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OBJECTIVES: This study aimed to investigate the effects of an adhesive bone conduction device (aBCD) in children with congenital single-sided deafness (SSD). Specifically, we examined whether the aBCD elicits improvement in the speech perception ability of children with congenital SSD and whether using this device would adversely affect the horizontal localisation abilities of these children. METHODS: Thirteen school-aged children with SSD and seven children with Normal Hearing (NH) were included in this study. Speech perception in noise was measured using the Mandarin Speech Test Materials and sound localisation performance was evaluated using broadband noise stimuli (0.5-20 kHz), randomly played from seven loudspeakers at different stimulus levels (65-, 70-, and 75-dB SPL). RESULTS: All children with SSD showed inferior speech perception and sound localisation performance compared with children with NH. The aBCD use remarkably improved the speech perception abilities of these children under quiet and noise conditions; however, their sound localisation abilities neither improved nor deteriorated. CONCLUSION: This study reveals the effectiveness and safety of a non-surgical aBCD in paediatric patients with SSD. Our results provide a theoretical basis for early hearing intervention with an aBCD in children with congenital SSD who are temporarily unable to undergo ear surgery. LEVEL OF EVIDENCE: Level 3.

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PURPOSE: To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. METHODS: Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. RESULTS: A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. CONCLUSION: The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.

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Introdução: O Sistema Contralateral Routing of Signal (CROS) é uma opção de intervenção auditiva com propósito de melhorar a percepção monoaural e minimizar as dificuldades da perda auditiva unilateral. Objetivo: analisar e descrever o público-alvo, o tempo de adaptação, o controle de uso do Sistema CROS, as avaliações utilizadas para medir os seus benefícios, sua efetividade e limitações. Método: Este estudo foi conduzido de acordo com as diretrizes PRISMA. A pesquisa bibliográfica foi realizada através dos bancos de dados científicos online na área da saúde, PubMed e Scopus, foram utilizadas as palavras-chave "Unilateral hearing loss", "Hearing aid", "CROS" e "Contralateral Routing of Signal". Os resultados da pesquisa limitaram-se a artigos científicos experimentais, que abordavam diretamente o sistema CROS, publicados em inglês, português ou espanhol. Resultados: Onze artigos foram selecionados para a revisão do texto completo. Quanto aos usuários do CROS, a faixa etária variou entre nove a 84 anos; prevalência do sexo masculino. Observou-se grande diversidade nas avaliações, sendo realizadas com tempo de uso inferior a 30 dias e superior a seis meses, após adaptação do CROS. Tal avaliação era realizada por meio de questionários não padronizados e avaliações objetivas com estímulos controlados. O uso do CROS proporcionou benefícios na localização sonora, efeito sombra da cabeça e inteligibilidade de fala, porém não mostrou eficácia em situações ruidosas. Conclusão: Por ser um dispositivo, não invasivo, de fácil adaptação e manuseio que traz benefícios imediatos, o CROS deve ser a primeira opção na reabilitação da perda auditiva unilateral.

Introducción: El Sistema Contralateral Routing of Signal (CROS) es una opción de intervención auditiva con el propósito de mejorar la percepción monoaural y minimizar las dificultades de la pérdida auditiva unilateral. Objetivo: analizar y describir el público objetivo, el tiempo de adaptación, el control del uso del Sistema CROS, las evaluaciones utilizadas para medir sus beneficios, su efectividad y limitaciones. Metodo: Este estudio se realizó de acuerdo con las pautas PRISMA. La búsqueda bibliográfica se realizó a través de bases de datos científicas online del área de salud, PubMed y Scopus, utilizando las palabras clave "Unilateral hearing loss", "Hearing aid", "CROS" y "Contralateral Routing of Signal". Los resultados de la investigación se limitaron a artículos científicos experimentales, que abordaron directamente el sistema CROS, publicados en inglés, portugués o español. Resultados: Se seleccionaron once artículos para revisión de texto completo. En cuanto a los usuarios de CROS, la edad osciló entre los nueve y los 84 años; prevalencia masculina. Hub gran diversidad en las evaluaciones, realizadas con tiempos de uso de menos de 30 días y más de seis meses tras la adaptación del CROS. Dicha evaluación se realizó mediante cuestionarios no estandarizados y evaluaciones objetivas con estímulos controlados. El uso de CROS proporcionó beneficios en la localización del sonido, el efecto de sombra de la cabeza y la inteligibilidad del habla, pero no fue efectivo en situaciones ruidosas. Conclusión: Al tratarse de un dispositivo no invasivo, de fácil adaptación y manejo que aporta beneficios inmediatos, CROS debería ser la primera opción en la rehabilitación de la hipoacusia unilateral.

