ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Auditory Cognitive Neuroscience
This article is part of the Research TopicNovel Technologies in the Field of Hearing Restoration where Over-the-Counter Hearing Aids are PermittedView all 5 articles
Spatial Hearing Adaptation in Congenital and Acquired Single-Sided Deafness
Provisionally accepted
- Otolaryngology, University of Miami Health System, Miami, United States
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Introduction: Spatial hearing depends on binaural integration of interaural time and level differences and monaural spectral cues. Single-sided deafness (SSD) disrupts this process, impairing localization and speech perception. Congenital (SSDc) and acquired (SSDa) SSD provide unique models for studying cortical adaptation, while cochlear implantation (CI) offers partial restoration of binaural hearing. This study examined differences in localization performance and response promptness across SSDc, SSDa, and SSD-CI listeners. Methods: Thirty-one SSD listeners (9 SSDc, 11 SSDa, 11 SSD-CI) and 16 normal-hearing (NH) controls completed broadband noise localization tasks in azimuth (90°) and elevation (30°). Azimuth and elevation localization, bias, mean absolute error (MAE), and response promptness were analyzed using linear regression and mixed-effects models. Results: SSD-CI listeners with CI on demonstrated significantly improved azimuth localization compared to CI off (gain = 0.97 vs. 0.26;, MAE = 27°, vs 47°, p < 0.001). SSDc listeners performed more accurately than SSDa (gain = 0.57 vs. 0.17, p < 0.001), consistent with enhanced adaptation to monaural cues following early deprivation. All SSD groups showed poor vertical localization on the deaf side (gain = 0.15) and slower responses (mean = 2.17 s⁻¹), compared to NH (4.02 s⁻¹, p < 0.037). CI was associated with faster responses, suggesting improved processing efficiency. Discussion: Early deprivation in SSDc promotes compensatory strategies for spatial hearing, while SSDa shows more limited adaptation. CI can partially reintroduce binaural cues, improving horizontal localization and processing efficiency, though vertical localization deficits persist. Conclusion: These findings demonstrate that auditory experience and hearing restoration jointly influence spatial hearing behavior. Understanding these adaptive patterns can guide individualized rehabilitation strategies and optimize outcomes for individuals with unilateral hearing loss.
Keywords: cochlear implant, congenitald deafness, monaural cues, single-sided deafness, spatial hearing sound localization
Received: 15 Oct 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Ausili, Prentiss, Sheets and Snapp. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hillary Anne Snapp
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