Background Bilateral vocal fold paralysis (BVFP) is a rare but potentially life-threatening cause of respiratory distress in newborns and infants. Although tracheotomy has traditionally been the standard treatment for severe airway obstruction, less invasive surgical alternatives have been developed to avoid associated morbidity. Endoscopic vocal fold lateralization (EVFLA) represents one such approach. Objective To evaluate the safety and efficacy of EVFLA using the Lichtenberger needle holder as an alternative to tracheotomy in neonates and infants with respiratory distress caused by BVFP. Methods This retrospective, single-center study included 8 infants younger than 6 months who underwent EVFLA between January 2017 and January 2025 at a tertiary pediatric airway center. All patients presented with significant respiratory distress requiring non-invasive ventilation (NIV). Preoperative, perioperative, and postoperative data were collected, with a minimum follow-up of 12 months. Primary outcome was the need for tracheotomy following surgery. Secondary outcomes included ventilatory status, feeding outcomes, complications, reinterventions, and dysphonia. Results Tracheotomy avoidance rate was 100%. Median duration of postoperative intubation was 1 day, median duration of continuous postoperative NIV was 1.5 days. At final follow-up, 6 patients achieved exclusive oral feeding, while persistent clinical aspiration was observed in only 1 patient. Three patients required revision surgery because of minor complications, including laryngeal edema, suture loosened, mild glottic synechia. Dysphonia was reported in 3 patients. No patient experienced structural damage to the vocal folds. Conclusions EVFLA using the Lichtenberger needle holder may represent a safe, effective, minimally invasive alternative to tracheotomy in newborns with BVFP-related airway obstruction.

Existing European national guidelines agree to provide cochlear implantation to children with bilateral severe to profound hearing loss and to offer bilateral treatment depending on the hearing status of the best hearing ear and progression of hearing loss, and in the case of congenital hearing loss to do this at the youngest possible age. However, studies and reports demonstrate substantial and persistent disparities in the provision of pediatric cochlear implantation across Europe. Variations in national policies, service quality, and access to timely diagnosis and intervention continue to affect equitable care, even in high-income countries. These findings underscore the need for a coordinated, European-level approach to harmonize clinical practice and guidance. A group of European experts, professionals and patient representatives have set out to develop consensus statements to address the disparity in European provision. The consensus statements have been drawn up by the group in an iterative process of online and in-person group discussions. The European consensus statements may also contribute to awareness of cochlear implantation for children and to ensure effective services for children with severe to profound hearing loss who are eligible for cochlear implantation.

ABSTRACTBackgroundNew CFTR Modulator triple therapy Elexacaftor‐Ivacaftor‐Tezacaftor (ETI) prove efficacy in pulmonary outcomes. However, its impact on nasal sinus symptoms in children has not been specifically studied. The aim of this study is to evaluate the impact of this therapy on nasal sinus symptomatology in children aged 6–12 years.MethodsA prospective, single‐center cohort study was conducted over a 12‐month follow‐up period in children aged 6–12 years at the initiation of ETI therapy. The primary outcome was evolution of the SN‐5 score, a validated pediatric questionnaire measuring quality of life related to nasal sinus symptoms. A decrease of 0.5 points is considered clinically significant. Secondary outcomes included changes in clinical examination findings (obstructive turbinate hypertrophy, polyps, presence of pus in the middle meatus, and externalized mucocele), quality of life measured by the Visual Analog Scale (VAS), and number of antibiotic courses during the study period.ResultsTwenty‐six patients were included between March and September 2023, with no lost to follow‐up. The initial mean SN‐5 score was 2.88 (95% CI {1.91; 3.85}). After 1 year, the mean SN‐5 score was significantly lower (1.41, 95% CI {1.00; 1.88}, Delta = 1.47, p < 0.001). The VAS related to symptoms also improved (Delta = 1.7, p < 0.001), and the number of antibiotic courses decreased (25 vs. 69, p < 0.001). A trend toward improvement in clinical examination parameters was observed.ConclusionETI therapy appears to significantly improve nasal sinus symptoms in children aged 6–12 years, as evidenced by improved quality‐of‐life scales and reduced antibiotic use.

