More children with single-sided deafness (SSD) are receiving cochlear implants (CIs) due to the expansion of CI indications. This unique group of pediatric patients has different needs than the typical recipient with bilateral deafness and requires special consideration and care. The goal of cochlear implantation in these children is to provide bilateral input to encourage the development of binaural hearing. Considerations for candidacy and follow-up care should reflect and measure these goals. The purpose of this document is to review the current evidence and provide guidance for CI candidacy, evaluation, and management in children with SSD.

The results of this study suggest that the Nucleus 6 sound processor with acoustic scene classification, automatic, adaptive directionality, and speech enhancement in noise processing provides significantly better speech recognition in noise when compared to performance with the Nucleus 5 processor.

Children with mild to moderate hearing loss have good access to high-frequency phonemes presented at fixed levels (e.g. 50 to 60 dBA) with both wideband and NLFC technology. Similarly, sentence recognition in noise was similar with wideband and NLFC. Adaptive test procedures that probe performance at lower input levels showed small but significant improvements in the detection and recognition of the phonemes /s/ and /sh/ with NLFC condition when compared to the NLFC Off and wideband conditions.

These results suggest that NLFC does not degrade or improve audibility for and recognition of high-frequency speech sounds as well as sentence recognition in noise when compared with wideband amplification for children with cookie-bite audiometric configurations.

Use of EAS provided better speech recognition in quiet and in noise when compared to performance obtained with use of acoustic- and electric-only stimulation, and children responded favorably to the use of EAS implemented in an integrated sound processor for real-world use.