Contralateral Routing Of Signal Hearing Aids Research Articles

Speech Perception in Noise and Sound Localization for Cochlear Implant With Single-Sided Deafness Compared With Contralateral Routing of Signal Hearing Aids.

Cochlear implantation (CI) for the treatment of single-sided deafness (SSD) is a relatively new treatment modality. Although comparing the effectiveness of CI and contralateral routing of signal (CROS) hearing aids (HAs) is important, very few reports on this topic exist. In this study, objective assessments and subjective assessments were conducted to determine which SSD individuals would prefer CI or CROS HAs. Objective assessments (speech perception and sound localization) and subjective assessments (Hearing Handicap Inventory for Adults (HHIA), Abbreviated Profile of Hearing Aid Benefit (APHAB), MOS Short-Form 36-Item Health Survey version 2 (SF-36v2)) were performed on 87 SSD patients. Of the 87 SSD patients, 33 patients hoped for CROS HAs, and 17 patients hoped for CI. The CI group underwent subjective and objective assessments at 6 and 12 months postoperatively. The CROS HAs group underwent objective assessments at 1 month after wearing CROS HAs. After the intervention, the localization ability was significantly improved in the CI group (p < 0.05) with no significant improvement in that of the CROS HAs group (p = 0.48). No significant improvement in speech perception in noise was observed in the CROS (Signal-to-Noise ratio + 10, p = 0.08; SN + 0, p = 0.17); however, a significant improvement in the CI group was observed at 12 months postoperatively. The APHAB subscale "background noise" and SF-36v2 health concepts of role-physical, general health, vitality, role-emotional, and mental health were significantly higher in the CI group. CI was superior to CROS HAs in speech perception in terms of noise and sound localization. Patients with postlingual acute-onset hearing loss and more handicaps and a more positive view of their hearing loss possibly tend to choose CI.

The Prevalence of Hearing Aid Use in Children With Single-Sided Sensorineural Deafness in Oxfordshire

The Prevalence of Hearing Aid Use in Children With Single-Sided Sensorineural Deafness in Oxfordshire

Objective Comparison of Benefits Derived From Contralateral Routing of Signal Hearing Aid and Bone Conduction Device in Noisy Surroundings in Patients With Single-Sided Deafness.

Single-sided deafness (SSD) leads to non-participation of the diseased ear in generating adequate auditory input, which results in poor speech discrimination in noisy surroundings. The present study objectively compared the audiological benefits rendered by contralateral routing of signal (CROS) hearing aid and bone conduction device (BCD) in patients with SSD >70 dB HL using the modified hearing in noise test (HINT). Patients with SSD >70 dB HL in poor and clinically normal hearing in the better ear were enrolled. Patients aged <18 or >70 years, with a history of neurological insult or ear infection in the last 3 months, mental retardation, psychiatric or developmental disorders, and diabetes were excluded. Modified HINT was performed with the affected ear unaided, aided with CROS hearing aid, and with BCD, generating three groups. Noise signal was presented at a fixed intensity of 65 dB at the neutral position in the center and speech signal was presented to either ear sequentially. The test was repeated with the speech signal fixed at the neutral position and the noise signal presented to either ear. BCD led to a better signal-to-noise ratio (SNR) than CROS hearing aid in all situations except when noise was centralized and speech was presented to the affected ear. A benefit was observed when auditory rehabilitation was used for the affected ear as demonstrated by better SNR scores. The results showed that BCD performed better than CROS hearing aid.

Comparison of Aided and Unaided Thresholds and Selection Processes of Contralateral Routing of Signal Hearing Aids and Implantable Bone Conduction Devices in Patients with Asymmetric Hearing Loss

Background and Objectives We reviewed the selection processes of contralateral routing of signal (CROS) hearing aids (HAs) and bone-conduction (BC) Has, and compared aided and unaided hearing thresholds. Subjects and Method Twenty-four patients with asymmetrical hearing loss who used BC HAs (n=12) and CROS HAs (n=12) were enrolled. The choice of two different HAs were compared with respect to the degree of hearing loss, the unaided hearing thresholds and functional gains. Results When the hearing thresholds of the better hearing ears were ＞30 dB HL, most (92%, 11 of 12) chose CROS rather than BC HAs, with significant difference (p=0.001). Both CROS and BC HAs groups showed significantly improved functional gains (46.6 dB and 53.4 dB, respectively). Aided air-conduction (AC) thresholds (40.2 dB HL) in the CROS group were similar to the AC thresholds (43.1 dB HL) of better hearing ears. However, the hearing threshold of Aided AC thresholds (35.8 dB HL) in BC HAs group were less than the BC thresholds (17.3 dB HL) of better hearing ears by 19 dB (p＜0.001). Conclusion Both groups showed significantly increased functional gains. CROS HAs were preferred when hearing thresholds in better hearing ears were ＞30 dB HL. The CROS group showed aided thresholds similar to the thresholds of better hearing ears, but the BC HAs group showed poorer aided thresholds than the thresholds of better hearing ears. For patients with asymmetric hearing loss, HAs should be selected based on the degree and types of hearing loss and the maximum output level of the selected device. Key words: Bone conduction ㆍ Contralateral routing of signal ㆍ Deafness ㆍ Hearing aids ㆍ Hearing loss ㆍ Single-sided

