Introduction: The benefits of bilateral cochlear implantation (BCI) are well established in the literature. However, there is no consensus on the optimal timing for implantation in adults, whether it should be simultaneous or sequential.

Materials and Methods: This retrospective study included patients who underwent BCI placement, patients were divided into two groups, depending on whether BCI was sequential (Seq-CI) or simultaneous (Sim-CI).

Results: The mean total surgery duration (TSD) for Sim-CI was 10.4 minutes shorter than the combined duration for Seq-CI, with no significant differences (p>0.05). Sim-CI patients had a 1.74-day shorter hospital stay and required 15.34 fewer follow-up consultations than Seq-CI patients (p<0.05). The Seq-CI group had an average PTA of 35.50 ± 7.52 dB, a speech threshold recognition (STR) of 30.61 ± 11.60 dB, and reached an average maximum speech intelligibility of 85.45%. The Sim-CI group had an average PTA of 36.17 ± 13.15 dB, a mean STR of 33.75 ± 4.79 dB, and achieved an average maximum intelligibility of 100%. No significant differences were detected in the auditory outcomes between groups, except for maximum speech intelligibility, which was significantly higher in the Sim-CI group (p<0.05). No differences were found in the frequency of surgical or non-surgical complications between groups (p>0.05).

Conclusion: Simultaneous BCI significantly reduced hospital stay and the number of post-operative consultations and exhibited higher maximum speech intelligibility compared to sequential implantation, without an increase in complication rates. These findings suggest that simultaneous implantation may offer advantages in terms of efficiency and auditory outcomes in adults.

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