Given the recent advancements in hearing aid technology, he noted, that’s not a surprising outcome. “The CROS/BiCROS hearing aids we are working with are light years ahead of where they used to be,” he said. Some companies, for example, are using a prescriptive approach to address the needs of individual patients. “Whether a patient is deaf in one ear or has additional loss in the better functioning ear—a scenario we frankly see a lot more frequently in our clinic than pure SSD—there are notable wireless hearing aid options that may do the job,” he added.
Explore This IssueJanuary 2014
Does a clinician still need to look to the literature for some guidance in choosing an SSD intervention? “Of course,” Dr. Bishop said. “But data can be misleading; it is notoriously difficult to do comparative studies of hearing aids versus implanted devices due to selection bias and other poorly controlled patient variables. With a two- to three-week trial of hearing aids, in contrast, you can’t really go wrong as a baseline strategy. The information you glean is absolutely invaluable.”
Dr. Baguley echoed the wisdom of such an approach. “In our hands, we almost always go with a CROS fitting as a first step to see if a patient with SSD will commit to wearing the device,” he said. “You really need to see if they are motivated enough to go with a technological solution. If they don’t tolerate CROS or don’t get the benefit they need, then and only then would we consider a move to BAHA or some other, more involved procedure.”
In The Netherlands, a Similar Approach
Myrthe K.S. Hol, PhD, MD, a widely published expert on hearing loss interventions from Radboud University Medical Center, Nijmegen, the Netherlands, also recommends nonsurgical trials for SSD patients. She demos not only CROS or BiCROS hearing aids but also BAHA devices that are worn on a headband, because in her clinical experience and research, the latter devices also have the potential for improving hearing thresholds and quality of life in selected patients (Eur Arch Otorhinolaryngol. 2010;267:889-896).
“We do think it is extremely important to have a very long period (at least two weeks) of headband testing before deciding on a given intervention, especially in ases of SSD,” Dr. Hol said. In the case of BAHA, “this is particularly useful, because in some cases, as effective as these devices can be, some patients still decide that they are not working for them. That is information you want to have before you actually subject them to BAHA surgery.”