Cochlear implants: bilateral versus unilateral

Policy context

Cochlear implants may be implanted unilaterally (one ear) or bilaterally (both ears). Important questions center on the balance of benefits, potential harms, and costs of bilateral versus unilateral implantation as related to key health outcomes.

Status: Decision completed

Primary criteria ranking

  • Safety = High
  • Efficacy = Medium
  • Cost = High

Assessment timeline

  • Draft key questions published: November 15, 2012
  • Public comment period: November 15 to 29, 2012
  • Draft report published: March 5, 2013
  • Public comment period: March 5 to April 5, 2013
  • Final report published: April 15, 2013
  • HTCC public meeting: May 17, 2013


Cochlear implants are designed to perform the function of cochlear hair cells in individuals where there has been a severe loss of cochlear hair cells. The implant devices convert sound into electrical impulses that stimulate the auditory nerve. Implantation may be performed unilaterally or bilaterally.