Benefits of Cochlear Implantation in Childhood Unilateral Hearing Loss (CUHL Trial).

OBJECTIVES/HYPOTHESES Children with unilateral sensory hearing loss (UHL) struggle to understand speech in noise and locate the origin of sound and have reduced quality of hearing. This clinical trial will determine the benefits of cochlear implantation in children with UHL. STUDY DESIGN Prospective clinical trial. METHODS Twenty children with at least moderate to profound sensory hearing loss and poor speech perception (word score <30%) in one ear and normal hearing in the contralateral ear participated in a Food and Drug Administration-approved clinical trial. Subjects were evaluated for speech perception in quiet, speech perception in noise, sound localization, and subjective benefits after implantation. RESULTS CNC word score perception in quiet significantly improved (1% to 50%, P < .0001) by 12 months after activation. Speech perception in noise by BKB-SIN significantly improved in all three noise configurations; there was a 3.6 dB advantage in head shadow (P < .0001), a 1.6 dB advantage in summation (P = .003), and a 2.5 dB advantage in squelch (P = .0001). Localization improved by 26° at 9 months (P < .0001). Speech, Spatial, and Qualities (SSQ) demonstrated significant improvements in speech (5.2 to 7.4, P = .0012), qualities of hearing (5.9 to 7.5, P = .0056), and spatial hearing (2.7 to 6.6, P < .0001). SSQ subscales associated with binaural hearing were significantly improved, as was listening effort (P = .0082). Subjects demonstrated a non-significant improvement in fatigue. CONCLUSIONS This study demonstrates that children with UHL significantly benefit from cochlear implantation. LEVEL OF EVIDENCE Level 3 Laryngoscope, 2021.