Acquired Single-Sided Deafness - Patients Prefer Invasive over Non-Invasive Hearing Solutions: A Systematic Review and Meta-analysis

Objective To compare the effectiveness of implanted and non-implanted hearing solutions on subjective hearing disability and health-related quality of life in adults with acquired single-sided deafness. Methods This systematic review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was registered in the Prospective Register of Systematic Reviews. Multiple databases were searched from January 1965 to October 2025 for studies reporting patient-reported hearing disability and health-related quality of life utility measures with cochlear implants, bone-conduction devices and contralateral routing of signal hearing aids as single-sided deafness treatments. Results Pooled analysis of 13 studies (403 participants) demonstrated improved hearing disability scores with implanted solutions compared with no intervention [mean difference = −14.71 (95% CI: −23.48, −5.93), p < 0.00001]. Non-implanted bone-conduction devices demonstrated lower hearing disability than contralateral routing of signal aids [mean difference = 4.70 (95% CI: 0.27, 9.14); p = 0.04]. Cochlear implants significantly improved health-related quality of life compared with no hearing solution [mean difference = 0.21 (95% CI: 0.10, 0.31); p = 0.0001]. Conclusion Single-sided deafness patients reported greater mean hearing-related improvement with implanted than non-implanted hearing solutions.