Incomplete binaural restoration in single-sided deafness treated with cochlear implants: insights from compensatory head-orienting behaviors

Single-sided deafness (SSD) disrupts binaural spatial hearing and may require active compensatory strategies, even for those with cochlear implants (CIs). This study examined spatial hearing adaptations in individuals with single-sided deafness (SSD), including those using cochlear implants (CIs) and unaided SSD, compared to normal-hearing (NH) controls.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Clinicians should counsel single-sided deafness (SSD) cochlear implant recipients that spatial hearing and sound localization are likely to remain partially impaired even with a well-functioning implant; head-orienting behavior may serve as a useful functional outcome marker.

✦ Why It Matters ✦

Quantifying the limits of binaural restoration in SSD-CI users challenges overly optimistic outcome expectations and highlights the need for complementary rehabilitation strategies targeting spatial hearing.

✦ Key Points ✦

01SSD patients fitted with cochlear implants showed persistent compensatory head-orienting behaviors, indicating incomplete binaural restoration.
02Head-turn compensation is proposed as an objective behavioral measure of residual spatial hearing deficits.
03Findings suggest current CI technology cannot fully restore normal binaural processing in SSD.
04Published in Frontiers in Neuroscience (2026); DOI 10.3389/fnins.2026.1918574.
05Results have implications for patient counseling and rehabilitation goal-setting in SSD-CI programs.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Cochlear implants do not fully restore binaural hearing in single-sided deafness patients.

studysupported

Compensatory head-orienting behaviors reflect residual spatial hearing deficits in SSD-CI users.

studypartially supported

✦ Research metadata ✦

PMID: 42662158
DOI: 10.3389/fnins.2026.1918574.
Journal: Frontiers in Neuroscience
Publication type: research_article
Evidence level: 2b
Population: Adults with single-sided deafness treated with cochlear implants
Intervention: Cochlear implantation for single-sided deafness
Comparator: Normal-hearing controls (implied) or pre-implant baseline

Primary outcomes

Degree of binaural restoration assessed via spatial hearing tasks; Frequency and magnitude of compensatory head-orienting behaviors

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