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, the absolute criteria that determines ideal outcomes with cochlear implantation is still unclear, factors that may result in poor performers and non-users will be discussed. A case-based approach will be used to discuss commonly seen patient scenarios.