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Implant cochléaire

Cochlear Implant for Single-Side Deafness

Description

Since February 2022, the Centre Québécois d’Expertise en Implant Cochléaire has included pediatric single-sided deafness in its reference criteria.  For adults, these are case-by-case decisions according to medical prioritization criteria.
 
 

Selection Criteria

The criteria currently in force for children are as follows:
  • Most affected ear: overall profound deafness.
  • Better ear: normal hearing to moderate deafness.
  • Overall profound deafness onset before the age of 2 years: the candidate must be less than 4 years old before implantation.
  • Overall profound deafness onset from the age of 2 years and +: the candidate must have a deafness duration of less than 5 years.
  • No adverse medical factors.
  • The entire clinical picture should not interfere with the optimal use of the cochlear implant.
  • Great motivation of the child and parents.
 
The evaluation process is the same.
 
 

Potential Benefits of Hearing in Both Ears

  • Improved sound localization.
  • Improved understanding of speech in noise (e.g., car, restaurant, classroom, etc.).
  • Reduction of fatigue after a day's work.
  • Improved listening comfort and better perception of the sounds around you.
  • Improved speech understanding when someone is talking to you on the affected side.
  • Decreased need to adapt to the position of the speaker.

     Indeed, when you hear less well in one ear, the person should be placed in front or on the side of the better ear to facilitate listening.
  • Reduction of the disturbance caused by tinnitus (when present).

 

Limitations

  • The cochlear implant does not restore normal hearing.
  • Speech comprehension in a quiet environment is rarely improved.
  • Although an improvement is noted, difficulties often persist in loud noise (e.g., car, restaurant, family gathering, etc.).
  • The localization of sounds remains less accurate than with two ears with normal hearing.
  • Wearing the processor makes deafness visible.

 

Things to Consider

  • Benefits do not appear instantly. An adaptation period is necessary. The brain has to get used to hearing with a cochlear implant.
  • Involvement and motivation are essential for the success of the cochlear implant. Intensive rehabilitation is to be expected (about 12 weeks for children and 8 weeks for adults).
  • The expected benefits with the cochlear implant depend on the duration of the deafness.
  • Wearing the processor for a minimum of 8 hours/day, every day is essential. This can be a challenge.
  • Initially, a minimum of 2 hours per day of sound broadcasting directly into the implant will be requested (e.g., music, video, podcast, etc.). This can be done via an electronic device (Bluetooth) or a compatible accessory that will be provided to you as needed. The goal is to make the cochlear implant work on its own, without the normal ear being able to hear.

 

Other Possible Options

There are different solutions for people with single-sided (one-ear) deafness. Please note that these may not be suitable for you.
 
If you are interested in any of these options, you can discuss it with your audiologist or hearing care professional. There may be a fee associated with some trials.
 


Hearing aid

  • Depending on the degree of hearing loss, a hearing aid may be considered.
  • This amplifies sounds to the affected ear.


CROS System

  • The CROS system uses a hearing aid in each ear. On the deafness side, a microphone picks up sounds and transfers them to the hearing aid worn in the normal ear.
  • With this type of device, you can hear everything from the normal ear, regardless of where the sounds come from.

 
Bone-anchored hearing aid

  • This type of hearing aid is possible when you have an ear with normal hearing.
  • Just like the CROS system, it is a transfer of sound to the normal ear.
  • The difference is that the vibration of the bones of the skull (bone conduction) is used to make the sound heard in the right ear.
  • This type of hearing aid requires surgery by an ENT doctor. An internal part (abutment or magnet) is implanted on the surface of the skull.
  • A headband trial is required before the surgery.


Voice transmission system (e.g. FM system)

  • This is an option that can be used in a group, in a meeting, or when away from the person speaking.
  • A microphone is used by the speaker. The voice is transmitted to headphones or a hearing aid worn by the person with hearing loss.


Communication strategies
Some simple strategies can facilitate communication despite single-sided deafness:

  • Explain that you hear less well on the one hand.
  • Place the normal ear on the side of the person speaking. This strategy may require, for example, a change of side on the sidewalk, at the table, or in the living room.
  • Get closer to the person speaking.
  • Make sure you can see the face of the person speaking.
  • Ask the person to avoid putting their hands in front of their mouth.
  • It is also preferable to favor well-lit spaces.
  • Move away or reduce noise if possible (e.g., turn off the TV, music, or dishwasher). If necessary, changing rooms will make it easier to talk if the place is too noisy.

 

Hearing restoration
  • With the exception of the hearing aid, the cochlear implant is the only option that allows a certain level of hearing to be restored in the deaf ear.