Impact of conductive unilateral hearing loss in children-A qualitative investigation.

  • Jaya Nichani

Student thesis: Master of Philosophy


Unilateral hearing loss (UHL) has been defined based on pure tone averages, and refers to average air conduction thresholds (0.5, 1 and 2 kHz) worse than or equal to 20 dB HL in the impaired ear. The developmental, social and communication risks from having a unilateral hearing loss in a child have often been discounted or down-played, based on the belief that a contralateral normally hearing ear would provide sufficient access to sound. The aim of our study was to identify what is known about the impact of UHL through a systematic review and through a qualitative study to understand the perspectives of children on the impact of their conductive UHL and their parents' perspective of the conductive UHL. The systematic review aimed to evaluate the literature to identify the impact of unilateral hearing loss on childhood development. 41 studies investigating the impact of unilateral hearing loss in children were included in this review. We identified seven main domains that have been studied in relation to the impact of UHL in children. The only outcome domain, where there was a consistent negative impact of UHL was hearing difficulties in real-life, such as hearing-in-noise and the ability to localise sound. Our qualitative study explored the perceptions of the impact of a unilateral conductive hearing loss in children aged 11-17 years and their parents. The aim of the study focusing on the children's qualitative interviews was to understand the perspectives of children regarding the impact of unilateral conductive hearing loss on their lives. Our results indicate children with unilateral conductive hearing loss are keen to normalize their hearing loss and adapt to the resulting difficulties. There is a need to identify hidden difficulties, which become apparent on exploring their daily routine, to ensure appropriate treatment strategies can be advocated. This study highlights patient-specific outcome domains that are most relevant to children with unilateral conductive hearing loss Our qualitative study also aimed to understand parental perception of the impact of unilateral conductive hearing loss in their children. Our study revealed three interlinked categories: (I) problems perceived by parents and acceptance, (ii) advice, monitoring and support to overcome these problems, and (iii) implications of active issues and parental concerns. Parental acceptance of relevant problems, and their concerns need to be considered when evaluating children with conductive unilateral hearing losses. Our study highlights that the potential impact of UHL in childhood is not inconsequential. We identify the following areas of unmet research need, which either hinder evaluation of the problem or limit options for clinical management: 1. Greater understanding of the impact of conductive UHL in children. 2. Need for bespoke outcome measurement instruments (OMI) to quantify the true extent of problems in children with conductive UHL. 3. Identification of interventions effective and acceptable in this patient group.
Date of Award31 Dec 2019
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorPeter Callery (Supervisor) & Kevin Munro (Supervisor)


  • Qualitative study
  • Unilateral hearing loss
  • Children

Cite this