Consensus Practice Parameter: Audiological Assessment and Management of Unilateral Hearing Loss in Children
International Journal of Audiology
Bagatto, M., DesGeorges, J., et al. (2019).
International Journal of Audiology, 58(12), 805-815.
This consensus guideline provides recommendations on the audiological assessment, monitoring, and management of children with unilateral hearing loss.
Phonak AG
Because unilateral hearing loss (UHL) is often associated with specific genetic causes or medical conditions (e.g., cochlear malformations, enlarged vestibular aquaduct syndrome), an etiologic assessment including a complete otologic evaluation, genetic testing (in children with suspected syndromic hearing loss), and temporal bone imaging should be conducted following a UHL diagnosis.
Children with unilateral hearing loss should receive a comprehensive speech and language evaluation and academic monitoring.
Assessments that target speech-in-noise ability are recommended to determine the need for hearing assistive technologies that may improve the signal-to-noise ratio.
Localization should be formally assessed, ideally, in an anechoic chamber using speakers arranged in an array. If that is not clinically feasible, audiologists may also use functional questionnaires or surveys such as the Auditory Behaviour in Everyday Life or the Speech, Spatial and Qualities of Hearing Questionnaire.
For permanent moderate to severe hearing loss, air conduction hearing aid fitting for the affected side should be considered a first-line treatment, regardless of the child's age. For profound loss on the affected side, a remote microphone system is recommended for certain listening situations. Determinations for remote microphone system use should include the child's age, child's use of amplification, degree and configuration of hearing loss in the affected ear, and where the system will be used. For some, due to safety purposes, sound detection and not just speech perception may be a desirable outcome
"For infants and young children with unilateral microtia or atresia and for whom conventional air-conduction hearing aids cannot be fitted, a bone-conduction device should be considered" (p. 808).
Cochlear implantation may be an option for some children with severe-to-profound unilateral hearing loss in order to achieve some level of binaural hearing.
Contralateral routing of signal (CROS) may be used when there is no expected benefit from fitting the affected ear with amplification. Considerations for CROS fittings include:<br />
<ul>
<li><span style="color: #333333;">the child's ability to localize sound;</span></li>
<li><span style="color: #333333;">the child's ability to hear speech on the affected side; and</span></li>
<li><span style="color: #333333;">the level of speech perception in the ear with unilateral hearing loss.</span></li>
</ul>
