Unilateral Hearing Loss in Children

PROGRAM DESCRIPTION: Evaluation and management of unilateral sensorineural hearing loss (UHL) in children has undergone significant evolution over the past decade as there has been increased understanding of etiologies and recognition of the harmful effects of UHL including delays in speech and language development, listening fatigue, academic hardship, and social-emotional difficulties. This expert lecture will provide an in-depth review of UHL in children with the discussion on evaluation and management based on hearing loss severity. The role for genetics evaluation, imaging with an emphasis on identifying critical anatomical considerations such as cochlear nerve deficiency, consulting services such as ophthalmology, and other aspects of evaluation for UHL will be reviewed. Options to manage UHL will be presented, including FM/Bluetooth systems, conventional hearing aids, Contralateral Routing of Signals (CROS) technology, osseointegrated bone conduction systems, and cochlear implantation. The most recent literature and evidence on the impact of mild UHL and utility of amplification will be reviewed. In more severe cases, candidacy criteria for surgical options will be discussed, along with a review of variables that determine outcomes including duration of hearing loss, age at implantation, patient motivation, family support, and isolated auditory training post-activation. Although it remains unclear what features determine ideal outcomes with cochlear implants in UHL, the presentation will discuss factors to minimize poor performance or non-use. A case-based approach will be used to discuss commonly seen patient scenarios.

OUTCOME OBJECTIVE 1: Review the audiological, scholastic, and social implications of unilateral hearing loss in children

OUTCOME OBJECTIVE 2: Discuss the management options for unilateral hearing loss based on severity, etiology, and anatomy.

OUTCOME OBJECTIVE 3: Review most recent literature on current candidacy criteria for surgical implants in unilateral hearing loss

BACKGROUND STATEMENT: Evaluation and management of unilateral hearing loss in children has undergone tremendous evolution with increased knowledge on impact, management options, and recently, cochlear implantation. This lecture helps distill the literature into the most relevant evidence to help clinicians.