unilateral deafness/unaidable

unilateral deafness/unaidable

Portrait photo of young boy holding his ears out

Kids Need Two Ears!

Children with hearing loss are at high risk for delays in acquiring and advancing speech and language, and achieving psycho-educational success. This fact, well known for decades, escapes clear guidelines for treatment when the hearing loss is unilateral, sensorineural, and “unaidable.” The traditional definition of “unaidable” is challenged by modern cochlear implants, which provide a potential—albeit “off-label” solution—to provide bimodal or binaural hearing in cases of unilateral hearing loss.

Topic(s): Pediatric Audiology, unilateral deafness/unaidable, Cochlear Implants (CI)


Publication Issue: Audiology Today January/February 2017

JAAA Editorial: Time is the Enemy

Vol. 30, No. 2 (February 2019) 
Gary P. Jacobson, Ph.D.
Editor-in-Chief, Journal of the American Academy of Audiology

Gary P. Jacobson, Ph.D

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Unilateral Hearing Loss: What to Do?

Patients with unilateral hearing loss can present with variable issues. Much is dependent on the severity of the hearing loss (threshold and speech understanding), age of onset, hearing status of contralateral ear, and presence of comorbidities (e.g., vertigo, cognitive status, central auditory processing, hyperacusis, tinnitus, disease/pathology/disorder, etc.). Adult-onset severe-to-profound unilateral sensorineural hearing loss with normal hearing sensitivity in the contralateral ear presents a unique dilemma.

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Unilateral Hearing Loss and Brain Changes

Liu et al (2015) report that sensorineural hearing loss (SNHL) may be due to multiple etiologies, such as noise exposure, aging, infections, ototoxic chemicals, vascular compromise, disruption of cochlear membranes, inner ear abnormalities, immunologic disorders, and more. However, they report that it is rare to have a single specific etiology attributed to an individual.

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Combining Cochlear Implants and Normal Hearing

Since 2008 (see Van De Hetning, Vermeire and Diebl), multiple reports and studies have addressed the benefit of cochlear implants (CIs) in the worse (unilateral deafness or “unaidable”) ear, given a normal (or nearly normal, or aidable) contralateral ear (see Arndt, Aschendorff, Laszig et al 2011, Baguley 2010, Buechner, Brendel, Lesinki-schiedat et al 2010, VanZon, Peters, Stegeman et al, 2015).

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