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Updated: Feb 5, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Limiting asymmetric hearing improves benefits of bilateral hearing in children using cochlear implants
Melissa Jane Polonenko1,2, Blake Croll Papsin3,4,5, Karen Ann Gordon3,6,4,5
1Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada. melissa.polonenko@mail.utoronto.ca.
Abstract:
Neurodevelopmental changes occur with asymmetric hearing loss, limiting binaural/spatial hearing and putting children at risk for social and educational challenges. These deficits may be mitigated by providing bilateral hearing in children through auditory prostheses. Effects on speech perception and spatial hearing were measured in a large cohort of >450 children who were deaf and used bilateral cochlear implants or bimodal devices (one cochlear implant and a contralateral hearing aid). Results revealed an advantage of bilateral over unilateral device use but this advantage decreased as hearing in the two ears became increasingly asymmetric. Delayed implantation of an ear with severe to profound deafness allowed asymmetric hearing, creating aural preference for the better hearing ear. These findings indicate that bilateral input with the most appropriate device for each ear should be provided early and without delay during development.
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