Resident Physician University of California, San Francisco
Introduction: Both unilateral hearing loss (UHL) and bilateral hearing loss (BHL) have a significant impact on educational success and social development. Universal newborn hearing screening should facilitate early diagnosis and intervention for both forms of hearing loss; however, differences in diagnosis patterns and resource utilization between them are not well described. This study compares differences in diagnosis and auditory and speech intervention utilization between children with permanent UHL and BHL.
Methods: We included children, 0-19 years of age, with permanent hearing loss seen at a multidisciplinary hearing loss clinic. T-tests evaluated differences in demographic and pathologic features between those with UHL versus BHL. Multivariate regressions evaluated the impact of hearing loss laterality (UHL versus BHL), insurance status, ethnicity, language, hearing loss severity, gender, and age of hearing loss diagnosis on hearing aids and speech therapy use as well as age of intervention initiation.
Results:389 children were evaluated in this study; 112 children had UHL, and 277 children had BHL. There were no demographic differences between groups. Hearing loss severity in the worst hearing ear did not differ between those with UHL or BHL. Those with BHL were diagnosed at a younger age (mean 3.6 years, SD 3.8 years) as compared to UHL (mean 5.3 years, SD 4.4 years). Those with BHL had higher rates of hearing aid (79% versus 47%) and speech therapy utilization (55% versus 34%) as compared to UHL (p < 0.001).
Conclusion:Children with UHL were diagnosed at a later age and were less likely to utilize hearing aids or speech therapy compared to those with BHL, despite having similar severity of hearing loss. Even with universal newborn hearing screening and access to hearing interventions and services, children with UHL remain underserved. There is room for improvement in identifying unilateral hearing loss and providing adequate services to optimize educational success. Evidence for efficacy of interventions for UHL, including cochlear implantation, is needed to improve healthcare utilization in this group.