Cochlear Implants in Single-Sided Deafness

Abstract

Single-sided deafness presents a unique challenge to otolaryngologists and audiologists. While the normal hearing ear may allow listeners to perform adequately on audiometric screening, individuals with only one functioning cochlea suffer when resolving speech in noisy environments and in sound localization—which both contribute to a reduced quality of life. Though there are a variety of strategies that provide contralateral routing of sound signals, the cochlear implant is the only treatment to truly restore binaural hearing. Only very recently has cochlear implantation (CI) for single-sided deafness begun in earnest, with encouraging results that demonstrate the strengths and pitfalls of implantation over traditional extracochlear methods. The purpose of this review is to update the field by emphasizing binaural benefits, discussing historical treatments of single-sided deafness, critically evaluating recent data on outcomes of CI for single-sided deafness, and recommending indications for cochlear implants in single-sided deafness in children, adults, and subjects with concurrent ipsilateral tinnitus.