From the Guidelines
Treatment options for unilateral hearing loss should prioritize early intervention with hearing aids, CROS (Contralateral Routing of Signal) hearing aids, BiCROS systems, bone-anchored hearing devices, or cochlear implants to improve quality of life and reduce the handicapping effects of hearing loss. According to the most recent evidence 1, the management of unilateral hearing loss requires a multidisciplinary approach, including counseling and audiologic rehabilitation. The choice of treatment depends on the type and degree of hearing loss, patient preference, and lifestyle needs.
Some key considerations for treatment include:
- Conventional hearing aids for mild to moderate hearing loss
- CROS systems for those with little to no usable hearing in the affected ear
- BiCROS systems for those with some hearing loss in both ears but worse in one
- Bone-anchored devices like the Baha or Ponto for surgical implantation
- Cochlear implants for profound sensorineural hearing loss
It is essential to address the need for hearing aids or hearing assistive technology systems as soon as possible, either as a means of bridging the period of time that hearing is impaired during treatment or as an option if recovery is not feasible 1. A systematic review of health-related quality of life and hearing aids determined that amplification improves the quality of life for individuals with unilateral hearing loss by aiding in a major reduction of psychosocial and emotional manifestations.
Referral to a multidisciplinary care center, when available, is recommended 1, as a team approach that includes otolaryngologists, clinical geneticists, genetic counselors, audiologists, speech and language specialists, and early hearing intervention and family support specialists can provide comprehensive care and support for individuals with unilateral hearing loss.
Overall, the goal of treatment is to improve communication, reduce the handicapping effects of hearing loss, and enhance quality of life, and early intervention with the most suitable treatment option is crucial to achieving these outcomes.
From the Research
Treatment Options for Unilateral Hearing Loss
- The treatment options for unilateral hearing loss depend on the underlying cause, which can be conductive, sensorineural, or mixed 2, 3.
- For conductive hearing loss, treatment may include surgery to correct the underlying cause, such as cerumen impaction, otitis media, or otosclerosis 3.
- For sensorineural hearing loss, treatment may include medical management, such as medication for sudden deafness or Menière's disease, or surgical treatment, such as removal of a cerebellopontine angle tumor 2.
- In some cases, hearing aids or other amplification devices may be recommended, including bone-anchored hearing aids (BAHAs) for patients with unilateral conductive hearing loss 4, 5.
- BAHAs have been shown to improve sound localization and speech recognition in noise, and can have a complementary effect on audiological and subjective outcomes in patients with unilateral conductive hearing loss 5.
- Less expensive, over-the-counter hearing aids may also be an option for patients with mild to moderate hearing loss 6.
Diagnostic Evaluation
- A comprehensive diagnostic evaluation is necessary to determine the underlying cause of unilateral hearing loss, and may include pure-tone audiometry, acoustic reflex testing, imaging, serologic testing, and auditory brainstem response testing 2, 6.
- Magnetic resonance imaging (MRI) may be used to evaluate for retrocochlear pathology, such as acoustic neuroma or other lesions of the internal auditory meatus or cerebello-pontine angle 2.
Importance of Early Diagnosis and Treatment
- Early diagnosis and treatment of unilateral hearing loss are important to prevent negative emotional, cognitive, economic, and social consequences, and to improve communication and quality of life 6, 4.
- Family physicians should counsel patients on the importance of protecting their hearing and provide guidance on treatment options and referral to specialized care when necessary 6, 3.