler F, Schon F, Peklo L, Muller J, Feinen Ch, Helms J. [The Wurzburg questionnaire for assessing the quality of hearing in CI-children (WH-CIK)]. Laryngorhinootologie. 2002 Mar;81(3):211-6. doi: 10.1055/s-2002-25042. German.
citation: Zimmerman-Phillips S, Robbins AM, Osberger MJ. Assessing cochlear implant benefit in very young children. Ann Otol Rhinol Laryngol Suppl. 2000 Dec;185:42-3. doi: 10.1177/0003489400109s1217. No abstract available.
citation: Kirk KI, Pisoni DB, Osberger MJ. Lexical effects on spoken word recognition by pediatric cochlear implant users. Ear Hear. 1995 Oct;16(5):470-81. doi: 10.1097/00003446-199510000-00004.
citation: Grantham DW, Ashmead DH, Ricketts TA, Labadie RF, Haynes DS. Horizontal-plane localization of noise and speech signals by postlingually deafened adults fitted with bilateral cochlear implants. Ear Hear. 2007 Aug;28(4):524-41. doi: 10.1097/AUD.0b013e31806dc21a.
citation: Ricketts TA, Grantham DW, Ashmead DH, Haynes DS, Labadie RF. Speech recognition for unilateral and bilateral cochlear implant modes in the presence of uncorrelated noise sources. Ear Hear. 2006 Dec;27(6):763-73. doi: 10.1097/01.aud.0000240814.27151.b9.
citation: Dorman MF, Dahlstrom L. Speech understanding by cochlear-implant patients with different left- and right-ear electrode arrays. Ear Hear. 2004 Apr;25(2):191-4. doi: 10.1097/01.aud.0000120367.70123.9a.
citation: Laback B, Pok SM, Baumgartner WD, Deutsch WA, Schmid K. Sensitivity to interaural level and envelope time differences of two bilateral cochlear implant listeners using clinical sound processors. Ear Hear. 2004 Oct;25(5):488-500. doi: 10.1097/01.aud.0000145124.85517.e8.
citation: Van Hoesel R, Ramsden R, Odriscoll M. Sound-direction identification, interaural time delay discrimination, and speech intelligibility advantages in noise for a bilateral cochlear implant user. Ear Hear. 2002 Apr;23(2):137-49. doi: 10.1097/00003446-200204000-00006.
citation: Pijl S. Single-channel versus bilateral multichannel cochlear implant results: a case report. Ear Hear. 1991 Dec;12(6):431-3. doi: 10.1097/00003446-199112000-00007.
citation: Beijen JW, Snik AF, Mylanus EA. Sound localization ability of young children with bilateral cochlear implants. Otol Neurotol. 2007 Jun;28(4):479-85. doi: 10.1097/MAO.0b013e3180430179.
citation: Truy E, Ionescu E, Ceruse P, Gallego S. The binaural digisonic cochlear implant: surgical technique. Otol Neurotol. 2002 Sep;23(5):704-9. doi: 10.1097/00129492-200209000-00017.
citation: Brown KD, Balkany TJ. Benefits of bilateral cochlear implantation: a review. Curr Opin Otolaryngol Head Neck Surg. 2007 Oct;15(5):315-8. doi: 10.1097/MOO.0b013e3282ef3d3e.
citation: Das S, Buchman CA. Bilateral cochlear implantation: current concepts. Curr Opin Otolaryngol Head Neck Surg. 2005 Oct;13(5):290-3. doi: 10.1097/01.moo.0000179808.00638.ab.
citation: Offeciers E, Morera C, Muller J, Huarte A, Shallop J, Cavalle L. International consensus on bilateral cochlear implants and bimodal stimulation. Acta Otolaryngol. 2005 Sep;125(9):918-9. doi: 10.1080/00016480510044412. No abstract available.
citation: Verschuur CA, Lutman ME, Ramsden R, Greenham P, O'Driscoll M. Auditory localization abilities in bilateral cochlear implant recipients. Otol Neurotol. 2005 Sep;26(5):965-71. doi: 10.1097/01.mao.0000185073.81070.07.
