scholarly journals Hearing with One Ear: Consequences and Treatments for Profound Unilateral Hearing Loss

2020 ◽  
Vol 9 (4) ◽  
pp. 1010 ◽  
Author(s):  
Hillary A. Snapp ◽  
Sebastian A. Ausili

There is an increasing global recognition of the negative impact of hearing loss, and its association to many chronic health conditions. The deficits and disabilities associated with profound unilateral hearing loss, however, continue to be under-recognized and lack public awareness. Profound unilateral hearing loss significantly impairs spatial hearing abilities, which is reliant on the complex interaction of monaural and binaural hearing cues. Unilaterally deafened listeners lose access to critical binaural hearing cues. Consequently, this leads to a reduced ability to understand speech in competing noise and to localize sounds. The functional deficits of profound unilateral hearing loss have a substantial impact on socialization, learning and work productivity. In recognition of this, rehabilitative solutions such as the rerouting of signal and hearing implants are on the rise. This review focuses on the latest insights into the deficits of profound unilateral hearing impairment, and current treatment approaches.

2017 ◽  
Vol 28 (10) ◽  
pp. 941-949 ◽  
Author(s):  
Charles E. Bishop ◽  
Elgenaid Hamadain ◽  
Jason A. Galster ◽  
Mary Frances Johnson ◽  
Christopher Spankovich ◽  
...  

Background: Unilateral sensorineural hearing loss (USNHL) can have a negative impact on functions associated with the advantages of balanced, binaural hearing. Although single-sided deafness, which is a complete loss of audibility in one ear, has gained increased interest in the published research, there is a gap in the literature concerning hearing aid outcomes for individuals with residual, or otherwise “aidable,” hearing in the affected ear. Purpose: To assess hearing aid outcomes for a group of individuals with USNHL with residual, aidable function. Research Design: A quasi-experimental study of hearing aid outcomes with paired comparisons made between unaided and aided test conditions. Study Sample: A convenience sample of twenty-two individuals with USNHL, with sufficient residual hearing in the affected ear as to receive audibility from use of a hearing aid, were recruited into the study from September 2011 to August 2012. Intervention: Each participant was fit with a digital behind-the-ear hearing aid coupled to a custom ear mold. Data Collection and Analysis: Assessments were performed at baseline (unaided) and after a three-month field trial (aided) with primary outcomes involving objective measures in sound field yielding signal-to-noise ratio loss (SNR Loss) via the Quick Speech-in-Noise Test and word recognition scores (WRS) via the Northwestern University Auditory Test, No. 6. Outcomes also involved the administration of two well-established subjective benefit questionnaires: The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the 49-item Speech, Spatial, and Qualities of Hearing Scale (SSQ49). Results: As a group, participants showed significantly improved median SNR Loss thresholds when aided in a test condition that included spatial separation of speech and noise, with speech stimuli directed toward the worse ear and noise stimuli directed toward the better ear (diff. = −4.5; p < 0.001). Hearing aid use had a small, though statistically significant, negative impact on median SNR Loss thresholds, when speech and noise stimuli originated from the same 0° azimuth (diff. = 1.0; p = 0.018). This was also evidenced by the median WRS in sound field (diff. = −6.0; p = 0.006), which was lowered from 98% in the unaided state to 92% in the aided state. Results from the SSQ49 showed statistically significant improvement on all subsection means when participants were aided (p < 0.05), whereas results from the APHAB were generally found to be unremarkable between unaided and aided conditions as benefit was essentially equal to the 50th percentile of the normative data. At the close of the study, it was observed that only slightly more than half of all participants chose to continue use of a hearing aid after their participation. Conclusions: We observed that hearing aid use by individuals with USNHL can improve the SNR Loss associated with the interference of background noise, especially in situations when there is spatial separation of the stimuli and speech is directed toward the affected ear. In addition, hearing aid use by these individuals can provide subjective benefit, as evidenced by the APHAB and SSQ49 subjective benefit questionnaires.


2018 ◽  
Vol 22 ◽  
pp. 233121651877117 ◽  
Author(s):  
Emily Buss ◽  
Margaret T. Dillon ◽  
Meredith A. Rooth ◽  
English R. King ◽  
Ellen J. Deres ◽  
...  