Background: Among all studies describing COVID-19 clinical features during the first wave of the pandemic, only a few retrospective studies have assessed the correlation between olfac-tory dysfunction (OD) and the evolution of disease severity. The main aim was to assess whether OD is a predictive factor of COVID-19 severity based on the patient’s medical management (outpa-tient care, standard hospital admission, and ICU admission). Methods: A national, prospective, mul-ticenter cohort study was conducted in 20 public hospitals and a public center for COVID-19 screen-ing. During the first wave of the pandemic, from 6 April to 11 May 2020, all patients tested positive for COVID-19 confirmed by RT-PCR underwent two follow-up ENT consultations within 10 days of symptom onset. The main outcome measures were the evolution of medical management (out-patient care, standard hospital admission, and ICU admission) at diagnosis and along the clinical course of COVID-19 disease. Results: Among 481 patients included, the prevalence of OD was 60.7%, and it affected mostly female patients (74.3%) under 65 years old (92.5%), with fewer comor-bidities than patients with normal olfactory function. Here, 99.3% (290/292) of patients with OD presented with non-severe COVID-19 disease. Patients reporting OD were significantly less hospi-talized than the ones managed as outpatients, in either a standard medical unit or an ICU. Conclu-sions: As regards the clinical course of COVID-19 disease, OD could predict a decreased risk of hospitalization during the first wave of the pandemic.

BACKGROUND:Perceptual and speech production abilities of children with cochlear implants (CIs) are usually tested by word and sentence repetition or naming tests. However, these tests are quite far apart from daily life linguistic contexts. AIM:Here, we describe a way of investigating the link between language comprehension and anticipatory verbal behaviour promoting the use of more complex listening situations. METHODS AND PROCEDURE:The setup consists in watching the audio-visual dialogue of two actors. Children's gaze switches from one speaker to the other serve as a proxy of their prediction abilities. Moreover, to better understand the basis and the impact of anticipatory behaviour, we also measured children's ability to understand the dialogue content, their speech perception and memory skills as well as their rhythmic skills, that also require temporal predictions. Importantly, we compared children with CI performances with those of an age-matched group of children with normal hearing (NH). OUTCOMES AND RESULTS:While children with CI revealed poorer speech perception and verbal working memory abilities than NH children, there was no difference in gaze anticipatory behaviour. Interestingly, in children with CI only, we found a significant correlation between dialogue comprehension, perceptual skills and gaze anticipatory behaviour. CONCLUSION:Our results extend to a dialogue context of previous findings showing an absence of predictive deficits in children with CI. The current design seems an interesting avenue to provide an accurate and objective estimate of anticipatory language behaviour in a more ecological linguistic context also with young children. WHAT THIS PAPER ADDS:What is already known on the subject Children with cochlear implants seem to have difficulties extracting structure from and learning sequential input patterns, possibly due to signal degradation and auditory deprivation in the first years of life. They also seem to have a reduced use of contextual information and slow language processing among children with hearing loss. What this paper adds to existing knowledge Here we show that when adopting a rather complex linguistic context such as watching a dialogue of two individuals, children with cochlear implants are able to use the speech and language structure to anticipate gaze switches to the upcoming speaker. What are the clinical implications of this work? The present design seems an interesting avenue to provide an accurate and objective estimate of anticipatory behaviour in a more ecological and dynamic linguistic context. Importantly, this measure is implicit and it has been previously used with very young (normal-hearing) children, showing that they spontaneously make anticipatory gaze switches by age two. Thus, this approach may be of interest to refine the speech comprehension assessment at a rather early age after cochlear implantation where explicit behavioural tests are not always reliable and sensitive.

Objectives: We assessed if spatial hearing training improves sound localization in bilateral cochlear implant (BCI) users and whether its benefits can generalize to untrained sound localization tasks. Design: In 20 BCI users, we assessed the effects of two training procedures (spatial versus nonspatial control training) on two different tasks performed before and after training (head-pointing to sound and audiovisual attention orienting). In the spatial training, participants identified sound position by reaching toward the sound sources with their hand. In the nonspatial training, comparable reaching movements served to identify sound amplitude modulations. A crossover randomized design allowed comparison of training procedures within the same participants. Spontaneous head movements while listening to the sounds were allowed and tracked to correlate them with localization performance. Results: During spatial training, BCI users reduced their sound localization errors in azimuth and adapted their spontaneous head movements as a function of sound eccentricity. These effects generalized to the head-pointing sound localization task, as revealed by greater reduction of sound localization error in azimuth and more accurate first head-orienting response, as compared to the control nonspatial training. BCI users benefited from auditory spatial cues for orienting visual attention, but the spatial training did not enhance this multisensory attention ability. Conclusions: Sound localization in BCI users improves with spatial reaching-to-sound training, with benefits to a nontrained sound localization task. These findings pave the way to novel rehabilitation procedures in clinical contexts.