citation: Senn P, Kompis M, Vischer M, Haeusler R. Minimum audible angle, just noticeable interaural differences and speech intelligibility with bilateral cochlear implants using clinical speech processors. Audiol Neurootol. 2005 Nov-Dec;10(6):342-52. doi: 10.1159/000087351. Epub 2005 Aug 5.
citation: Sharma A, Dorman MF, Kral A. The influence of a sensitive period on central auditory development in children with unilateral and bilateral cochlear implants. Hear Res. 2005 May;203(1-2):134-43. doi: 10.1016/j.heares.2004.12.010.
citation: Laszig R, Aschendorff A, Stecker M, Muller-Deile J, Maune S, Dillier N, Weber B, Hey M, Begall K, Lenarz T, Battmer RD, Bohm M, Steffens T, Strutz J, Linder T, Probst R, Allum J, Westhofen M, Doering W. Benefits of bilateral electrical stimulation with the nucleus cochlear implant in adults: 6-month postoperative results. Otol Neurotol. 2004 Nov;25(6):958-68. doi: 10.1097/00129492-200411000-00016.
citation: Litovsky RY, Parkinson A, Arcaroli J, Peters R, Lake J, Johnstone P, Yu G. Bilateral cochlear implants in adults and children. Arch Otolaryngol Head Neck Surg. 2004 May;130(5):648-55. doi: 10.1001/archotol.130.5.648.
citation: Schauwers K, Gillis S, Daemers K, De Beukelaer C, De Ceulaer G, Yperman M, Govaerts PJ. Normal hearing and language development in a deaf-born child. Otol Neurotol. 2004 Nov;25(6):924-9. doi: 10.1097/00129492-200411000-00011.
citation: Seeber BU, Baumann U, Fastl H. Localization ability with bimodal hearing aids and bilateral cochlear implants. J Acoust Soc Am. 2004 Sep;116(3):1698-709. doi: 10.1121/1.1776192.
citation: Stark T, Engel A, Borkowski G. [Bilateral cochlea implantation in varying duration of deafness]. Laryngorhinootologie. 2004 Jan;83(1):20-2. doi: 10.1055/s-2004-814097. German.
citation: Tyler RS, Witt SA, Dunn CC. Trade-offs between better hearing and better cosmetics. Am J Audiol. 2004 Dec;13(2):193-9. doi: 10.1044/1059-0889(2004/024).
citation: van Hoesel RJ. Exploring the benefits of bilateral cochlear implants. Audiol Neurootol. 2004 Jul-Aug;9(4):234-46. doi: 10.1159/000078393.
citation: Au DK, Hui Y, Wei WI. Superiority of bilateral cochlear implantation over unilateral cochlear implantation in tone discrimination in chinese patients. Am J Otolaryngol. 2003 Jan-Feb;24(1):19-23. doi: 10.1053/ajot.2003.8.
citation: Kong W, Yu L, Xu Y, Yue J, Xiong X, Zhu L, Duan J. [Benefit of bilateral cochlear implantation on congenital prelingually deafened Chinese-speaking children]. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003 Oct;17(10):577-9. Chinese.
citation: Caleffe-Schenck, N, Franz, D. (2004). Checklist of Auditory Communication Skills. Volta Review 104(3): 175-196.
citation: Semel, E, Wiig, E, Secord, W. (2003). Clinical Evaluation of Language Fundamentals Fourth Edition. San Antonio, Texas: The Psychological Corporation
citation: Stark, T, Müller, J, Vischer, M, Schön, F, Senn, P, Engel, A, Kompis, M, Hildmann, H, Helms, J. (2002). Multicenter study on bilateral cochlear implantation. In Kubo, T, Takahashi, Y, Iwaki, T, (eds.) Cochlear implants - an update. The Hague: Kugler.
citation: Goldman, R, Fristoe, M. (2000). Goldman-Fristoe Test of Articulation Second Edition. Circle Pines, Minnesota: American Guidance Service.
citation: In Kim, C, Chang, S, Lim, D, (eds). Updates in cochlear implantation. Adv. Otorhinolarygol, Basel: Karger.
