Outcomes of a late sequential cochlear implantation: A case report

Introduction: Sequential cochlear implantation is a rehabilitative strategy for patients with bilateral profound sensorineural hearing loss who receive the second implant years after the first. When sequential cochlear implantation is performed after a long interval, there are many uncertainties about the outcomes achieved with the second device. Case Report: This study presents the case of a 24-year-old patient, implanted on the right ear in 2007 and on the left ear in 2023. The objective was to assess the speech therapy outcomes obtained with the second implant and compare them with those of the first. After the left implant was activated, the patient underwent a speech therapy program designed to achieve balanced bilateral auditory input. Postoperative evaluations revealed rapid adaptation to the new auditory stimulus, with steady progress in sound discrimination and verbal comprehension. After 12 months, performance with the second implant was comparable to that of the first, both in word recognition tests and in speech perception in complex acoustic contexts. Conclusion: These results suggest that despite the long interval between the two implants, the brain retains significant auditory plasticity. This plasticity may involve cortical reorganization or strengthened commissural pathways, allowing effective acquisition with the first implant to have facilitated the integration of the second one, thereby optimizing the rehabilitative process. This case confirms the effectiveness of sequential cochlear implantation even when the second implant is performed in adulthood, supporting the hypothesis that binaural stimulation promotes better speech perception and higher quality of life.