Nonsurgical Management of Single-Sided Deafness: Contralateral Routing of Signal.

In recent years, an increasing research effort has been directed toward remediation of single-sided deafness. Contralateral routing of signal (CROS) is the longest standing rehabilitation solution for individuals with single-sided deafness. The primary goal of CROS technology is to transfer the signal received at the deaf ear to the better hearing ear, thereby reducing the impact of the acoustic head-shadow. This allows for individuals with single-sided deafness to regain access to sounds located at the deaf ear. The hearing deficits associated with single-sided deafness are often debilitating. While surgical management of single-sided deafness is on the rise, CROS hearing aids offer a nonsurgical option to compensate for some of the deficits that occur when a listener is limited to a single ear. Limitations of early CROS devices resulted in poor adoption and acceptance in those with single-sided deafness. Following significant advances in both design and technology, the acceptance of CROS devices has increased in recent years. This paper reviews relevant literature in CROS application for the management of single-sided deafness. Technological advances, benefits, limitations, and clinical considerations are also reviewed in this article.

Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review.

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

Subjective and Objective Outcomes from New BiCROS Technology in a Veteran Sample

Patients with single-sided deafness (SSD), where one ear has an unaidable hearing loss and the other ear has normal or aidable hearing, often complain of difficulties understanding speech and localizing sound sources, and report a higher self-perceived hearing disability. Patients with SSD may benefit from using contralateral routing of signal (CROS) or bilateral contralateral routing of the signal (BiCROS) amplification. Dissatisfaction of previously available (Bi)CROS devices has been reported, such as, interfering transmissions, low-fidelity sound quality, poor "user-friendly" set-up, and a bulky and cosmetically cumbersome appearance. Recent advances in hearing aid technology have improved (Bi)CROS hearing aids; however, these devices have not been experimentally evaluated. We hypothesized that newer technology with reports of improved digital signal processing, wireless transmission, and physical design would be as good, or better than, our participants' previous-generation BiCROS systems. A within-subjects, pretest-posttest design was executed. Thirty-nine veterans (one female, 38 males; mean age = 74 yr, range = 49-85 yr) from the Audiology Section of the Bay Pines Veterans Affair Healthcare System participated. All participants were previously experienced BiCROS hearing aid users with varying degrees of sensorinerual hearing impairment in their better ear. Participants were provided at least 4 wk of consistent use with the new BiCROS. DATA COLLECTION AND ANALYSES: Participants completed three research visits. At Visit 1, with their previous BiCROS, and at Visit 3, with their new BiCROS, the following objective and subjective measures were obtained: (1) soundfield speech-in-noise testing using the Words-In-Noise (WIN) test; (2) speech, spatial, and qualities of the hearing scale (SSQ) questionnaire; (3) selected questions from the MarkeTrak questionnaire; and, (4) three open-ended questions. Data were analyzed using parametric and nonparametric statistics. Overall, the objective (WIN) and subjective (SSQ, MarkeTrak, and open-ended questions) measures indicated that the new BiCROS provided better outcomes than the previous BiCROS system. In addition, an overlap of favorable results was seen across measures. Of the 39 participants, 95% reported improvements with the new BiCROS and chose to utilize the device regularly. The favorable objective and subjective outcomes indicate that the new BiCROS system is as good, or better than, what was previously utilized by our sample of veterans.