citation: Lawson, D, Wilson, B, Zerbi, M, Finley, C. (1999). Fourth quarterly progress report: Speech processors for auditory prostheses. NIH Contract N01-DC-8-2105.
citation: Schön, F, Mueller, J, Helms, J. (1999). Results of bilateral cochlear implantation. European Archives of Oto-Rhino-Laryngology 156:106.
citation: Lawson, D, Zerbi, M, Wilson, B. (1998). First quarterly progress report: Speech processors for auditory prostheses. NIH Contract N01-DC-8-2105.
citation: Dunn, L, Dunn, L. (1997). Peabody Picture Vocabulary Test Third Edition. Circle Pines, Minnesota: American Guidance Service.
citation: Williams, K. (1997). Expressive Vocabulary Test. Circle Pines, Minnesota: American Guidance Service.
citation: Kaufman, N. (1995). Kaufman Speech Praxis Test for Children. Detroit, Michigan: Wayne State University Press.
citation: Fenson, L, Dale, P, Resnick, J, Thal, D, Bates, E, Hartung, J, Pethick, S, Reilly, J. (1993). MacArthur Communicative Development Inventories: User's Guide and Technical Manual. Baltimore, Maryland: Paul H. Brokes Publishing Company.
citation: Reynell, J, Gruber, C. (1990). Reynell Developmental Language Scales. Los Angeles, California: Western Psychological Services.
citation: Jerger, S, Jerger, J. (1984). Pediatric Speech Intelligibility Test. St. Louis, Missouri: Auditec of St. Louis.
citation: Erber, N. (1982). Auditory Training. Washington, DC: Alexander Graham Bell Association.
citation: Haskins, H. (1949). A phonetically balanced test of speech discrimination for children. Master's Theis. Northwestern University, Evanston, Illinois.
citation: Ramsden R, Greenham P, O'Driscoll M, Mawman D, Proops D, Craddock L, Fielden C, Graham J, Meerton L, Verschuur C, Toner J, McAnallen C, Osborne J, Doran M, Gray R, Pickerill M. Evaluation of bilaterally implanted adult subjects with the nucleus 24 cochlear implant system. Otol Neurotol. 2005 Sep;26(5):988-98. doi: 10.1097/01.mao.0000185075.58199.22.
citation: Schoen F, Mueller J, Helms J, Nopp P. Sound localization and sensitivity to interaural cues in bilateral users of the Med-El Combi 40/40+cochlear implant system. Otol Neurotol. 2005 May;26(3):429-37. doi: 10.1097/01.mao.0000169772.16045.86.
citation: Long CJ, Eddington DK, Colburn HS, Rabinowitz WM. Binaural sensitivity as a function of interaural electrode position with a bilateral cochlear implant user. J Acoust Soc Am. 2003 Sep;114(3):1565-74. doi: 10.1121/1.1603765.
citation: Tyler RS, Dunn CC, Witt SA, Preece JP. Update on bilateral cochlear implantation. Curr Opin Otolaryngol Head Neck Surg. 2003 Oct;11(5):388-93. doi: 10.1097/00020840-200310000-00014.
citation: van Hoesel RJ, Tyler RS. Speech perception, localization, and lateralization with bilateral cochlear implants. J Acoust Soc Am. 2003 Mar;113(3):1617-30. doi: 10.1121/1.1539520.
citation: Vermeire K, Brokx JP, Van de Heyning PH, Cochet E, Carpentier H. Bilateral cochlear implantation in children. Int J Pediatr Otorhinolaryngol. 2003 Jan;67(1):67-70. doi: 10.1016/s0165-5876(02)00286-0.
citation: Wilson BS, Lawson DT, Muller JM, Tyler RS, Kiefer J. Cochlear implants: some likely next steps. Annu Rev Biomed Eng. 2003;5:207-49. doi: 10.1146/annurev.bioeng.5.040202.121645. Epub 2003 Apr 16.
citation: Au, D., Hui, Y., Wei, W, & Wong, B. (2002). Speech recognition between bilaterally and unilaterally cochlear implanted and hearing aid fitted users. In Kubo, T., Takahashi Y., & Iwaki, T. (Ed.) Cochlear implants - an update. The Hague: Kugler.
