Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation

Purpose: The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Method: Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-tomoderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. Results: The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Conclusions: Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.