Otolaryngologists’ and residents’ approaches to the management of unilateral sensorineural hearing loss: A cross-sectional survey study

Evaluation of management of unilateral hearing loss

Abstract

Background/Aim: Unilateral sensorineural hearing loss (USNHL) impairs sound localization, reduces speech perception in noise, and may lead to academic and psychosocial consequences, particularly in children. Nevertheless, clinical approaches remain heterogeneous, and standardized management protocols are lacking. This study aimed to investigate the diagnostic and management approaches of ear, nose, and throat (ENT) physicians and residents in Türkiye regarding USNHL and to evaluate the availability of diagnostic resources and professionals involved in management.

Methods: This web-based, cross-sectional survey targeted ENT residents, specialists, and academic physicians. A structured 20-item questionnaire was administered between April 6 and April 16, 2024. Participants were required to be actively practicing in a clinic equipped with audiological assessment tools and to provide informed consent. Physicians with less than one year of ENT practice were excluded. Descriptive statistics are presented as frequency and percentage. Chi-squared tests were used for comparisons between groups.

Results: A total of 90 physicians participated; 48 (53.3%) were residents, 25 (27.8%) specialists, and 17 (18.9%) academic physicians. Most respondents (80.0%) worked in tertiary hospitals with broad access to tympanometry, audiometry, otoacoustic emissions, and brainstem evoked response audiometry. More than half (53.3%) accepted 15 dB as the diagnostic threshold for pediatric USNHL, whereas 71.1% used 25 dB as a diagnostic threshold in adults. Hearing aids were recommended for losses >40 dB by 57.0% of participants, while cochlear implantation for >80 dB USNHL was recommended by only 6.0%. Although 93.0% acknowledged difficulties in sound localization and 79.0% believed USNHL negatively affects academic performance, fewer than half (48.9%) supported definitively recommending cochlear implantation in children with very severe USNHL.

Conclusion: Despite the recognized functional burden of USNHL, considerable variability persists in diagnostic thresholds and rehabilitation preferences among ENT physicians in Türkiye. Increasing awareness of binaural hearing benefits and establishing clearer national guidance may improve rehabilitation uptake and patient outcomes.