citation: Gantz BJ, Tyler RS, Rubinstein JT, Wolaver A, Lowder M, Abbas P, Brown C, Hughes M, Preece JP. Binaural cochlear implants placed during the same operation. Otol Neurotol. 2002 Mar;23(2):169-80. doi: 10.1097/00129492-200203000-00012.
citation: Summerfield AQ, Marshall DH, Barton GR, Bloor KE. A cost-utility scenario analysis of bilateral cochlear implantation. Arch Otolaryngol Head Neck Surg. 2002 Nov;128(11):1255-62. doi: 10.1001/archotol.128.11.1255.
citation: Mawman DJ, Ramsden RT, O'Driscoll M, Adams T, Saeed SR. Bilateral cochlear implantation--a case report. Adv Otorhinolaryngol. 2000;57:360-3. doi: 10.1159/000059132. No abstract available.
citation: Mueller J, Schoen F, Helms J. Bilateral cochlear implant--new aspects for the future? Adv Otorhinolaryngol. 2000;57:22-7. doi: 10.1159/000059172. No abstract available.
citation: Lawson, D., Wilson, B., Zerbi, M., & Finley, C. (1999). Fourth Quarterly Progress Report. NIH Contract N01-DC-8-2105. Retrieved from http://npp.ninds.nih.gov/ProgressReports/Speech ProcessorsforAuditoryProstheses%20DC82105/SpeechProcessorsWilson4DC82105.pdf
citation: van Hoesel, R. J. M., & Clark, G. M. (1999). Speech results with a bilateral multi-channel cochlear implant subject for spatially separated signal and noise. Australian Journal of Audiology, 21, 23-28.
citation: Müller, J., Schön, F., & Helms J. (1998). Binaural cochlear implantation: a case report discussing preliminary results. European Archives of Oto-Rhino-Laryngology, 255, 38.
citation: Lawson DT, Wilson BS, Zerbi M, van den Honert C, Finley CC, Farmer JC Jr, McElveen JT Jr, Roush PA. Bilateral cochlear implants controlled by a single speech processor. Am J Otol. 1998 Nov;19(6):758-61.
citation: Lawson, D., Zerbi, M., & Wilson, B. (1998). First Quarterly Progress Report. NIH Contract N01-DC-8-2105. Retrieved from http://npp.ninds.nih.gov/ProgressReports/SpeechProcessorsfor AuditoryProstheses%20DC82105/qpr1/qpr1a.html
citation: van Hoesel RJ, Clark GM. Psychophysical studies with two binaural cochlear implant subjects. J Acoust Soc Am. 1997 Jul;102(1):495-507. doi: 10.1121/1.419611.
citation: Lawson, D., Wilson, B., Zerbi, M., & Finley, C. (1996). Fifth Quarterly Progress Report. NIH Contract N01-DC-5-2103. Retrieved from http://npp.ninds.nih.gov/ProgressReports/Speech ProcessorsforAuditoryProstheses%20DC52103/qpr5/qpr5.html.
citation: Van Hoesel RJ, Clark GM. Fusion and lateralization study with two binaural cochlear implant patients. Ann Otol Rhinol Laryngol Suppl. 1995 Sep;166:233-5.
citation: van Hoesel RJ, Tong YC, Hollow RD, Clark GM. Psychophysical and speech perception studies: a case report on a binaural cochlear implant subject. J Acoust Soc Am. 1993 Dec;94(6):3178-89. doi: 10.1121/1.407223.
citation: Green JD Jr, Mills DM, Bell BA, Luxford WM, Tonokawa LL. Binaural cochlear implants. Am J Otol. 1992 Nov;13(6):502-6.
citation: Pelizzone M, Kasper A, Montandon P. Binaural interaction in a cochlear implant patient. Hear Res. 1990 Oct;48(3):287-90. doi: 10.1016/0378-5955(90)90069-2.
citation: Balkany T, Boggess W, Dinner B. Binaural cochlear implantation: comparison of 3M/House and Nucleus 22 devices with evidence of sensory integration. Laryngoscope. 1988 Oct;98(10):1040-3. doi: 10.1288/00005537-198810000-00002.