Quality of life of children treated for unilateral hearing loss: a systematic review and meta-analysis

Abstract

ObjectiveTo evaluate the treatments’ consequences for unilateral hearing loss in children.DesignSystematic review and meta-analysis (CRD42018109417). The MEDLINE, CENTRAL, ISRCTN and ClinicalTrials databases were searched between September 2018 and May 2019. Articles were screened and data were collected independently by two authors following the Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. The risk of bias was evaluated using the Cochrane tool, the Newcastle-Ottawa Scale, the National Institute of Health, USA tool and considering the risk of confounding. In the studies with the lowest risk of bias, a meta-analysis was conducted.InterventionsValidated hearing rehabilitation devices.Patients6–15 years old children with moderate to profound unilateral hearing loss.Main outcome measuresThe primary study outcome was children’s quality of life. Academic performances were studied as an additional outcome.Results731 unique articles were identified from the primary search. Of these, 18 articles met the Population, Intervention, Control, Outcomes and Study design selection criteria. In the eight studies with the lowest risk of bias, two meta-analysis were conducted. There was not enough data on academic results to conduct a meta-analysis. In 73 children included in a fixed effect meta-analysis (two studies), no effect of treatment could be shown (g=−0.20, p=0.39). In 61 children included in a random-effect meta-analysis (six studies), a strong positive effect of hearing treatment on quality of life was demonstrated (g=1.32, p<0.05).ConclusionsThe treatment of unilateral hearing loss seems to improve children’s quality of life. Further research is needed to identify the most effective treatment and its corresponding indications.

Functional Reorganization of the Central Auditory System in Children with Single-Sided Deafness: A Protocol Using fNIRS

“…A recent meta-analysis by Benchetrit et al [36] showed that CI for children with profound SSD was associated with clinically meaningful improvements in auditory skills (sound localization and speech perception in quiet and noise) and patient-reported outcomes (for speech recognition, spatial hearing, and hearing quality, as assessed using a questionnaire). Similarly, a meta-analysis by Nicolas et al [35] showed improved quality of life following treatment for UHL using various devices in children. However, the failure rate of UHL treatment is high, regardless of the rehabilitation method adopted, with failure rates ranging from 21 to 75% [22,23,37].…”

“…In the case of conductive hearing loss, there have been encouraging results for BA-HAs, with improved speech perception in noise [26]. For moderate to profound UHL, there is evidence that CROS or bone conduction hearing devices improve the pure tone average and speech recognition in quiet or noise [35]. A recent meta-analysis by Benchetrit et al [36] showed that CI for children with profound SSD was associated with clinically meaningful improvements in auditory skills (sound localization and speech perception in quiet and noise) and patient-reported outcomes (for speech recognition, spatial hearing, and hearing quality, as assessed using a questionnaire).…”

Impact of unilateral hearing loss in early development

“…In a recent meta-analysis evaluating QoL in children who received treatment for UHL, the authors were able to deduce that hearing rehabilitation in children with moderate to profound UHL had a positive impact on QoL. However, the authors also concluded that further research was needed to identify the most effective treatments and corresponding indications [85]. A separate recent clinical trial demonstrated that hearing rehabilitation for children with even mild-moderate UHL had a positive effect on QoL [30].…”

Speech, language, functional communication, psychosocial outcomes and QOL in school-age children with congenital unilateral hearing loss

“…There is general agreement in the literature that the introduction of Universal Newborn Hearing Screening (UNHS) has resulted in the identification of an increased number of children with unilateral hearing loss (UHL) at an earlier age (1)(2)(3). This increase has brought with it a strengthened research focus on the impact of early identified UHL on children's language and other outcomes [e.g., (4)], and a related interest in evaluating the benefits of audiological rehabilitation with hearing aids (HAs) or cochlear implants (CIs) for this population [e.g., (5,6)]. The aim of this research was to build on current literature; first, by examining a range of outcomes for a sample of 9-year-old children with congenital UHL; and second, by examining the association between children's outcomes and a set of predictor variables, including whether or not they had been fitted with hearing devices.…”