Learning Objectives: Cochlear implantation treatment is significantly superior to alternative therapy options (Bi-/CROS and BCI) in terms of speech comprehension in background noise and sound localization.

In the past, unilateral hearing loss had not been perceived as a severe handicap. However, our research results show that, despite a normal hearing capacity in one ear and the ability to understand language in quiet surroundings, patients suffering from single-sided deafness (SSD) and asymmetric hearing loss (AHL) experience significant challenges in various everyday situations. This is particularly evident when the language reaches the deaf ear in additional background noise.

The limitation of the auditory function may result in a fatigue due to increased listening effort and can have a major impact on psychosocial factors. Furthermore, the localization capacity is significantly limited, as bilateral hearing is mandatory for spatial hearing. Thus, treatment of single-sided deafness has to become a relevant issue.

Patients with SSD and AHL can be rehabilitated with conventional CROS or Bi-CROS systems (contra-lateral routing of signal), bone anchored hearing systems or with a cochlear implant (CI). The indications and results of the different treatments are presented.