To develop and validate a new questionnaire, the Kid-SSQ, for the rapid screening of hearing abilities in children with hearing impairment, aged 7–17 years. The questionnaire was constructed from two existing, validated versions of the ‘Speech, Spatial and Qualities of Hearing’ - (SSQ) questionnaire (pediatric form and adult short-form). The 12 selected items included auditory aspects from three subscales: speech perception, spatial hearing, and qualities of hearing. This new short form was then validated in 154 children with cochlear implants (100 bilaterally, and 54 unilaterally implanted children). Construct validity was assessed by testing relationships between Kid-SSQ scores and objective clinical parameters (e.g., age at test, pure-tone audiometry-PTA threshold, speech reception threshold-SRT, duration of binaural experience). Completion time was acceptable for use with children (less than 10 min) and the non-response rate was less than 1

Perceptual and speech production abilities of children with cochlear implants (CI) are usually tested by word and sentence repetition or naming tests. However, in their daily life they show very heterogeneous language skills. Here, we describe a way of increasing the ecological validity of language assessment, promoting the use of close to real-life listening situations. The setup consists in watching the audio-visual conversation of two individuals. Children’s gaze-switches from one speaker to the other serve as a proxy of their prediction abilities. Moreover, to better understand the basis and the impact of anticipatory behaviour, we also measured children’s ability to understand the dialogue content, their speech perception and memory skills as well as their rhythmic skills. Importantly, we compared children with CI performances with those of an age-matched group of children with NH. While children with CI revealed poorer speech perception and verbal working memory abilities than NH children, there was no difference in gaze anticipatory behaviour. Interestingly, in children with CI only, we found a significant correlation between dialogue comprehension, perceptive skills and gaze anticipatory behaviour. Our results confirm and extend to a conversational context previous findings showing an absence of predictive deficits in children with CI. The current design seems an interesting avenue to provide an accurate and objective estimate of anticipatory language behaviour in a rather ecological conversational context also with young children.

Objective: The aim of this study was to evaluate the feasibility of a virtual reality-based spatial hearing training protocol in bilateral cochlear implant (CI) users and to provide pilot data on the impact of this training on different qualities of hearing. Design: Twelve bilateral CI adults aged between 19 and 69 followed an intensive 10-week rehabilitation program comprised eight virtual reality training sessions (two per week) interspersed with several evaluation sessions (2 weeks before training started, after four and eight training sessions, and 1 month after the end of training). During each 45-minute training session, participants localized a sound source whose position varied in azimuth and/or in elevation. At the start of each trial, CI users received no information about sound location, but after each response, feedback was given to enable error correction. Participants were divided into two groups: a multisensory feedback group (audiovisual spatial cue) and an unisensory group (visual spatial cue) who only received feedback in a wholly intact sensory modality. Training benefits were measured at each evaluation point using three tests: 3D sound localization in virtual reality, the French Matrix test, and the Speech, Spatial and other Qualities of Hearing questionnaire. Results: The training was well accepted and all participants attended the whole rehabilitation program. Four training sessions spread across 2 weeks were insufficient to induce significant performance changes, whereas performance on all three tests improved after eight training sessions. Front-back confusions decreased from 32% to 14.1% ( p = 0.017); speech recognition threshold score from 1.5 dB to −0.7 dB signal-to-noise ratio ( p = 0.029) and eight CI users successfully achieved a negative signal-to-noise ratio. One month after the end of structured training, these performance improvements were still present, and quality of life was significantly improved for both self-reports of sound localization (from 5.3 to 6.7, p = 0.015) and speech understanding (from 5.2 to 5.9, p = 0.048). Conclusions: This pilot study shows the feasibility and potential clinical relevance of this type of intervention involving a sensorial immersive environment and could pave the way for more systematic rehabilitation programs after cochlear implantation.

The present study investigates how electrically evoked Auditory Brainstem Responses (eABRs) can be used to measure local channel interactions along cochlear implant (CI) electrode arrays. eABRs were recorded from 16 experienced CI patients in response to electrical pulse trains delivered using three stimulation configurations: (1) single electrode stimulations (E11 or E13); (2) simultaneous stimulation from two electrodes separated by one (En and En+2, E11 and E13); and (3) stimulations from three consecutive electrodes (E11, E12, and E13). Stimulation level was kept constant at 70% electrical dynamic range (EDR) on the two flanking electrodes (E11 and E13) and was varied from 0 to 100% EDR on the middle electrode (E12). We hypothesized that increasing the middle electrode stimulation level would cause increasing local electrical interactions, reflected in characteristics of the evoked compound eABR. Results show that group averaged eABR wave III and V latency and amplitude were reduced when stimulation level at the middle electrode was increased, in particular when stimulation level on E12 reached 40, 70, and 100% EDR. Compound eABRs can provide a detailed individual quantification of electrical interactions occurring at specific electrodes along the CI electrode array. This approach allows a fine determination of interactions at the single electrode level potentially informing audiological decisions regarding mapping of CI systems.

Background and Purpose Use of unilateral cochlear implant (UCI) is associated with limited spatial hearing skills. Evidence that training these abilities in UCI user is possible remains limited. In this study, we assessed whether a Spatial training based on hand-reaching to sounds performed in virtual reality improves spatial hearing abilities in UCI users Methods Using a crossover randomized clinical trial, we compared the effects of a Spatial training protocol with those of a Non-Spatial control training. We tested 17 UCI users in a head-pointing to sound task and in an audio-visual attention orienting task, before and after each training. Study is recorded in clinicaltrials.gov (NCT04183348). Results During the Spatial VR training, sound localization errors in azimuth decreased. Moreover, when comparing head-pointing to sounds before vs. after training, localization errors decreased after the Spatial more than the control training. No training effects emerged in the audio-visual attention orienting task. Conclusions Our results showed that sound localization in UCI users improves during a Spatial training, with benefits that extend also to a non-trained sound localization task (generalization). These findings have potentials for novel rehabilitation procedures in clinical contexts.

Lateralized sounds can orient visual attention, with benefits for audio-visual processing. Here, we asked to what extent perturbed auditory spatial cues-resulting from cochlear implants (CI) or unilateral hearing loss (uHL)-allow this automatic mechanism of information selection from the audio-visual environment. We used a classic paradigm from experimental psychology (capture of visual attention with sounds) to probe the integrity of audio-visual attentional orienting in 60 adults with hearing loss: bilateral CI users (N = 20), unilateral CI users (N = 20), and individuals with uHL (N = 20). For comparison, we also included a group of normal-hearing (NH, N = 20) participants, tested in binaural and monaural listening conditions (i.e., with one ear plugged). All participants also completed a sound localization task to assess spatial hearing skills. Comparable audio-visual orienting was observed in bilateral CI, uHL, and binaural NH participants. By contrast, audio-visual orienting was, on average, absent in unilateral CI users and reduced in NH listening with one ear plugged. Spatial hearing skills were better in bilateral CI, uHL, and binaural NH participants than in unilateral CI users and monaurally plugged NH listeners. In unilateral CI users, spatial hearing skills correlated with audio-visual-orienting abilities. These novel results show that audio-visual-attention orienting can be preserved in bilateral CI users and in uHL patients to a greater extent than unilateral CI users. This highlights the importance of assessing the impact of hearing loss beyond auditory difficulties alone: to capture to what extent it may enable or impede typical interactions with the multisensory environment.

Localising sounds means having the ability to process auditory cues deriving from the interplay among sound waves, the head and the ears. When auditory cues change because of temporary or permanent hearing loss, sound localization becomes difficult and uncertain. The brain can adapt to altered auditory cues throughout life and multisensory training can promote the relearning of spatial hearing skills. Here, we study the training potentials of sound-oriented motor behaviour to test if a training based on manual actions toward sounds can learning effects that generalize to different auditory spatial tasks. We assessed spatial hearing relearning in normal hearing adults with a plugged ear by using visual virtual reality and body motion tracking. Participants performed two auditory tasks that entail explicit and implicit processing of sound position (head-pointing sound localization and audio-visual attention cueing, respectively), before and after having received a spatial training session in which they identified sound position by reaching to auditory sources nearby. Using a crossover design, the effects of the above-mentioned spatial training were compared to a control condition involving the same physical stimuli, but different task demands (i.e., a non-spatial discrimination of amplitude modulations in the sound). According to our findings, spatial hearing in one-ear plugged participants improved more after reaching to sound trainings rather than in the control condition. Training by reaching also modified head-movement behaviour during listening. Crucially, the improvements observed during training generalize also to a different sound localization task, possibly as a consequence of acquired and novel head-movement strategies.

Young (mean age 22.4 years) and elderly (mean age 82.3 years) subjects tasted and rated a range of liquids containing between 0.5% and 36% dairy fat by weight. The liquids also contained either sucrose (0–20%) or NaCl (0–0.584%). Within each age group both normal weight and overweight subjects participated. The fat content in the mixtures was unrelated to pleasantness ratings for elderly subjects. The concentrations of both fat and sucrose in the mixtures determined the hedonic responses of young normal weight subjects. Overweight young subjects' hedonic responses were predominantly influenced by sucrose concentration. Fat content in dairy-salt mixtures was significantly related to pleasantness ratings by young subjects, but did not influence ratings by elderly subjects. These findings suggest that the elderly can significantly reduce dietary fat intake without sacrificing perceived pleasantness.

Objectives: To determine whether temporal bone computed tomography (CT) features are linked to the presence and type of hearing loss in osteogenesis imperfecta (OI) when considering hearing-impaired OI patients and normally hearing (NH) OI ones. A secondary objective was to assess whether other factors influence CT features in a large sample: age, type of mutation, or bone mineral density (BMD). Methods: A total of 41 adults with OI underwent CTs and pure-tone audiometry in 82 ears. Hearing thresholds were normal in 64 out of 82 ears, and most had not been operated on for stapedectomy or stapedotomy. Ossicle density, footplates, oval and round windows, retrofenestral peri- and endolabyrinths, and temporal pneumatization were analyzed twice by an experienced radiologist. CT features were compared to hearing, age, collagen mutations, and bone mineral density. Results: Unexpectedly a high prevalence of footplate, ossicle, and otic capsule anomalies was observed, even in NH ears. Footplate hypodensity or thickening was mostly found in ears without conductive hearing loss. There were significantly more retrofenestral anomalies or window obstruction in ears with a sensorineural hearing loss component than in ears without. Age was significantly higher in ears with middle layer hypodensity than in ears without. Patients with mutations were expected to have reduced collagen quantity and had significantly more footplate or retrofenestral anomalies than those with qualitative mutations. BMD was significantly higher in ears without temporal hyperpneumatization. Conclusion: Temporal bone CT features in OI are present in a large proportion of patients, had they hearing loss or not, and might be determined more by collagen mutation type than by age or BMD.

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care.

In everyday life, sound localization entails more than just the extraction and processing of auditory cues. When determining sound position in three dimensions, the brain also considers the available visual information (e.g., visual cues to sound position) and resolves perceptual ambiguities through active listening behavior (e.g., spontaneous head movements while listening). Here, we examined to what extent spontaneous head movements improve sound localization in 3D-azimuth, elevation, and depth-by comparing static vs. active listening postures. To this aim, we developed a novel approach to sound localization based on sounds delivered in the environment, brought into alignment thanks to a VR system. Our system proved effective for the delivery of sounds at predetermined and repeatable positions in 3D space, without imposing a physically constrained posture, and with minimal training. In addition, it allowed measuring participant behavior (hand, head and eye position) in real time. We report that active listening improved 3D sound localization, primarily by ameliorating accuracy and variability of responses in azimuth and elevation. The more participants made spontaneous head movements, the better was their 3D sound localization performance. Thus, we provide proof of concept of a novel approach to the study of spatial hearing, with potentials for clinical and industrial applications.

In everyday life, localizing a sound source entails more than the sole extraction of auditory cues to define its three-dimensions: spatial hearing also takes into account the available visual information (e.g. cues to sound position) and resolves perceptual ambiguities through active listening behavior (e.g. exploring the auditory environment with head movements). We introduce a novel approach to sound localization in 3D named SPHERE which exploits a commercially available Virtual Reality Head-mounted display system with real- time kinematic tracking to combine all of these elements (controlled positioning of a real sound source, recording of participants’ responses in 3D, controlled visual stimulations and active listening behavior). SPHERE allows accurate sampling of 3D spatial hearing abilities, and allows detection and quantification of the contribution of active listening.

