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August 27, 2020

Understanding Patient Perspectives on Single-Sided Deafness

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of Illinois at Chicago
JAMA Otolaryngol Head Neck Surg. Published online August 27, 2020. doi:10.1001/jamaoto.2020.2287

Single-sided deafness (SSD) is a challenging condition for otolaryngologists to treat. This condition is defined as having normal or nearly normal hearing in one ear, with profound hearing loss in the contralateral ear. Patients with SSD differ from patients with bilateral hearing loss in that a patient with SSD hears normally in a quiet environment with a limited number of speakers. In challenging environments, patients begin to notice difficulty with hearing and understanding speech. They have difficulty with localizing the speaker, differentiating words from background sounds, and understanding a speaker on the nonhearing side.1 These 3 factors, hearing in noise, directionality, and the head shadow effect, have variable effects depending on the acoustic environment. As a result, patients perceive a wide range of hearing difficulty, and the need for intervention depends on their daily sound environments. In addition, SSD can have an effect on balance, spatial awareness, and quality of life.2,3 Patients with SSD have multiple therapeutic options, including living with 1 hearing ear, a contralateral routing of signal (CROS) hearing aid, and an osseointegrated bone conduction device. However, none of these treatment modalities has been shown to provide the best therapeutic outcome. Recently, cochlear implantation has emerged as a surgical option.4,5 Given the multiple therapeutic options, how do clinicians treat patients who have variable perceptions of auditory disability and also have multiple reasonable therapeutic options?

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