CROS and Baha-Which Type of Hearing Assistance Is Better?

However, coverage for children is not available until they are five years of age, because their skulls are usually too thin for a surgically implanted system prior to that time. Until then, they may use a soft headband to hold the Baha in place.

Overall, the Baha system is one of the fastest growing technologies in otolaryngology, noted Dr. Niparko. One of the things that I find astounding is that close to 50,000 Bahas are in use worldwide, and just three years ago the number was under 10,000, he said.

CROS Disadvantages

For both traditional and transcranial CROS, you don’t find much user satisfaction, said Dr. Niparko.

Both systems require that a device be placed in the ear canal of the better-hearing ear, which the vast majority of users find to be a drawback, he said. As this better ear is the lifeline to the world of sound for the monaural patient, any type of impediment to hearing on that side is noticeable and often distressing, explained Dr. Niparko.

Patients can experience a blocking sensation with sound because of having to wear a device in their good ear, agreed Sam J. Marzo, MD, Associate Professor in the Department of Otolaryngology at Loyola University Health System in Maywood, IL, and a consultant for Cochlear Corporation. Dr. Marzo often sees patients who have tried CROS hearing aids but who are unhappy with the technology for this reason.

Moreover, because transcranial CROS must fit deeply and tightly within the ear canal, patients may experience discomfort, pain, and problems with cerumen buildup or infection, said Dr. Wazen.

Dr. Murray and her colleagues generally don’t use transcranial CROS for this reason. It’s also twice as expensive as a traditional CROS device, and neither the traditional or transcranial CROS is covered by most insurance companies, she said. Prices vary greatly from center to center. We charge $3500 for a CROS system and $4700 for a transcranial CROS, she said.

Baha Disadvantages

Although CROS may be uncomfortable, having to undergo surgery is the main drawback of Baha. The chief concern with the bone-anchored system is the need for a bony implant that connects to the processor through the skin, said Dr. Niparko. However, with careful surgical planning, the implant can be placed in a manner that makes it unobtrusive and a useful conduit of sound, he added.

Additionally, patients may experience infection around the external abutment. I tell patients they have to take care of the post like they take care of their teeth, said Dr. Wazen. They need to clean and brush it and remove any crusting that occurs so it will last a lifetime without major problems, he explained. If patients are not careful, the surrounding skin can become inflamed and infected. Most of these problems can be treated by a topical antibiotic or, in some cases, an oral antibiotic, he said.