La otitis media crónica (OMC) se define de forma bastante sencilla como un proceso inflamatorio que afecta a la mucosa de las cavidades del oído medio de forma prolongada (más allá de 3 meses). La patogenia de la OMC no se conoce por completo. En este artículo se presentan unas reseñas fundamentales de embriología (papel del mesénquima), de anatomía (compartimentación y ventilación de las cavidades del oído medio), de histología (constituyentes de la membrana timpánica, características de la epidermis del conducto auditivo externo [CAE] y funcionamiento de la mucosa del oído medio), de fisiología (funcionamiento tubárico, difusión transmembrana de los gases e impacto sobre la regulación de presiones, papel del aclaramiento mucociliar), así como la fisiopatología que puede explicar la aparición y persistencia de un proceso de otitis crónica. Este término genérico de «otitis media crónica» engloba entidades clínicas distintas, más o menos evolutivas, que se detallan en la segunda parte: otitis seromucosa (OSM), otitis mucosa abierta, otitis atelectásica, otitis fibroadhesiva (OFA) y atelectasias excéntricas localizadas, denominadas «bolsas de retracción (BR)». Además de estas formas evolutivas, cuyo riesgo último es la evolución hacia una otitis colesteatomatosa, se distinguen otras lesiones otoscópicas que, cuando se observan de forma aislada, sólo constituyen secuelas. Se trata en este caso de las perforaciones timpánicas no marginales, las membranas timpánicas pelúcidas y las osteólisis osiculares, a menudo secundarias a una otitis mucosa abierta. Por último, la timpanosclerosis es un fenómeno cicatricial lentamente evolutivo, caracterizado por la aparición de depósitos hialinos y calcáreos en el interior de la membrana timpánica de forma aislada («miringoesclerosis») y/o en la caja del tímpano, que puede existir de forma aislada o asociarse a otra forma de otitis crónica.

Objectives: The aim of this study was to assess three-dimensional (3D) spatial hearing abilities in reaching space of children and adolescents fitted with bilateral cochlear implants (BCI). The study also investigated the impact of spontaneous head movements on sound localization abilities. Design: BCI children (N = 18, aged between 8 and 17) and age-matched normal-hearing (NH) controls (N = 18) took part in the study. Tests were performed using immersive virtual reality equipment that allowed control over visual information and initial eye position, as well as real-time 3D motion tracking of head and hand position with subcentimeter accuracy. The experiment exploited these technical features to achieve trial-by-trial exact positioning in head-centered coordinates of a single loudspeaker used for real, near-field sound delivery, which was reproducible across trials and participants. Using this novel approach, broadband sounds were delivered at different azimuths within the participants’ arm length, in front and back space, at two different distances from their heads. Continuous head-monitoring allowed us to compare two listening conditions: “head immobile” (no head movements allowed) and “head moving” (spontaneous head movements allowed). Sound localization performance was assessed by computing the mean 3D error (i.e. the difference in space between the X-Y-Z position of the loudspeaker and the participant’s final hand position used to indicate the localization of the sound’s source), as well as the percentage of front–back and left–right confusions in azimuth, and the discriminability between two nearby distances. Several clinical factors (i.e. age at test, interimplant interval, and duration of binaural experience) were also correlated with the mean 3D error. Finally, the Speech Spatial and Qualities of Hearing Scale was administered to BCI participants and their parents. Results: Although BCI participants distinguished well between left and right sound sources, near-field spatial hearing remained challenging, particularly under the “ head immobile” condition. Without visual priors of the sound position, response accuracy was lower than that of their NH peers, as evidenced by the mean 3D error (BCI: 55 cm, NH: 24 cm, p = 0.008). The BCI group mainly pointed along the interaural axis, corresponding to the position of their CI microphones. This led to important front–back confusions (44.6%). Distance discrimination also remained challenging for BCI users, mostly due to sound compression applied by their processor. Notably, BCI users benefitted from head movements under the “head moving” condition, with a significant decrease of the 3D error when pointing to front targets ( p < 0.001). Interimplant interval was correlated with 3D error ( p < 0.001), whereas no correlation with self-assessment of spatial hearing difficulties emerged ( p = 0.9). Conclusions: In reaching space, BCI children and adolescents are able to extract enough auditory cues to discriminate sound side. However, without any visual cues or spontaneous head movements during sound emission, their localization abilities are substantially impaired for front–back and distance discrimination. Exploring the environment with head movements was a valuable strategy for improving sound localization within individuals with different clinical backgrounds. These novel findings could prompt new perspectives to better understand sound localization maturation in BCI children, and more broadly in patients with hearing loss.