Misguided Cochlear Implant Recommendation in a 3-Year-Old with Asymmetric Hearing Loss

Three/four months ago, a 3-year-old boy came to me at Shravya Clinic along with all his hearing test reports and CT & MRI scans. The diagnosis showed:

• Right ear: Profound hearing loss (very severe, no hearing)

• Left ear: Severe hearing loss (can hear loud voices)

His parents told me that their child can hear loud voices even without hearing aids in the left ear. He was using hearing aids for the past 6 months, but there was not much improvement.

The MRI scan showed:

• Right ear: No cochlear nerve (the nerve that sends sound signals to the brain is absent)

• Left ear: The nerve is not clearly visible.

They had already visited an ENT hospital where cochlear implant surgeries are done, and the doctor there suggested an implant in the left ear (child was hearing loud sounds with that ear).

But someone advised them to take a second opinion, so they came to see me.

After checking all the reports and talking to the parents, I had a big question in mind:

Why do an implant in the better (left) ear, where the child is already hearing some sounds and has developed a few words.

Why not the right ear, where there is no benefit from the hearing aid?

I told the parents, “Yes, your child needs a cochlear implant. But let us find out which ear is the best choice. For that, I need about a week to observe and test the child.”

We did several tests over ten days and finally came to a conclusion:

👉 Implant should be done in the right ear, not the left.

Even though the scan showed that the right ear had no nerve, sometimes the nerve is very thin and doesn’t show clearly in the scan. That’s why the radiologist also mentioned: “Clinical correlation needed.” Based on our tests, we confidently recommended the right ear for cochlear implant.

The parents saw the test results and agreed with our decision.

The child underwent cochlear implant surgery in the right ear, and we did the switch-on after two weeks.

Now, a month has passed, and the parents happily say:

“Our child is now responding to sounds with the implant!”

It was a proud and emotional moment for us.

👉 Audiologists play a very important role in cochlear implant decisions and outcomes.

As an audiologist, I feel truly happy to make a positive difference in children’s lives.

🙏 Thank you to all the parents who trust us.

These are the reports of that boy: