Learning Objectives: CI: favorable treatment option for acquired SSD children, as it is the only opportunity to restore binaural hearing abilities. Outcomes of auditory habilitation in congenital SSD children with CI vary significantly.

SSD in children can have a negative impact on the normal development of the auditory cortex in the young child. Furthermore, the ability to develop and use binaural hearing and its subsequent hearing abilities in daily life can be affected. Especially when entering full-time education, children with SSD display behavioural problems and academic weaknesses. The impairment of the auditory function may result in fatigue due to increased listening effort. It can also impinge on psychosocial factors. Particularly when the language reaches the deaf ear in additional background noise problems become evident. Furthermore, the localization capacity is significantly limited, since bilateral hearing is mandatory for spatial hearing. Patients with SSD can derive benefit from conventional CROS or Bi-CROS systems (contralateral routing of signal), bone anchored hearing systems or from a cochlear implant (CI). The indications and results of the treatment are presented.

Considering our experience, a thorough evaluation and extensive counselling regarding the treatment options is necessary. Irrespective of age, MRI of the cranium at pre-examination for CI surgery is essential to exclude aplasia or hypoplasia of the hearing nerve. CI as a treatment option for adult patients with acquired SSD is now widely accepted since it can achieve binaural hearing rehabilitation. In contrast, children suffering from SSD have been provided with a CI only in rare cases. While the decision for CI surgery in children with acquired SSD is quite simple due to the good results in adults, CI in children with congenital SSD has been discussed controversially.