2021 ◽  
Vol 25 ◽  
pp. 233121652110512
Author(s):  
Claire McSweeny ◽  
Sharon L. Cushing ◽  
Jennifer L. Campos ◽  
Blake C. Papsin ◽  
Karen A. Gordon

Poor binaural hearing in children was hypothesized to contribute to related cognitive and academic deficits. Children with unilateral hearing have normal hearing in one ear but no access to binaural cues. Their cognitive and academic deficits could be unique from children receiving bilateral cochlear implants (CIs) at young ages who have poor access to spectral cues and impaired binaural sensitivity. Both groups are at risk for vestibular/balance deficits which could further contribute to memory and learning challenges. Eighty-eight children (43 male:45 female, aged 9.89  ±  3.40 years), grouped by unilateral hearing loss ( n = 20), bilateral CI ( n = 32), and typically developing ( n = 36), completed a battery of sensory, cognitive, and academic tests. Analyses revealed that children in both hearing loss groups had significantly poorer skills (accounting for age) on most tests than their normal hearing peers. Children with unilateral hearing loss had more asymmetric speech perception than children with bilateral CIs ( p < .0001) but balance and language deficits ( p = .0004, p < .0001, respectively) were similar in the two hearing loss groups ( p > .05). Visuospatial memory deficits occurred in both hearing loss groups ( p = .02) but more consistently across tests in children with unilateral hearing loss. Verbal memory was not significantly different than normal ( p > .05). Principal component analyses revealed deficits in a main cluster of visuospatial memory, oral language, mathematics, and reading measures (explaining 46.8% data variability). The remaining components revealed clusters of self-reported hearing, balance and vestibular function, and speech perception deficits. The findings indicate significant developmental impacts of poor binaural hearing in children.


1994 ◽  
Vol 73 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Jack L. Pulec

Experience with the use of The Audiant Bone Conductor hearing implant in 8 patients who had unilateral profound hearing loss following acoustic neuroma surgery shows it to beneficial. Patients must have good hearing by bone conduction in the opposite uninvolved ear to be a candidate. Patients with unilateral hearing loss have the choice of doing nothing and getting along with one ear, they may be fitted with a CROS (contralateral routing of the signal) hearing aid or they may use the bone conductor hearing implant. Our experience suggests that patients prefer the bone conductor hearing implant since the resulting binaural hearing sounds more natural and an instrument needs to be worn on only one side. A surgical technique and new instrumentation to minimize the size and extent of the surgeries is described. The surgical implantation is usually done one month after acoustic neuroma surgery and is performed under local anesthesia in the outpatient surgery.


2016 ◽  
Vol 27 (07) ◽  
pp. 601-611 ◽  
Author(s):  
Tobias Weller ◽  
Virginia Best ◽  
Jörg M. Buchholz ◽  
Taegan Young

Background: Deficits in spatial hearing can have a negative impact on listeners’ ability to orient in their environment and follow conversations in noisy backgrounds and may exacerbate the experience of hearing loss as a handicap. However, there are no good tools available for reliably capturing the spatial hearing abilities of listeners in complex acoustic environments containing multiple sounds of interest. Purpose: The purpose of this study was to explore a new method to measure auditory spatial analysis in a reverberant multitalker scenario. Research Design: This study was a descriptive case control study. Study Sample: Ten listeners with normal hearing (NH) aged 20–31 yr and 16 listeners with hearing impairment (HI) aged 52–85 yr participated in the study. The latter group had symmetrical sensorineural hearing losses with a four-frequency average hearing loss of 29.7 dB HL. Data Collection and Analysis: A large reverberant room was simulated using a loudspeaker array in an anechoic chamber. In this simulated room, 96 scenes comprising between one and six concurrent talkers at different locations were generated. Listeners were presented with 45-sec samples of each scene, and were required to count, locate, and identify the gender of all talkers, using a graphical user interface on an iPad. Performance was evaluated in terms of correctly counting the sources and accuracy in localizing their direction. Results: Listeners with NH were able to reliably analyze scenes with up to four simultaneous talkers, while most listeners with hearing loss demonstrated errors even with two talkers at a time. Localization performance decreased in both groups with increasing number of talkers and was significantly poorer in listeners with HI. Overall performance was significantly correlated with hearing loss. Conclusions: This new method appears to be useful for estimating spatial abilities in realistic multitalker scenes. The method is sensitive to the number of sources in the scene, and to effects of sensorineural hearing loss. Further work will be needed to compare this method to more traditional single-source localization tests.