Einseitige Taubheit und Cochlear-implant-Versorgung

Cochlear implantation (CI) is a new form of treatment in the rehabilitation of single-sided deafness. The patient requires thorough initial examination and a full explanation of alternative treatment options prior to determining the indication for CI treatment. To date, we have treated 28 patients with CI, of whom data are available for 11 after 12 months. We examined speech comprehension in background noise and localisation ability 12 months after CI implantation compared to conventional CROS (contralateral routing of signal) hearing aids, BAHA (bone-anchored hearing aid) and hearing in untreated patients. In addition, we determined the subjective handicap (HHIE, hearing handicap inventory for the elderly) and the subjective success (IOI-HA, international outcome inventory for hearing aids; SSQ, spatial and qualities of hearing scale) of each treatment option. After 12 months' experience, the results show a significantly better localisation ability and an improvement in speech comprehension in background noise with CI than with the other treatment options. Subjective results also show a clear benefit with CI. Careful patient selection is a decisive factor for successful treatment of this patient group. Under these conditions, CI is a treatment option with which significant improvement in speech comprehension and localization ability in single-sided deafness is possible.

Assessment of Patient Satisfaction with Various Configurations of Digital CROS and BiCROS Hearing Aids

We conducted a study of 91 patients with severe-to-profound asymmetric hearing loss to assess their satisfaction with digital contralateral routing of signal (CROS) or bilateral contralateral routing of signal (BiCROS) hearing aids, Satisfaction was evaluated on the basis of the number of patients who elected to purchase their hearing aid following a free 30-day trial and on the results of a subsequent 8-question survey. We found that overall patient satisfaction was generally high. At the end of the 30-day trial, 66 of the 91 patients (72.5%) elected to keep their CROS or BiCROS device, a percentage that is far greater than the acceptance rates of 10 to 20% that had been previously reported with older models of the CROS and BiCROS devices. According to the survey responses, those who kept their devices gave them an overall rating of 3.4 on a scale of 1 (very dissatisfied) to 5 (very satisfied); those who returned their devices gave them an overall rating of 1.9.

Transcranial contralateral cochlear stimulation in unilateral deafness

Objectives The purpose of this study is to evaluate the effectiveness of Bone Anchored Cochlear Stimulator (BAHA) in transcranial routing of signal by implanting the deaf ear. Study design and settings Eighteen patients with unilateral deafness were included in a multisite study. They had a 1-month pre-implantation trial with a contralateral routing of signal (CROS) hearing aid. Their performance with BAHA was compared with the CROS device using speech reception thresholds, speech recognition performance in noise, and the Abbreviated Profile Hearing Benefit and Single Sided Deafness questionnaires. Results Patients reported a significant improvement in speech intelligibility in noise and greater benefit from BAHA compared with CROS hearing aids. Patients were satisfied with the device and its impact on their quality of life. No major complications were reported. Conclusion and significance BAHA is effective in unilateral deafness. Auditory stimuli from the deaf side can be transmitted to the good ear, avoiding the limitations inherent in CROS amplification.

Children's use of CROS hearing aids.

Ten children with unilateral hearing loss, aged 7 to 17 years, who were fit with contralateral routing of signal (CROS) hearing aids were followed up for three years to assess the suitability of this type of hearing aid fitting on children. The determination of the success of the fitting was based on follow-up visits, chart review, and response to a questionnaire sent to the parents. The fitting was considered to be successful if the child accepted the aid and if parents and teachers observed substantial improvement in academic performance and/or social behavior. Seven children were considered to be successful users of their CROS aids; one was unavailable for follow-up; one did better with a BICROS aid; and one did not do well with amplification. Our experience suggests that children with unilateral hearing loss can benefit from CROS amplification.

An Objective Assessment of a CROS Hearing Aid

A lack of clinically demonstrable evidence causes many professionals to be reticent about recommending a CROS (contralateral routing of signal) hearing aid for unilaterally deafened individuals. This is a case report demonstrating, objectively, the benefit of a CROS hearing aid. Evidence was obtained by the comparison of sound field speech audiometry under two conditions: the patient facing the loudspeaker and the patient turned with his poor ear directed toward the speaker. The drop in discrimination scores under the second condition warranted the recommendation for a CROS. A follow-up test disclosed that the CROS unit benefited this patient substantially.

Non-occluding earmolds with CROS and IROS hearing aids.

FOLLOWING early reports by Harford and Barry1and Harford and Dodds2which described CROS (contralateral routing of signal) hearing aids, audiologists have sought to apply the CROS principle and to explore its effectiveness in hearing aid selection. Although initially designed to ameliorate the hearing problems of unilaterally deaf patients, CROS hearing aids have been found beneficial with other types of hearing problems as well (Green et al3and Dodds and Harford4). The latter authors have recently emphasized that the open earmold (their term for a non-occluding earmold) commonly used with a CROS hearing aid gave greater improvement in speech discrimination than either a regular or a special vented earmold as determined with persons having high frequency hearing loss. The effect of an earmold coupler on the amplification characteristics of hearing aids has been studied by a number of investigators. Briskey et al5and Lybarger,6