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Quality of life of children treated for unilateral hearing loss: a systematic review and meta-analysis
  1. Sarah Nicolas1,
  2. Yohan Gallois1,
  3. Marie-Noëlle Calmels1,
  4. Olivier Deguine1,2,
  5. Bernard Fraysse1,
  6. Mathieu Marx1,2
  1. 1 Service d’Oto-Rhino-Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, Toulouse, Midi-Pyrénées, France
  2. 2 CerCo UMR 5549 CNRS, Université Paul Sabatier, Université de Toulouse, Toulouse Cedex 9, France
  1. Correspondence to Dr Sarah Nicolas, ORL, Centre Hospitalier Universitaire de Toulouse, Toulouse 31300, Midi-Pyrénées, France; sarah31.nicolas{at}


Objective To evaluate the treatments’ consequences for unilateral hearing loss in children.

Design Systematic review and meta-analysis (CRD42018109417). The MEDLINE, CENTRAL, ISRCTN and ClinicalTrials databases were searched between September 2018 and May 2019. Articles were screened and data were collected independently by two authors following the Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. The risk of bias was evaluated using the Cochrane tool, the Newcastle-Ottawa Scale, the National Institute of Health, USA tool and considering the risk of confounding. In the studies with the lowest risk of bias, a meta-analysis was conducted.

Interventions Validated hearing rehabilitation devices.

Patients 6–15 years old children with moderate to profound unilateral hearing loss.

Main outcome measures The primary study outcome was children’s quality of life. Academic performances were studied as an additional outcome.

Results 731 unique articles were identified from the primary search. Of these, 18 articles met the Population, Intervention, Control, Outcomes and Study design selection criteria. In the eight studies with the lowest risk of bias, two meta-analysis were conducted. There was not enough data on academic results to conduct a meta-analysis. In 73 children included in a fixed effect meta-analysis (two studies), no effect of treatment could be shown (g=−0.20, p=0.39). In 61 children included in a random-effect meta-analysis (six studies), a strong positive effect of hearing treatment on quality of life was demonstrated (g=1.32, p<0.05).

Conclusions The treatment of unilateral hearing loss seems to improve children’s quality of life. Further research is needed to identify the most effective treatment and its corresponding indications.

  • audiology
  • deafness
  • pathology
  • rehabilitation
  • therapeutics

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors SN and BF designed the study. SN conducted the systematic search. SN and YG conducted the study selection and data collection with important intellectual and methodological input from MM and M-NC. SN prepared the manuscript draft with input from MM and OD. All authors approved the final manuscript. The Toulouse CHU provided funding for the statistical support with input from MM and SN.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.