Exploring Spatial Hearing Abilities in Children With Bilateral Cochlear Implants Using Three-Dimensional Virtual Reality Systems

Abstract

Purpose: This study aimed to (a) examine the contribution of head movements to sound localization through a within-participant manipulation (i.e., movement vs. no-movement conditions) across all three groups (children with normal hearing and simultaneous and sequential bilateral cochlear implant users) and (b) compare sound localization performance across the three groups, with particular emphasis on the inclusion of two distinct groups of cochlear implant users (simultaneous and sequential bilateral cochlear implant users). Method: Twenty-one normal-hearing children and 14 children with simultaneous cochlear implants, as well as 18 children with sequential cochlear implants, aged 6–14 years, participated in the study. Three-dimensional hearing abilities were examined using virtual reality systems. Participants were evaluated in two listening conditions, head mobile and head immobile, at two distances (35 and 55 cm) and at four angles (right-front, +30°; left-front, −30°; right-back, +150°; left-back, −150°). The relationship between overall three-dimensional error and several demographic characteristics under head-immobile conditions was investigated. Results: Significant differences were found between the normal-hearing group and the bilateral cochlear implant groups under both listening conditions for azimuth error, front–back and right–left errors, overall three-dimensional errors, and front–back confusion percentage ( p < .001). In the virtual reality localization test, azimuth error, overall error amounts, and front–back confusion percentage differed significantly between head-mobile and head-immobile conditions ( p < .05). There were no significant differences in perception of the two distances across all three groups ( p > .05). Additionally, no significant relationships were found between the demographic characteristics and overall three-dimensional error amount ( p > .05). Conclusions: Head movements were found to improve sound localization abilities in children. Although errors among children with bilateral simultaneous cochlear implants were less than those of sequential cochlear implants, no significant difference was found between the two groups. Spatial hearing was significantly enhanced due to head movements, suggesting that incorporating head movements into auditory rehabilitation strategies could improve the hearing performance of children.