Download PDF
J Neurol Surg B Skull Base 2019; 80(02): 132-138
DOI: 10.1055/s-0039-1677687
Invited Review
Georg Thieme Verlag KG Stuttgart · New York

Nonsurgical Management of Single-Sided Deafness: Contralateral Routing of Signal

Hillary Snapp
1   Department of Otolaryngology, University of Miami, Miami, Florida, United States
› Author Affiliations
Further Information

Publication History

01 June 2018

26 November 2018

Publication Date:
17 January 2019 (online)

    Permissions and Reprints

Abstract

In recent years, an increasing research effort has been directed toward remediation of single-sided deafness. Contralateral routing of signal (CROS) is the longest standing rehabilitation solution for individuals with single-sided deafness. The primary goal of CROS technology is to transfer the signal received at the deaf ear to the better hearing ear, thereby reducing the impact of the acoustic head-shadow. This allows for individuals with single-sided deafness to regain access to sounds located at the deaf ear. The hearing deficits associated with single-sided deafness are often debilitating. While surgical management of single-sided deafness is on the rise, CROS hearing aids offer a nonsurgical option to compensate for some of the deficits that occur when a listener is limited to a single ear. Limitations of early CROS devices resulted in poor adoption and acceptance in those with single-sided deafness. Following significant advances in both design and technology, the acceptance of CROS devices has increased in recent years. This paper reviews relevant literature in CROS application for the management of single-sided deafness. Technological advances, benefits, limitations, and clinical considerations are also reviewed in this article.

Keywords

CROS - contralateral routing of signal - single-sided deafness - SSD - unilateral hearing loss - hearing aid
 

