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Managing Unilateral Hearing Loss

It is very important that you see both an otologist (or an otolaryngologist) and an audiologist. Although I can't offer specific help without a thorough and personal examination of your daughter, I can offer some guidance. By the way, the above issue is very important. There are lots of quacks writing on the internet and it's important to understand that absolutely nobody can tell you the best option for you or your family, or any patient for that matter, without a personal, in-person real life review of the patient's history, a physical exam, appropriate tests and analysis, and personal knowledge of the individuals involved.

The doctor's opinion you shared with me (above) may be 100 percent accurate, but if it was not from an ear doctor, and if it wasn't based on a thorough history, physical exam, and possibly blood work and radiographic images, it is worthwhile to obtain more information.

It is possible that the doctor is correct, and your daughter's hearing loss would not respond to any treatment or intervention. Most audiologists can cite cases of children with unilateral hearing loss that do just fine academically and socially. On the other hand, it is more likely that the unilateral hearing loss will create many difficulties.

''Inner ear'' or sensorineural hearing loss can be caused many things. It may have been there since birth, as the doctor suggested. If so, it would be helpful to know if it is likely to progress or likely to remain relatively stable. It may also have been acquired since birth. Disease processes such as cytomegalovirus (CMV), mumps, bone changing syndromes like Mondini's, trauma to the head or ears, reactions to certain medicines, and other vascular or viral causes are just some of the things to investigate. Knowing that the loss is ''inner ear'' is important, but perhaps a more thorough diagnosis will help determine the best management and treatment alternatives.

For most inner ear problems there is little that can be done with medicine or surgery. Nonetheless, if an audiologist determines your daughter is a hearing aid candidate, hearing aid amplification can potentially make an enormous difference. You may know that children with one normal ear and one ear with a significant hearing loss have a greater likelihood of repeating a grade. That is, the brain is setup for input from both sides, and it is MUCH harder to get by and do well in life with only one ear hearing.

Further, I absolutely disagree with the idea that one ear will compensate for the other. I have never seen evidence that implies that the ear can ''overcome'' any unilateral (one ear) loss. Additionally, perhaps the idea of ''compensation'' implies that the child should be able to initiate some sort of self correction, which is essentially unlikely and highly improbable!

Luckily, even with only one ''good'' ear there are management techniques and tools that would be VERY helpful for your daughter, depending on what problems she is experiencing.

There are FM systems designed for classroom use. There are also sound-field amplification systems and other assistive lisening devices (ALDs) for movie theaters,TV, and many other ALDs for various other listening situations too.

Your daughter should almost certainly be sitting in the front of the class, with her ''good'' ear toward the teacher and away from any noise sources in the room (heating or AC units, open windows, fans etc).

She may have services and products available to her through the school, depending on the school district, the state regulations, etc. You need to check this out through the schools, and it would be best if you could speak one-on-one with their educational audiologist. Most school districts have one on staff, or they contract services through one.

Importantly, if you have other children, you should have their hearing checked as well. Also, there are important precautions you should take with your daughter to make sure her hearing is not further damaged by loud noise. Activities involving the use of power tools or motorized equipment (lawn mower, woodworking tools, dirt bike, skimobile, ATV, etc) should be limited or performed only while using proper hearing protection.

So bottom line....I strongly recommend that you see an otologist, or an otolaryngologist to get an accurate and thorough diagnosis. Both are physicians specializing in problems of the ear, and are also called an ENT, ear nose and throat doctor. Then, see an educational audiologist to learn about specific management and amplification options.

I hope the above is helpful. Good luck to you and your family! ---Dr. Beck

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