Introduction: The system Contralateral Routing of Signal (CROS) is an option of auditory intervention in order to improve the monaural perception and minimize the difficulties of unilateral hearing loss. Objective: to analyze and describe the target users, the adaptation time and the control use of CROS system, the evaluations utilized to measure its benefits, as well as its effectiveness and limitations. Method: This study was conducted according to the PRISMA guidelines. The bibliographic research was through the scientific data online banks in the health area, PubMed and Scopus, using the keywords "Unilateral hearing loss", "Hearing aid", "CROS" and "Contralateral Routing of Signal". The results of the research were limited to experimental scientific articles, which address directly the CROS system, published in English, Portuguese or Spanish. Results: Eleven studies were selected to review. The age of CROS users ranged from nine to 84 years and male sex prevalence. There was great diversity in the evaluations being carried out. The performance's evaluation date varied between less than 30 days and more than six months after the adaptation. Such assessments were performed using non-standardized questionnaires and objective evaluations with controlled stimuli. The use of CROS provides benefits in sound localization, head shadow effect and speech intelligibility, but it is not effective in noisy situations. Conclusion: CROS should be the first option in unilateral hearing loss rehabilitation for being a non-invasive, easy adaption, handling dispositive and with good benefits to the client.

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La hipoacusia unilateral (HUL) definida como la pérdida auditiva de cualquier grado en un solo oído tiene prevalencias en edad escolar de 3% a 6%. La etiología es desconocida en la mayoría de los casos, pero destacan las anormalidades anatómicas severas a diferencia de las hipoacusias bilaterales, lo que le otorga importancia al estudio de imágenes. También se recomienda realizar evaluación oftalmológica. El impacto de la HUL se observa en la localización sonora, reconocimiento del habla, desarrollo del lenguaje, desempeño social y conducta, pero por sobre todo en el rendimiento académico. En este sentido es relevante mencionar que además de existir mayor probabilidad de repitencia de curso, es necesario mayor apoyo educacional individualizado para evitar dicha repitencia o lograr mismo éxito académico que un normoyente. En relación al diagnóstico aún faltan normas o protocolos, siendo éste un desafío en las zonas donde no hay screening universal. Se discute la importancia de las encuestas para realizar evaluaciones y seguimiento en estos casos. Finalmente se abordan las estrategias de intervención disponibles, además de un plan individualizado considerando al niño, su familia y sus expectativas, particularmente se discuten las características o factores a tomar en cuenta en el momento de la adaptación, para así lograr un tratamiento tendiente al éxito.

Unilateral hearing loss (UHL) defined as hearing loss of any degree in only one ear has a school-age prevalence of 3% to 6%. The etiology is unknown in most cases, but severe anatomical abnormalities stand out as opposed to bilateral hearing loss, which gives importance to the study of images. Ophthalmological evaluation is also recommended. The impact of UHL is observed in sound localization, speech recognition, language development, social performance and behavior, but above all in academic performance. In this sense, it is relevant to mention that in addition to having a higher probability of repeating the course, it is necessary to have more individualized educational support to avoid this repetition or achieve the same academic success as a normal listener. Regarding the diagnosis, there are still missing norms or protocols, this being a challenge in areas where there is no universal screening. The importance of surveys to carry out evaluations and follow-up in these cases is discussed. Finally, the available intervention strategies are discussed, in addition to an individualized plan considering the child, his family and his expectations, particularly, the factors to be taken into account at the time of adaptation, in order to achieve a success treatment.

