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Auditory Localization Skills of Adult Cochlear Implant Users: Self-Report Assessment Results

Ann Otol Rhinol Laryngol. 2026 Feb 14:34894261422107. doi: 10.1177/00034894261422107. Online ahead of print.

ABSTRACT

OBJECTIVES: Auditory localization, an essential skill for survival and communication, enables individuals to identify the source of sounds in their environment. Hearing loss (HL) in one or both ears often disrupts binaural hearing mechanisms, compromising auditory localization abilities. This study aimed to compare auditory localization abilities among unilateral cochlear implant (UnCI) users, bimodal cochlear implant (BimCI) users, and individuals with normal hearing (NH).

METHODS: This study included a total of 119 participants: 50 with NH, 46 UnCIs, and 23 BimCIs. The Auditory Localization Scale was used to compare the participants’ localization abilities. The scale consists of 24 items across 5 subdimensions: traffic zone, outdoor situations, indoor situations, psychological aspects, and quiet situations. On this scale, higher scores represent greater difficulty with hearing and sound localization, whereas lower scores correspond to better performance in these situations.

RESULTS: A statistically significant difference was observed among the 3 groups across all subsections of the Auditory Localization Scale (traffic-zone, P < .001; outdoor situations, P < .001; indoor situations, P < .001; psychological aspects, P = .001; quiet situations, P < .001), as well as in the total score (P < .001). Post-hoc analyses revealed no significant difference between the bimodal and unilateral CI users (P > .017). However, the NH group obtained significantly lower scores across all subsections and in the total score compared with both CI groups. (P < .017).

CONCLUSIONS: While bimodal hearing is advantageous for providing binaural signals, it may not be adequate for auditory localization; consequently, further endeavors are required to enhance subjective benefits and hearing outcomes in adult CI users.

PMID:41689812 | DOI:10.1177/00034894261422107

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