title: Unilateral hearing loss in children: a retrospective study and a review of the current literature.
abstract: Despite the introduction of universal newborn hearing screening (UNHS), unilateral hearing loss (UHL) is sometimes recognized late. This diagnostic delay has adverse repercussions, given the importance of binaural hearing for the development of normal auditory processing. It is incorrect to maintain that unilateral hearing is the minimum requirement for adequate speech development and that hearing aid provision is consequently unnecessary. In our retrospective study, hearing aid provision resulted in improved directional and selective hearing (quiet and noisy environments) and, compared with their chronically ill counterparts, the children in our study displayed superior health-related quality of life (HRQoL) scores in all areas. On the basis of the results, the authors conclude that even mild hearing losses (from an auditory threshold of 30 to 40 dB) should have the opportunity for hearing aid provision. A selective literature review was conducted in PubMed and textbooks and with reference to national and international guidelines. Early diagnosis and treatment of UHL have a positive effect on verbal-cognitive, linguistic, communicative, and socio-emotional development, as demonstrated by neurophysiological studies. Among the treatment modalities with differing effects on the quality of binaural hearing, cochlear implants are now used increasingly in children with hearing loss bordering on deafness.
  
  
  CONCLUSIONS
  Published evidence and clinical experience support early diagnosis and treatment. Wherever feasible, hearing aid provision before or at the end of the first year of life is recommended for children with UHL. What is Known: • Almost 30 years ago, poor academic performance was reported in children with unilateral hearing loss (UHL). • Despite improvements in treatment options, it is traditionally held that unilateral hearing is the minimum requirement for adequate speech development and hearing aid provision is unnecessary. What is New: • Academic and behavioral deficits in children with UHL may be mediated by deficiencies in the default mode network. • Published evidence supports the recommendation for hearing aid provision before or at the end of the first year of life in children with UHL.
authors.affiliation: Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany. a.rohlfs@uke.de.
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Rohlfs
authors.affiliation: Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Friedhoff
authors.affiliation: Department for ENT and Communication Disorders, University Medical Center of the Johannes Gutenberg University, Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bohnert
authors.affiliation: Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Breitfuss
authors.affiliation: Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Hess
authors.affiliation: Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Müller
authors.affiliation: KIND Hörgeräte, Erdkampsweg, 55 22335, Hamburg, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Strauch
authors.affiliation: Community Practice for Otorhinolaryngology, Phoniatrics and Pediatric Audiology, Pestalozzistraße, 24 22305, Hamburg, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Röhrs
authors.affiliation: Department of Phoniatrics and Pediatric Audiology, Werner Otto Institut, Bodelschwinghstrasse, 23 22337, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiesner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006310:Hearing Aids; D046088:Hearing Loss, Unilateral / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006320:Hearing Tests; D006801:Humans; D015994:Incidence; D007804:Language Development; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Auditory processing; Binaural hearing; Health-related quality of life; Hearing aid provision; Speech development; Unilateral hearing loss (UHL)