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Purpose The purpose of this study was to characterize spatial hearing abilities of children with longstanding unilateral hearing loss (UHL). UHL was expected to negatively impact children's sound source localization and masked speech recognition, particularly when the target and masker were separated in space. Spatial release from masking (SRM) in the presence of a two-talker speech masker was expected to predict functional auditory performance as assessed by parent report. Method Participants were 5- to 14-year-olds with sensorineural or mixed UHL, age-matched children with normal hearing (NH), and adults with NH. Sound source localization was assessed on the horizontal plane (-90° to 90°), with noise that was either all-pass, low-pass, high-pass, or an unpredictable mixture. Speech recognition thresholds were measured in the sound field for sentences presented in two-talker speech or speech-shaped noise. Target speech was always presented from 0°; the masker was either colocated with the target or spatially separated at ±90°. Parents of children with UHL rated their children's functional auditory performance in everyday environments via questionnaire. Results Sound source localization was poorer for children with UHL than those with NH. Children with UHL also derived less SRM than those with NH, with increased masking for some conditions. Effects of UHL were larger in the two-talker than the noise masker, and SRM in two-talker speech increased with age for both groups of children. Children with UHL whose parents reported greater functional difficulties achieved less SRM when either masker was on the side of the better-hearing ear. Conclusions Children with UHL are clearly at a disadvantage compared with children with NH for both sound source localization and masked speech recognition with spatial separation. Parents' report of their children's real-world communication abilities suggests that spatial hearing plays an important role in outcomes for children with UHL.

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BACKGROUND: Contralateral noise masking is an important aspect of auditory brainstem response (ABR) measurements. PURPOSE: The primary aim of this study is to determine how contralateral white noise (WN) masking influences the amplitude and the latency of V wave generated during ABR measurements, using tone burst (TB), in adult ears with normal hearing (NH). The secondary aim of this study is to ascertain the need of contralateral masking in ABR measurements with the TB stimuli using a 3A insertion earphone, and to propose the applicability of WN masking in unilateral sensorineural hearing loss (USNHL). RESEARCH DESIGN: It is a cross-sectional observational and descriptive study. STUDY SAMPLE: Experiment 1: Thirty individuals, without any otologic, psychological, or neurological dysfunction, were selected. Experiment 2: Fifteen individuals with previous audiological diagnoses of severe and profound USNHL were considered. INTERVENTION: The study involves ABR TB at specific frequencies of 0.5, 1, 2, and 4 kHz. DATA COLLECTION AND ANALYSIS: Experiment 1: The evaluation was performed at the fixed intensity of 80 dB nHL (decibel normalized hearing level) on the tested ear, followed by the application of simultaneous masking to the nontested ear, intensity ranged from 0 to 80 dB. Experiment 2: ABR threshold measurements were first performed on the ear with hearing loss (HL) at the frequencies of 1, 2, and 4 kHz. The results were subsequently confirmed using contralateral masking. RESULTS: Experiment 1: At any given frequency, there were no statistically significant differences in the amplitude and latency of V wave with increase in the intensities of WN masking. Experiment 2: Cross-hearing was observed at least once in all frequencies analyzed through the occurrence of V wave. CONCLUSION: In conclusion, the contralateral WN masking at the maximum intensity of 80 dB does not affect the amplitude and latency of V wave of the ABR TB at 1, 2, and 4 kHz. Contralateral masking for the ABR TB presented using 3A insertion earphones is necessary at 1, 2, and 4 kHz in individuals with severe or profound degrees of USNHL and at intensities of 15, 20, and 10 dB above the ABR threshold of the nontested ear.

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RESUMO Objetivo Tradução e adaptação transcultural do Unilateral Hearing Loss Questionnaire para a língua portuguesa brasileira, e aplicação do questionário em um grupo de crianças/adolescentes com perda auditiva unilateral, usuárias de aparelho de amplificação sonora individual, e seus respectivos pais/responsáveis. Métodos O trabalho foi dividido em duas partes: tradução e adaptação transcultural do Unilateral Hearing Loss Questionnaire para a língua portuguesa brasileira e aplicação nas crianças/adolescentes e em seus pais/responsáveis, a fim de realizar a comparação entre as respostas do questionário por meio do percentual de concordância. Resultados A análise do trabalho dos tradutores brasileiros considerou a equivalência semântica e houve apenas dois ajustes terminológicos. A retrotradução não apresentou discrepâncias conceituais, apenas problemas linguísticos. Uma comparação entre as respostas dos entrevistados permitiu realizar o percentual de concordância. Conclusão O questionário de perda auditiva unilateral para crianças e pais foi traduzido para o português brasileiro, apresentando equivalência e semântica e idiomática. A análise descritiva do percentual de concordância entre crianças/adolescentes com perda auditiva unilateral e seus pais/responsáveis mostrou ser um preditor na equivalência das repostas.

