Abstract
Single-sided deafness (SSD) leads to difficulties with speech perception in noise, sound localisation, and sometimes tinnitus. Current treatments (Contralateral Routing of Sound hearing aids (CROS) and Bone Conduction Devices (BCD)) do not sufficiently overcome these problems. Cochlear implants (CIs) may help. Our aim was to evaluate these treatments in a Randomised Controlled Trial (RCT). Adult SSD patients were randomised using a web-based randomisation tool into one of three groups: CI; trial period of 'first BCD, then CROS'; trial period of 'first CROS, then BCD'. After these trial periods, patients opted for BCD, CROS, or No treatment. The primary outcome was speech perception in noise (directed from the front (S0N0)). Secondary outcomes were speech perception in noise with speech directed to the poor ear and noise to the better ear (SpeNbe) and vice versa (SbeNpe), sound localisation, tinnitus burden, and disease-specific quality of life (QoL). We described results at baseline (unaided situation) and 3 and 6 months after device activation. 120 patients were randomised. Seven patients did not receive the allocated intervention. The number of patients per group after allocation was: CI (n = 28), BCD (n = 25), CROS (n = 34), and No treatment (n = 26). In S0N0, the CI group performed significantly better when compared to baseline, and when compared to the other groups. In SpeNbe, there was an advantage for all treatment groups compared to baseline. However, in SbeNpe, BCD and CROS groups performed worse compared to baseline, whereas the CI group improved. Only in the CI group sound localisation improved and tinnitus burden decreased. In general, all treatment groups improved on disease-specific QoL compared to baseline. This RCT demonstrates that cochlear implantation for SSD leads to improved speech perception in noise, sound localisation, tinnitus burden, and QoL after 3 and 6 months of follow-up. For most outcome measures, CI outperformed BCD and CROS. Trial registration: Netherlands Trial Register (www.trialregister.nl): NTR4580, CINGLE-trial.
Highlights
Single-sided deafnessSingle-sided deafness (SSD) is defined as severe to profound hearing loss in one ear and near to near-normal hearing in the contralateral ear [1]
We report on data obtained at baseline, at 3, and at 6 months follow-up
120 patients were randomised into three groups: 29 patients to the Cochlear implants (CIs) group, patients to the ‘first Bone Conduction Devices (BCDs), Contralateral Routing of Sound hearing aids (CROS)’ group, and patients to the ‘first CROS, BCD’ group
Summary
Single-sided deafnessSingle-sided deafness (SSD) is defined as severe to profound hearing loss in one ear and near to near-normal hearing in the contralateral ear [1]. Patients with SSD often experience problems with speech perception in noise and sound localisation, because they lack binaural benefits [2]. They cannot benefit from the binaural summation effect (redundancy of auditory input) and the squelch effect (the ability of the brain to suppress noise on the side with the best signal-to-noise-ratio using the noise information of the contralateral side) [2,3]. The head shadow effect can be of benefit for SSD patients when the speaker is on the side of the better hearing ear, but it may deteriorate speech perception when the speaker is on the deaf side. Due to these hearing-related difficulties, patients with SSD may experience problems in social interaction and communication, possibly negatively affecting their quality of life (QoL) [6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
