Single-sided deafness. What are your options?

Time to read: 10 minutes


This is a transcript from the Value Hearing video you can find on our Value Hearing YouTube Channel. We regularly add new videos to our channel, so be sure you like, subscribe, comment and share our videos to anyone you know you wants to know more about hearing, hearing loss and hearing aids. Today's video is presented by Emma Russell from our Bondi clinic.

Hi there, welcome back to Value Hearing’s YouTube channel. I'm Emma, I'm a clinical audiologist and today I would like to talk to you about one of the really common treatment options for single-sided deafness.

So, what exactly is single-sided deafness?

Well, some unlucky people are in a position where they have lost the hearing in one ear completely.

Or, perhaps there's a little bit of hearing there, but their audiologist has told them that there's just not enough to work with in order to give them a hearing aid, or they're just simply not suitable for a hearing aid.

What those people experience - although anyone with two normal ears or even people that have a hearing aid on both sides may not really be able to understand or empathise with - is that when you only have one good ear or, even if it's perfect, there are many situations where it's simply not enough.

A classic one obviously being if you're sat next to someone in a restaurant or at the dinner table, and they are on your bad side it will be very difficult to hold a conversation. So in a fairly quiet room if that person speaks quite clearly, you might be able to hear them on the good side.

Their voice will travel over your head but very often what we call the ‘head shadow effect’ has an impact. This means your head's in the way so they're talking here and it (the sound) can't get across your head to get to the good ear enough for you to hear it.

WP_Oticon_CROS_figure-1People with single-sided deafness can become very, very frustrated and upset when they are in big group situations when there's background noise, maybe even when they're at work if someone's trying to speak to them from that side.

There are endless situations where those of us with two working ears really, really take them for granted.

Another thing that can happen when we have single-sided deafness, again you can have a perfect ear, but that one ear won't be enough in a pub or a restaurant  for you to localize signs and be able to pick up the speech you do want to hear and help you filter out the noise that you don't want to hear.

I won't go into the details of the psychoacoustics about it, it's not that interesting, but essentially the brain likes to use information from both ears and compare it to help you focus on speech and filter noise or help you eavesdrop on a particular conversation happening in a particular direction.

And when you've only got one ear, you can't do that. When you're in a noisy pub or a restaurant, even having a conversation with someone right in front of you with noise, is more challenging than if you had two good ears, or two ears that are using hearing aids.

It's obviously a big, big issue and thankfully the technology has moved along to support these people. 

So, essentially, what I wanted to talk about today was CROS, which at the moment is the most common treatment for single-sided deafness. 

CROS stands for ‘contralateral routing of signal’. You are putting something that looks exactly pretty much like a hearing aid on that dead ear or the bad side and you're wearing something that is kind of like a hearing aid, in some cases, on the better ear.

Then the sound is being picked up on the dead side and sent across the head over to the good ear, or better ear. It certainly doesn't mean you're all of a sudden going to be able to localise and know where all signs are coming from, but it gives you awareness of sound on that side.

So again, if you were in that restaurant situation or at the dinner table, you would actually be able to hear the conversation from the person on your bad side.

As you can imagine for many people, this is really life-changing and it is a fantastic  technology and I have to say, and you'll probably hear this from a lot of audiologists our happiest clients are often those that got a CROS, particularly a BICROS.

BICROS is worn by people who have a dead ear and an ear on the other side that is a lot better but is not normal and could do with some amplification as well. We set this up on the good side as a hearing aid, so not just a transmitter situation.

Instead, you've got the transmitter on the bad ear and receiver on the good ear. Then the sound is being amplified and treated for that person's hearing loss.

Like I said, we find that people absolutely love this technology and what's so good is that 10 years ago, we really only had one manufacturer that made a good CROS and now we've got several.


So, it's been in the last 10 years that things have really developed in that area. CROS is definitely worth considering if you have single-sided deafness.

I won't go into great detail in this video but there are other options. There's something called ‘bone anchored hearing aids’ or BAHA. This treatment has been around for a long time and it's for anyone who's got the the bad ear the dead ear on one side and either a perfectly good ear on the other side or an ear that has a mild hearing loss on that side.

Okay, so some extent of hearing is lost there, but what the BAHA can do is, we basically implant it into the skull so it does require surgery and it sits on the bone, and it vibrates the bone. When the sound is picked up on that bad side, it actually travels through the skull across to the better ear,  so you don't have anything sitting on this ear, and nothing receiving it.

It literally travels through the skull and goes to the cochlea on the better side. The skull is an amazing thing, the whole hearing system is an amazing thing and this really does work, so this is another very valid treatment that should be considered.

It probably is not quite as common now since CROS has developed but it is still a really really good valid option to consider.

Finally, here in Australia,  we are seeing a lot of our ENT surgeons over the last decade actually implanting a cochlear implant on the dead ear, particularly with people who've had a sudden sensorineural hearing loss.

For example, they've had good hearing one day and unfortunately lost their hearing in a matter of days and we're not able to get that hearing back after they've had treatment, and so they're being offered cochlear implants.

It's not just for people that have had sudden hearing loss. What we're saying is that here in Australia this has been an option that is offered and wasn't something that was commonly offered more than a decade ago.

And that was simply because the belief was 'you've got perfect hearing on one side, you know you're hearing acoustically and then you're going to put this electronic signal on the other. How do you know how the brain would receive that?'.

It turns out the brain receives it incredibly well.

The evidence is pretty strong and we've heard a lot of really good feedback here in Australia from clients who have gone through this process. Having the cochlear implant on that side has been a really really good treatment option for them.

So again, it is definitely something to consider.

There you have it! Single-sided deafness is incredibly common and not easy to live with, so you don't necessarily have to. We do have lots of options and they keep developing.

There's even a few more than those I've mentioned today.

Another topic that we have been asked for about CROS is actually talking about the different manufacturers and the pros and cons of each of their CROS and BICROS systems, so we will definitely do that in the future.

If you have any questions, any comments, any requests for other videos please leave them in the little comment section below.

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