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For children with prelingual deafness, bilateral Cochlear Implant (CI) use is beneficial in terms of sound localization and speech recognition in quiet and in noise when compared to unilateral CI use. However, little is known about the benefits of bilateral CI use in children with prelingual deafness whose mother tongue is Mandarin, a tonal language. Furthermore, sufficient data on surgical approaches are currently lacking. Objectives: This study aims to collect more evidence on these topics. Material and Methods: 30 children (aged 12-18 months) with prelingual severe to profound bilateral sensorineural hearing loss were implanted with a CI at the Peking Union Medical College Hospital in Beijing. 10 children were implanted unilaterally, 20 were implanted bilaterally. All children were from Mandarin-speaking families. The surgical approach was documented. The following outcomes are investigated over a period of three years and compared between the unilateral and the bilateral group: • Auditory development - LittleEars Auditory Questionnaire (LEAQ) - Speech, Spatial and Quality of hearing questionnaire (SSQ, parent version) - Categories of Auditory Perception (CAP) • Speech perception - Mandarin Early Speech Perception test (MESP) • Speaking performance -Speech Intelligibility Rating (SIR) -Mandarin Paediatric Speech Intelligibility test (MPSI) •Spatial hearing -Reaching For Sound (RFS) Results and Conclusion: At 1-year post-CI activation, average SSQ, CAP, SIR, and LEAQ scores improved. The bilateral group had better scores in the spatial domain of the SSQ questionnaire than did the unilateral group. Due to the very young age, only a small number of children could be tested for speech recognition and spatial hearing skills. The data collected so far contribute to the assessment of benefits of bilateral CI use in toddlers and to the study of their auditory skills development. [ABSTRACT FROM AUTHOR]