HSC Section 8_April 2017

Reprinted by permission of Otol Neurotol. 2015; 36(5):819-825.

Otology & Neurotology 36: 819 Y 825 2015, Otology & Neurotology, Inc.

A Comparison Between Wireless CROS and Bone-anchored Hearing Devices for Single-sided Deafness: A Pilot Study

*Jennifer Finbow, * † Manohar Bance, *Steve Aiken, ‡ Mark Gulliver, ‡ Janine Verge, and *Rachel Caissie

*Dalhousie University, Halifax; Þ QEII Health Sciences Center, Halifax; and þ Nova Scotia Hearing and Speech Centres, Halifax, Nova Scotia, Canada

Introduction: This study compared wireless Contralateral Routing of Signals (CROS) hearing aid and bone-anchored hearing device (BAHD) in patients with single-sided deafness. Methods: Eight adults with single-sided deafness previously implanted with a BAHD were given a 2-week trial with a CROS hearing aid and tested in unaided and aided conditions. Both devices were compared on head shadow effect reduction, speech perception measures in quiet and in noise, self-assessment questionnaires, and daily diaries. Results: Both the CROS and BAHD significantly reduced the head shadow effect. QuickSIN scores were significantly better with noise presented to the poorer ear, as compared to the better ear, for the unaided condition, the BAHD, and the CROS. Scores showed no significant differences between the CROS and BAHD with noise presented to the better ear, but scores with the CROS were significantly poorer than in the unaided Unilateral sensorineural hearing loss or single-sided deafness (SSD) results in several communication diffi- culties particularly in noisy situations (1). These diffi- culties stem from the loss of binaural hearing and the head shadow effect, in which the good ear is shielded from sounds from the side of the poorer ear (2). Currently, there are two main intervention methods (SSD aids) used worldwide to help alleviate the head shadow effect: the Contralateral Routing of Signals (CROS) hearing aid and the bone-anchored hearing device (BAHD), which routes sound to the better ear by transcranial bone conduction from a microphone/processor attached to an osseointegrated implant in the skull on the poor hearing Address correspondence and reprint requests to Rachel Caissie, Ph.D., Associate Professor, School of Human Communication Disorders, Dalhousie University, 1256 Barrington St., 6th floor, P.O. Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada; E-mail: rcaissie@dal.ca The authors report no conflicts of interest. Source of Funding: Nova Scotia Health and Research Foundation.

condition with noise presented to the poorer ear. There were no significant differences between BAHD and CROS for the ratings on the Bern Benefit in Single-Sided Deafness and Speech Spatial Qualities questionnaires. Both devices were worn an average of 10 hours per day. Four participants pre- ferred the CROS for sound quality; three preferred the BAHD for comfort. Conclusion: Comparisons of CROS and BAHD need to be re-evaluated as both technologies have evolved. In our pilot study, both devices seem comparable, with the CROS avoid- ing the risks of surgery, and we recommend a trial of CROS in our center for first line treatment of single-sided deafness. Key Words: BAHD V Bone-anchored hearing device V Contralateral routing of signals V CROS V Single-sided deafness V Unilateral hearing loss. Otol Neurotol 36: 819 Y 825, 2015. ear side. Neither restores hearing to the affected ear, but rather alleviates the head shadow effect. Other, newer interventions for SSD include cochlear implantation (3,4) and the SoundBite (5). These devices will not be dis- cussed in this article. For several decades, the CROS was the traditional in- tervention approach, with older CROS models consisting of an analog hearing aid on each ear connected together by a wire along the neck of the patient (6,7). Newer CROS models are wireless and new CROS and BAHD models include more sophisticated digital noise reduction and adaptive directional microphones (8,9). Previous studies have compared older models of CROS to older models of BAHD, but both technologies have improved substantially, especially the CROS. It is well established that the CROS and BAHD do not improve sound localization abilities for people with SSD (10 Y 18). However, the benefits of the devices for the improvement of communication are not as well under- stood, as indicated by conflicting results in the literature.

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