La sordità monolaterale infantile : vi è indicazione all'impianto cocleare?

The stimulation of both ears allows the integration of the two inputs in the central auditory pathways ensuring the activation of the binaural system that happens with the auditory experience. Its maturation takes place within a critical period after which the acoustic pathway changes structurally, decreasing the number of synapses of the afferent and contralateral fibers, decreasing the synapses of the ipsilateral efferent fibers, increasing the synapses of the afferent fibers ipsilateral to the healthy side, developing the auditory cortex ipsilateral to the hearing ear and inhibiting the development of the auditory cortex ipsilateral to the deaf ear. The benefits of binaural listening result in the summation of loudness, localization, best listening in presence of noise, incidental listening, the best listening of the reproduced voice; in the case of unilateral deafness they are lost. Important are the consequences of severe unilateral congenital hearing loss and specifically the delay and/or disturbance of language, diminished attention and concentration, the difficult of learning resulting in increased fatigue and cognitive effort. In cases of severe to profound unilateral deafness, unfortunately, hearing aid does not help to overcome the cochlear impairment so that in most cases it is not applied; the only way to objectively replace the compromised cochlear function is the cochlear implant, even if to date there is no clear indication to cochlear implant from the scientific community, despite the studies published so far show encouraging results on SSD.