American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness.
Margaret T Dillon, Armine Kocharyan, Ghazal S Daher and 4 others
PMID 35994570WHAT IT FOUND
Cochlear implantation for adults with single-sided deafness consistently improves hearing in the deaf ear, sound localization, tinnitus, and quality of life.
Speech recognition in noise improves only when the target is directed toward the impaired ear. These outcomes support CI as a viable treatment option.
Key findings
01The systematic review found a high probability (greater than 75 to 100 percent) of improvement in speech recognition in the implanted ear, sound source localization, tinnitus perception, and quality of life.
02Improvement in speech recognition in noise was highly dependent on the listening configuration, with high probability of benefit when the target was directed to the impaired ear but low or moderately low probability when the target was directed to the normal hearing ear or when both were co-located.
03Advanced age is not a contraindication for cochlear implantation in adults with single-sided deafness, as no additional complications were reported in studies including subjects 65 years of age or older.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The majority of included studies had small sample sizes, which limits the generalizability of the findings. Most studies had short durations of deafness (10 years or less), so outcomes for individuals with very long-standing deafness are less certain. The review excluded case series with 10 or fewer participants, potentially omitting some early pilot data. Methodological variability across studies, particularly in the setup of spatial hearing tests, makes direct comparison difficult. The review does not include data on children or individuals with congenital single-sided deafness, who may have different outcomes due to cortical reorganization.
Declared interests
One author (M.T.D.) is supported by a research grant from MED-EL Corporation, a cochlear implant manufacturer. The task force was convened by the American Cochlear Implant Alliance.
The easy way to misread this
Do not assume cochlear implantation will restore normal binaural hearing in all complex noise environments. The review shows that while localization and hearing in the deaf ear improve significantly, the ability to understand speech when the speaker is facing the normal-hearing ear or when noise and speech are co-located is much less reliable.