Cochlear implantation in a child with posttraumatic single-sided deafness

Abstract

Cochlear implantation has become a standard therapy for children with bilateral profound hearing loss, resulting in substantial and sustainable benefits for the development of expressive and receptive and expressive language skills and cognition. During the last few years, audiologic and otologic criteria for cochlear implantation have been expanded. Recently, patients with profound single-sided deafness with or without tinnitus have received cochlear implants despite normal to near-normal hearing on the contralateral side. This indication, however, has thus far been restricted to adult patients. Although it is known that unilateral hearing has an impact on social-emotional development in children, otologic surgeons have been reluctant to treat children with single-sided deafness with a cochlear implant. We report here on a case of successful cochlear implantation in an 8-year-old boy with acute single-sided deafness due to a lateral skull-base fracture, after an MRI showed signs of imminent fibrosis of the inner ear with possible prevention of cochlear implantation at a later stage. There was normal hearing in the contralateral ear. The child showed rapid development of speech discrimination in the implanted ear, improvements in sound localization and speech perception in noise, and a high degree of patient satisfaction. This experience may encourage using this therapeutic approach in children with chronic profound single-sided deafness.

Cochlear Implantation in Children with Single-Sided Deafness: Does Aetiology and Duration of Deafness Matter?

“…Results from CI surgery in young children with acquired SSD suggest results comparable to those of adults suffering from acquired SSD [Cadieux et al, 2013;Hassepass et al, 2013;Plontke et al, 2013;Tzifa and Hanvey, 2013;Távora-Vieirea and Rajan, 2015]. Evidence of rehabilitation of binaural hearing skills in quiet and noise as well as improvement in the localisation of sounds has been demonstrated.…”

“…Evidence of rehabilitation of binaural hearing skills in quiet and noise as well as improvement in the localisation of sounds has been demonstrated. Moreover, CI surgery remains the only treatment option available to individuals with SSD that may enable children to regain or improve binaural hearing [Arndt et al, 2011b;Cadieux et al, 2013;Gordon et al, 2013;Plontke et al, 2013;Tzifa and Hanvey, 2013]. Hassepass et al [2013] reported improvements in speech comprehension in noise and localisation of sound following CI surgery in 3 children with unilateral hearing loss (UHL).…”

Guía clínica para la indicación de implantes cocleares en la Comunidad Foral de Navarra

“…Su repercusión durante la edad infantil es aún mayor, por su alta incidencia 25 y por su implicación directa en el desarrollo auditivo, rendimiento académico y en la autoestima de estos niños 26 . En los niños con sordera unilateral se están realizando estudios para demostrar la eficacia que supondría la implantación coclear, tanto a nivel de integración auditiva como derivados del beneficio binaural [27][28][29] . Más allá de los beneficios clínicos mencionados, una de las principales razones para promover la implantación coclear en niños con sordera unilateral es facilitar un completo desarrollo del sistema auditivo central dentro del periodo crítico o de mayor sensibilidad que se corresponde con los primeros años de la vida.…”

Cochlear Implants in Single-Sided Deafness

“…Localization deviation from the source decreased in both of the two subjects who were tested. In noisy conditions, Plontke et al reported improvements in angle detection error when the noise was presented frontally or to the CI side [36]. Finally, Cadieux et al demonstrate that for 3/5 children implanted with asymmetric hearing loss, adding a contralateral hearing aid significantly increased hearing ability compared to the CI-alone or HAalone conditions [37].…”

“…Plontke et al present a case where a child with a lateral skull base fracture and imminent fibrosis was implanted [36]. Improvements in speech discrimination in both quiet and noise, localization, and patient satisfaction .…”