Children with unilateral sensorineural hearing loss experience problems with sound localization, speech perception in noise, and increased auditory effort due to loss of binaural cues. This is particularly detrimental as they are still learning language, frequently in noisy classrooms, and their loss is associated with increased risks of failing a grade, behavioral issues, and speech delay. Restoration of true binaural hearing can only be accomplished with a cochlear implant, and use of a cochlear implant has demonstrated marked improvements in localization, speech perception in noise and auditory effort in these children. Selected children, as early as 9 months of age, should undergo cochlear implantation as soon as hearing loss and appropriate anatomy is verified to avoid missing a developmental window that permits integration of binaural cues. It is the position of the AAO-HNS that cochlear implantation is an appropriate management option for rehabilitation of unilateral sensorineural hearing loss in appropriately selected children.
Approved April 2023
Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology–Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.
