Bone-anchored hearing system, contralateral routing of signals hearing aid or cochlear implant: what is best in single-sided deafness?

Abstract Purpose The aim of the study was to compare long-term results after 1 year in patients with single-sided deafness (SSD) who were fitted with different hearing aids. The participants tested contralateral routing of signals (CROS) hearing aids and bone-anchored hearing systems (BAHS). They were also informed about the possibility of a cochlear implant (CI) and chose one of the three devices. We also investigated which factors influenced the choice of device. Methods Prospective study with 89 SSD participants who were divided into three groups by choosing BAHS, CROS, or CI. All participants received test batteries with both objective hearing tests (speech perception in noise and sound localisation) and subjective questionnaires. Results 16 participants opted for BAHS-, 13 for CROS- and 30 for CI-treatment. The greater the subjective impairment caused by SSD, the more likely patients were to opt for surgical treatment (BAHS or CI). The best results in terms of speech perception in noise (especially when sound reaches the deaf ear and noise the hearing ear), sound localization, and subjective results were achieved with CI. Conclusion The best results regarding the therapy of SSD are achieved with a CI, followed by BAHS. This was evident both in objective tests and in the subjective questionnaires. Nevertheless, an individual decision is required in each case as to which SSD therapy option is best for the patient. Above all, the patient's subjective impairment and expectations should be included in the decision-making process.

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Short-term outcomes of cochlear implantation for single-sided deafness compared to bone conduction devices and contralateral routing of sound hearing aids—Results of a Randomised controlled trial (CINGLE-trial)

PLoS ONE ◽

10.1371/journal.pone.0257447 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257447

Author(s):

Jeroen P. M. Peters ◽

Jan A. A. van Heteren ◽

Anne W. Wendrich ◽

Gijsbert A. van Zanten ◽

Wilko Grolman ◽

...

Keyword(s):

Speech Perception ◽

Hearing Aids ◽

Controlled Trial ◽

Bone Conduction ◽

Trial Period ◽

Speech Perception In Noise ◽

Treatment Groups ◽

Sound Localisation ◽

Single Sided Deafness ◽

Randomised Controlled

Single-sided deafness (SSD) leads to difficulties with speech perception in noise, sound localisation, and sometimes tinnitus. Current treatments (Contralateral Routing of Sound hearing aids (CROS) and Bone Conduction Devices (BCD)) do not sufficiently overcome these problems. Cochlear implants (CIs) may help. Our aim was to evaluate these treatments in a Randomised Controlled Trial (RCT). Adult SSD patients were randomised using a web-based randomisation tool into one of three groups: CI; trial period of ‘first BCD, then CROS’; trial period of ‘first CROS, then BCD’. After these trial periods, patients opted for BCD, CROS, or No treatment. The primary outcome was speech perception in noise (directed from the front (S0N0)). Secondary outcomes were speech perception in noise with speech directed to the poor ear and noise to the better ear (SpeNbe) and vice versa (SbeNpe), sound localisation, tinnitus burden, and disease-specific quality of life (QoL). We described results at baseline (unaided situation) and 3 and 6 months after device activation. 120 patients were randomised. Seven patients did not receive the allocated intervention. The number of patients per group after allocation was: CI (n = 28), BCD (n = 25), CROS (n = 34), and No treatment (n = 26). In S0N0, the CI group performed significantly better when compared to baseline, and when compared to the other groups. In SpeNbe, there was an advantage for all treatment groups compared to baseline. However, in SbeNpe, BCD and CROS groups performed worse compared to baseline, whereas the CI group improved. Only in the CI group sound localisation improved and tinnitus burden decreased. In general, all treatment groups improved on disease-specific QoL compared to baseline. This RCT demonstrates that cochlear implantation for SSD leads to improved speech perception in noise, sound localisation, tinnitus burden, and QoL after 3 and 6 months of follow-up. For most outcome measures, CI outperformed BCD and CROS. Trial registration: Netherlands Trial Register (www.trialregister.nl): NTR4580, CINGLE-trial.

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Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-Electrode Cochlear Implant

Journal of the American Academy of Audiology ◽

10.3766/jaaa.21.1.6 ◽

2010 ◽

Vol 21 (01) ◽

pp. 044-051 ◽

Cited By ~ 53

Author(s):

Camille C. Dunn ◽

Ann Perreau ◽

Bruce Gantz ◽

Richard S. Tyler

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Hearing Aids ◽

Hearing Aid ◽

Low Frequency ◽

Noise Sources ◽

Speech Perception In Noise ◽

Hearing Aid Use ◽

Significant Difference ◽

Array Performance

Background: Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose: The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Research Design: Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results: Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion: Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

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The long-term results of speech perception in elderly cochlear implant users

Cochlear Implants International ◽

10.1080/14670100.2016.1162383 ◽

2016 ◽

Vol 17 (3) ◽

pp. 146-150 ◽

Cited By ~ 10

Author(s):

C. Jolink ◽

H. W. Helleman ◽

E. van Spronsen ◽

F. A. Ebbens ◽

M. J. L. Ravesloot ◽

...

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Long Term Results

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A Role for Acoustic Stimulation in Advanced Otosclerosis: Direct Acoustic Cochlear Implant versus Cochlear Implant

Audiology and Neurotology ◽

10.1159/000491990 ◽

2018 ◽

Vol 23 (2) ◽

pp. 89-97

Author(s):

Nicolas Verhaert ◽

Charlotte Borgers ◽

Katleen De Voecht ◽

Ellen Boon ◽

Christian Desloovere

Keyword(s):

Speech Perception ◽

Cochlear Implant ◽

Hearing Aids ◽

Standard Treatment ◽

Acoustic Stimulation ◽

Grading System ◽

Effective Treatment Option ◽

Computed Tomographic ◽

Direct Acoustic Cochlear Implant ◽

Acoustic Component

Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1–3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.

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