ABSTRACT Purpose Translate and make the cross-cultural adaptation of the Unilateral Hearing Loss Questionnaire. This questionnaire will be conducted with children / adolescents and also by caregivers into the Brazilian Portuguese language. Methods The work was divided into two parts: translation and cross-cultural adaptation of the Unilateral Hearing Loss Questionnaire into Brazilian Portuguese and application to children/adolescents and caregives through the agreement percentage. Results The analysis of the work of Brazilian translators considered semantic equivalence, and there were only two terminological adjustments. The back-translation did not present conceptual discrepancies, only linguistic problems. A preliminary comparison showed that the agreement percentage between the answers of caregivers and children/teenagers was satisfactory. Conclusion The Unilateral Hearing Loss Questionnaire for children and parents was translated and cross-culturally adapted into the Brazilian Portuguese language showing semantic equivalence and idiomatic. The comparative descriptive analysis of the agreement percentage between children and caregivers showed a predictor in the equivalence of responses.

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Resumen La hipoacusia unilateral es una alteración prevalente e importante en la población infantil que puede llevar a un deterioro del procesamiento auditivo. Cualquier patología que cause hipoacusia asimétrica (conductiva o sensorioneural) durante ventanas críticas del desarrollo cerebral, puede dar lugar a déficits del procesamiento auditivo que podrían persistir incluso después de la rehabilitación audiológica. Este proceso fisiopatológico se ha denominado "ambliaudia" y los niños que la presentan tienen un mayor riesgo de sufrir retraso en el desarrollo del lenguaje, así como de padecer dificultades académicas, sociales y cognitivas. Por esto, la ambliaudia se presenta como un desafío en audiología, siendo necesario comprender los mecanismos neurobiológicos que la subyacen. Entender de mejor manera cuáles son las consecuencias que tiene la pérdida auditiva asimétrica sobre el desarrollo del sistema nervioso podría ser clave para guiar de mejor forma las intervenciones terapéuticas. En este artículo se revisan trabajos en humanos y en modelos animales que describen las consecuencias neurobiológicas de la deprivación auditiva unilateral durante el desarrollo del sistema nervioso y su posible aplicación a la práctica clínica.

Abstract Unilateral hearing loss is a prevalent and important disorder in children that can lead to an impairment of auditory processing. Any pathology that causes asymmetric (conductive or sensorineural) hearing loss during critical brain development windows can lead to hearing deficits that may persist even after audiological rehabilitation. This pathophysiological process has been referred to as amblyaudia, and children are at greater risk of experiencing language developmental delays as well as academic, social and cognitive impairments. For this reason, amblyaudia presents itself as a challenge in audiology, and it has become necessary to understand its neurobiological mechanisms. A better understanding of the consequences of asymmetric hearing loss on the development of the nervous system may be key to better guiding therapeutic interventions. This article reviews studies performed in humans and animal models that describe the neurobiological consequences of unilateral hearing deprivation during the development of the nervous system and its possible applications to clinical practice.

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PURPOSE: To verify the speech perception in subjects with ear malformation and unilateral hearing loss, fitted with two types of amplification as follows: conventional hearing aids and softband (band with vibrator bone). METHOD: The study included fifteen subjects of both sexes who presented congenital malformation of the middle or outer ear, diagnosed with unilateral conductive or mixed hearing loss, moderate to severe hearing loss, age range between 15 to 25 years and, prescription from a specialist doctor for hearing device fitting. We performed the speech perception assessment without amplification after the hearing aid and softband fitting, with the hearing aid linked to the bone vibrator (conventional) and the softband (band with the bone vibrator). The subjects were evaluated using the Hearing in Noise Test (HINT), in silence and in noise. RESULTS: Seven subjects with unilateral ear malformation were evaluated, 57.1 % had impairment in the right ear and 42.9 % in the left ear. Regarding the type and the level of hearing loss, 71 % of all subjects included in the sample presented moderate conductive hearing loss. The assessment of speech perception was performed during silence, frontal noise, lateral noise and, during three specifics situations: no amplification, with conventional hearing aid and with the softband. The results with the amplification devices were positive in all evaluated conditions. CONCLUSION: Evaluated subjects presented improvement in speech perception, in silence, frontal noise and lateral noise situations, regardless of the type of amplification; however, the difference was not statistically significant.

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