A future for unilateral deafness
Reviewed by Linnea Cheung

Every year, we see several patients struggling with irreversible unilateral hearing loss that is non-responsive to sound amplification. This article emphasises that clinicians should not underestimate the functional and psychological impairment single-sided deafness can have on an individual, even though patients themselves may find it difficult to describe this impact, particularly when the hearing loss is mild. Usually the complaint is of poor discrimination of sounds in the presence of background noise, for instance, at a social gathering, but the problem can be more dangerous in situations where audio-spatial discrimination is required, such as when crossing a busy road. There are several devices available including various CROS-aids and bone-anchored hearing aids that may be useful in these patients, but this article highlights that some evidence shows cochlear implantation may also play a beneficial role. It is however too early to tell which patients exactly may benefit and clearly further studies are required to evaluate this potential, but for the meantime, cochlear implantation is not recommended by United States or British guidance authorities. Paediatric patients pose a further challenge since the brain’s ability to adapt is enhanced by early identification and intervention of unilateral deafness, and therefore further work is required in order to evaluate when and what intervention is appropriate in the management of this problem particularly in babies and infants. In general there has been an improvement in awareness of this condition but for now there is no perfect solution without further research. We should no longer be settling for just “one good ear”. We should strive to seek out more accurate evaluation studies for assessment of sound localisation and hearing ability and research further into the comparative efficacy of the devices currently available so that we are best able to inform and manage our patients for the future.

Single-sided deafness: causes, and solution, take many forms.
Weaver J.
THE HEARING JOURNAL
2015:68(3):20-4.