2010 ◽  
Vol 21 (08) ◽  
pp. 522-534 ◽  
Author(s):  
Patti M. Johnstone ◽  
Anna K. Náblek ◽  
Velma S. Robertson

Background: Disrupted binaural hearing is thought to contribute in part to the academic, social, and communication problems often associated with unilateral hearing loss (UHL) in childhood. It is not known, however, if putting a hearing aid in the impaired ear of a child with UHL will lead to bilateral or binaural benefit. This study seeks to utilize sound localization acuity measurements to assess hearing aid amplification efficacy in children with UHL. Purpose: To measure sound localization ability in children with UHL who use a hearing aid in the impaired ear to determine the extent to which amplification, age, early intervention, and degree of hearing loss affects localization acuity. Research Design: A within-subjects experimental design using repeated measures is used to determine the effect of amplification on localization acuity in children with UHL. A between-subjects experimental design is used to compare localization acuity between children with UHL and age-matched controls with normal hearing. Study Sample: Twelve children with UHL who used a hearing aid in the impaired ear and 12 age-matched controls with normal hearing. Children with UHL were divided into two groups based on degree of hearing loss. Children in both groups were divided into two age groups: older children (10–14 yr) and younger children (6–9 yr). Data Collection and Analysis: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Results: In the experimental study a significant interaction was found between hearing aid amplification and child age. A hearing aid significantly improved localization acuity in younger children with UHL and significantly impaired localization acuity in older children. A significant correlation was found between age at intervention and localization bilateral benefit. Children who were fit earlier showed bilateral benefit whereas children who were fit later showed bilateral interference. Development, however, may play a role in sound localization acuity. When unaided, older children had significantly better localization acuity than younger children with UHL. Conclusions: A hearing aid can provide bilateral localization benefit to some children with UHL. Early intervention may increase the likelihood of bilateral benefit. However, developmental factors appear to play a role in improving localization abilities over time for children with UHL. Nonetheless, without a means of establishing bilateral benefit with hearing aid amplification, localization performance in children with UHL will rarely equal that of peers.


2020 ◽  
Vol 51 (1) ◽  
pp. 42-54 ◽  
Author(s):  
Sarah Al-Salim ◽  
Mary Pat Moeller ◽  
Karla K. McGregor

Purpose The aims of this study were to (a) determine if a high-quality adaptation of an audiovisual nonword repetition task can be completed by children with wide-ranging hearing abilities and to (b) examine whether performance on that task is sensitive to child demographics, hearing status, language, working memory, and executive function abilities. Method An audiovisual version of a nonword repetition task was adapted and administered to 100 school-aged children grouped by hearing status: 35 with normal hearing, 22 with mild bilateral hearing loss, 17 with unilateral hearing loss, and 26 cochlear implant users. Participants also completed measures of vocabulary, working memory, and executive function. A generalized linear mixed-effects model was used to analyze performance on the nonword repetition task. Results All children were able to complete the nonword repetition task. Children with unilateral hearing loss and children with cochlear implants repeated nonwords with less accuracy than normal-hearing peers. After adjusting for the influence of vocabulary and working memory, main effects were found for syllable length and hearing status, but no interaction effect was observed. Conclusions The audiovisual nonword repetition task captured individual differences in the performance of children with wide-ranging hearing abilities. The task could act as a useful tool to aid in identifying children with unilateral or mild bilateral hearing loss who have language impairments beyond those imposed by the hearing loss.


2015 ◽  
Vol 25 (2) ◽  
pp. 60-69 ◽  
Author(s):  
Peter M. Vila ◽  
Judith E. C. Lieu

Unilateral hearing loss (UHL) in children is only recently beginning to be widely appreciated as having a negative impact. We now understand that simply having one normal-hearing ear may not be sufficient for typical child development, and leads to impairments in speech and language outcomes. Unfortunately, UHL is not a rare problem among children in the United States, and is present among more than 1 out of every 10 of adolescents in this country. How UHL specifically affects development of speech and language, however, is currently not well understood. While we know that children with UHL are more likely than their normal-hearing siblings to have speech therapy and individualized education plans at school, we do not yet understand the mechanism through which UHL causes speech and language problems. The objective of this review is to describe what is currently known about the impact of UHL on speech and language development in children. Furthermore, we discuss some of the potential pathways through which the impact of unilateral hearing loss on speech and language might be mediated.


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