Functional Impairments Due to Unilateral Deafness

The authors investigated the impact of unilateral listening upon two central auditory functions: speech discrimination in a noisy environment, and the ability to process and clearly recognize modestly accelerated speech by 30% compression (shortened exposure). We determined that the negative impact of listening to speech in the milieu of noise was individually variable. The data revealed a wide range of impairment, from mild to relatively severe (ie, 0% to 60% [mean, 34%]; normative data, 4% to 36% [mean, 14%]). The performance scores for recognition of compressed sentences were not markedly influenced by unilateral deafness, but the functional results of the residual ear were correlated with a loss of high-frequency sensitivity (mean of 54% correct in severe unilateral deafness with an associated high-frequency loss versus 93% correct in normal controls). Reorganization of the central nervous system by "plasticity" or biological maturation over time failed to improve the performance of monaural listening. The currently recommended methods of remediation for this sensory deficit are discussed, and newer technologies under investigation are examined.