Cochlear implantation in children with unilateral hearing loss: A systematic review.
OBJECTIVE
To systematically review the literature on cochlear implantation (CI) for children with unilateral hearing loss (UHL).


METHODS
PubMed, Cochrane, CINAHL, and Embase databases were searched for articles up to June 29, 2015 for UHL, children and CI, and all of their synonyms.


METHODS
After screening of titles, abstracts, and full texts for eligible articles, directness of evidence (DoE) and risk of bias (RoB) were assessed for the included articles. Study characteristics and data on our outcomes of interest (speech perception in noise, sound localization, quality of life, and speech and language development) were extracted.


RESULTS
In total, 296 unique articles were retrieved, of which five articles satisfied the eligibility criteria. All of these articles were case series or case reports and had a low to moderate DoE and a high RoB. In these studies, heterogeneous findings were reported in small patient samples. Speech perception in noise and localization ability improved in most patients. Although only measured in one study each, quality of life and speech and language development improved. Most of these results were not statistically significant.


CONCLUSIONS
No firm conclusions can be drawn on the effectiveness of CI in children with UHL, due to heterogeneous findings, small sample sizes, and the lack of high Level of Evidence studies. Based on the findings of this systematic review, cochlear implantation may be an effective treatment option in children with UHL. Laryngoscope, 126:713-721, 2016.
Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Jeroen P M
JP
Peters
Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Geerte G J
GG
Ramakers
Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Adriana L
AL
Smit
Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Wilko
W
Grolman
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D003054:Cochlear Implants; D005260:Female; D046088:Hearing Loss, Unilateral / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D011788:Quality of Life; D018570:Risk Assessment; D013017:Sound Localization; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome
Hearing loss; asymmetric hearing loss; children; cochlear implantation; pediatric; unilateral hearing loss