Several measures of auditory function improved significantly in the 19 patients who were available for up to a one-year follow-up. “One of the more surprising findings in both groups was that many of the patients were able to localize sound,” said Dr. Gantz. “This is not generally possible with bone conduction devices or CROS [contralateral routing of sound] hearing aid technology. There was also improved performance in noise [discrimination] with binaural hearing.”
Explore This IssueJanuary 2014
Overall, he added, the patients with vertigo “were the most satisfied, because they were free of the recurring spells of dizziness and also had significant return of hearing in an ear that had not heard for several years.”
Dr. Gantz added, “We need much more clinical research with SSD and CI before we can identify the best population for this intervention.”
Trial First, Then Decide
The SoundBite, CI surgery, and the latest generation of BAHA devices aren’t the only choices clinicians have to weigh as potential SSD interventions. One sometimes neglected option is CROS hearing aids, albeit those enhanced with the latest signal processing equipment and other high-tech refinements, according to Charles E. Bishop, AuD, an assistant professor in the department of otolaryngology and communicative sciences at the University of Mississippi Medical Center in Jackson. Coupled with a traditional hearing aid, the CROS device becomes a BiCROS application and can amplify sound for an impaired ear as well as receive input from the “dead” ear, meeting the needs of a large percentage of SSD patients.
Why, then, are current hearing aid options sometimes overlooked? “It all comes down to what we consider to be the gold standard of how to manage these patients,” said Dr. Bishop. “Despite the wonderful advancements in BAHA and similar implantable devices, we feel that a very thorough patient trial with a non-surgical approach is a good [place to] start. But we recommend using the best new hearing aid technology as the basis for the trial, and not some archaic device stored in a cabinet.”
Does testing with outmoded devices happen very often? “I hope not,” Dr. Bishop said. “Still, practices have financial constraints; it can be hard to have expensive devices on hand for demonstration purposes. But it’s worth the effort in terms of patient satisfaction and outcomes.”
He added that his team always tries to demo CROS and/or BiCROS aids that have wireless features, so that patient concerns over cosmetics and the stigma associated with older wired hearing aids can be overcome. The trials, which last for several weeks, include detailed patient counseling on how to use the devices. “Tweaking” of the signal processing settings is done as needed. When such an approach is taken, Dr. Bishop said, patients are often very pleased with the results, obviating the need for BAHA and other more invasive, surgical procedures.