  • References

  • 1 Tos M, Stangerup SE, Cayé-Thomasen P, Tos T, Thomsen J. What is the real incidence of vestibular schwannoma?. Arch Otolaryngol Head Neck Surg 2004; 130 (02) 216-220
    CrossrefPubMedGoogle Scholar
  • 2 Nicoucar K, Momjian S, Vader JP, De Tribolet N. Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life. J Neurosurg 2006; 105 (02) 205-212
    CrossrefPubMedGoogle Scholar
  • 3 Rigby PL, Shah SB, Jackler RK, Chung JH, Cooke DD. Acoustic neuroma surgery: outcome analysis of patient-perceived disability. Am J Otol 1997; 18 (04) 427-435
    PubMedGoogle Scholar
  • 4 Giolas TG, Wark DJ. Communication problems associated with unilateral hearing loss. J Speech Hear Disord 1967; 32 (04) 336-343
    CrossrefPubMedGoogle Scholar
  • 5 Sargent EW, Herrmann B, Hollenbeak CS. , et al. The minimum speech test battery in profound unilateral hearing loss. Otol Neurotol 2001; 22 (04) 480-486
    CrossrefPubMedGoogle Scholar
  • 6 Douglas SA, Yeung P, Daudia A, Gatehouse S, O'Donoghue GM. Spatial hearing disability after acoustic neuroma removal. Laryngoscope 2007; 117 (09) 1648-1651
    CrossrefPubMedGoogle Scholar
  • 7 Gatehouse S, Noble W. The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol 2004; 43 (02) 85-99
    CrossrefPubMedGoogle Scholar
  • 8 Middlebrooks JC, Green DM. Sound localization by human listeners. Annu Rev Psychol 1991; 42: 135-159
    CrossrefPubMedGoogle Scholar
  • 9 Araújo PG, Mondelli MF, Lauris JR, Richiéri-Costa A, Feniman MR. Assessment of the auditory handicap in adults with unilateral hearing loss. Rev Bras Otorrinolaringol (Engl Ed) 2010; 76 (03) 378-383
    PubMedGoogle Scholar
  • 10 Sano H, Okamoto M, Ohhashi K, Iwasaki S, Ogawa K. Quality of life reported by patients with idiopathic sudden sensorineural hearing loss. Otol Neurotol 2013; 34 (01) 36-40
    CrossrefPubMedGoogle Scholar
  • 11 Silverman CA, Silman S, Emmer MB, Schoepflin JR, Lutolf JJ. Auditory deprivation in adults with asymmetric, sensorineural hearing impairment. J Am Acad Audiol 2006; 17 (10) 747-762
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Augustine AM, Chrysolyte SB, Thenmozhi K, Rupa V. Assessment of auditory and psychosocial handicap associated with unilateral hearing loss among Indian patients. Indian J Otolaryngol Head Neck Surg 2013; 65 (02) 120-125
    CrossrefPubMedGoogle Scholar
  • 13 Schrøder SA, Ravn T, Bonding P. BAHA in single-sided deafness: patient compliance and subjective benefit. Otol Neurotol 2010; 31 (03) 404-408
    CrossrefPubMedGoogle Scholar
  • 14 Desmet J, Bouzegta R, Hofkens A. , et al. Clinical need for a BAHA trial in patients with single-sided sensorineural deafness. Analysis of a Baha database of 196 patients. Eur Arch Otorhinolaryngol 2012; 269 (03) 799-805
    CrossrefPubMedGoogle Scholar
  • 15 Sano H, Kamijo T, Ino T, Okamoto M. Edaravone, a free radical scavenger, in the treatment of idiopathic sudden sensorineural hearing loss with profound hearing loss. Auris Nasus Larynx 2010; 37 (01) 42-46
    CrossrefPubMedGoogle Scholar
  • 16 Harford E, Barry J. a rehabilitative approach to the problem of unilateral hearing impairment: the contralateral routing of signals cros. J Speech Hear Disord 1965; 30: 121-138
    CrossrefPubMedGoogle Scholar
  • 17 Agterberg MJ, Hol MK, Van Wanrooij MM, Van Opstal AJ, Snik AF. Single-sided deafness and directional hearing: contribution of spectral cues and high-frequency hearing loss in the hearing ear. Front Neurosci 2014; 8: 188
    PubMedGoogle Scholar
  • 18 Rothpletz AM, Wightman FL, Kistler DJ. Informational masking and spatial hearing in listeners with and without unilateral hearing loss. J Speech Lang Hear Res 2012; 55 (02) 511-531
    CrossrefPubMedGoogle Scholar
  • 19 Kumpik DP, Kacelnik O, King AJ. Adaptive reweighting of auditory localization cues in response to chronic unilateral earplugging in humans. J Neurosci 2010; 30 (14) 4883-4894
    CrossrefPubMedGoogle Scholar
  • 20 Hill III SL, Marcus A, Digges EN, Gillman N, Silverstein H. Assessment of patient satisfaction with various configurations of digital CROS and BiCROS hearing aids. Ear Nose Throat J 2006; 85 (07) 427-430 , 442
    CrossrefPubMedGoogle Scholar
  • 21 Picou EM, Aspell E, Ricketts TA. Potential benefits and limitations of three types of directional processing in hearing aids. Ear Hear 2014; 35 (03) 339-352
    CrossrefPubMedGoogle Scholar
  • 22 Kim G, Lu Y, Hu Y, Loizou PC. An algorithm that improves speech intelligibility in noise for normal-hearing listeners. J Acoust Soc Am 2009; 126 (03) 1486-1494
    CrossrefPubMedGoogle Scholar
  • 23 McCreery RW, Venediktov RA, Coleman JJ, Leech HM. An evidence-based systematic review of directional microphones and digital noise reduction hearing aids in school-age children with hearing loss. Am J Audiol 2012; 21 (02) 295-312
    CrossrefPubMedGoogle Scholar
  • 24 Kochkin S. MarkeTrak VIII: The key influencing factors in hearing aid purchase intent. Hear Rev 2012; 19 (03) 12-25
    PubMedGoogle Scholar
  • 25 Stone MA, Moore BC, Meisenbacher K, Derleth RP. Tolerable hearing aid delays. V. Estimation of limits for open canal fittings. Ear Hear 2008; 29 (04) 601-617
    CrossrefPubMedGoogle Scholar
  • 26 Kiessling J, Brenner B, Jespersen CT, Groth J, Jensen OD. Occlusion effect of earmolds with different venting systems. J Am Acad Audiol 2005; 16 (04) 237-249
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Snapp HA, Holt FD, Liu X, Rajguru SM. Comparison of speech-in-noise and localization benefits in unilateral hearing loss subjects using contralateral routing of signal hearing aids or bone-anchored implants. Otol Neurotol 2017; 38 (01) 11-18
    CrossrefPubMedGoogle Scholar
  • 28 Finbow J, Bance M, Aiken S, Gulliver M, Verge J, Caissie R. A comparison between wireless cros and bone-anchored hearing devices for single-sided deafness: a pilot study. Otol Neurotol 2015; 36 (05) 819-825
    CrossrefPubMedGoogle Scholar
  • 29 Williams VA, McArdle RA, Chisolm TH. Subjective and objective outcomes from new BiCROS technology in a veteran sample. J Am Acad Audiol 2012; 23 (10) 789-806
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Gelfand SA. Usage of CROS hearing aids by unilaterally deaf patients. Arch Otolaryngol 1979; 105 (06) 328-332
    CrossrefPubMedGoogle Scholar
  • 31 LinL M, Bowditch S, Anderson MJ, May B, Cox KM, Niparko JK. Amplification in the rehabilitation of unilateral deafness: speech in noise and directional hearing effects with bone-anchored hearing and contralateral routing of signal amplification. Otol Neurotol 2006; 27 (02) 172-182
    CrossrefPubMedGoogle Scholar
  • 32 Niparko JK, Cox KM, Lustig LR. Comparison of the bone anchored hearing aid implantable hearing device with contralateral routing of offside signal amplification in the rehabilitation of unilateral deafness. Otol Neurotol 2003; 24 (01) 73-78
    CrossrefPubMedGoogle Scholar
  • 33 Bosman AJ, Hol MK, Snik AF, Mylanus EA, Cremers CW. Bone-anchored hearing aids in unilateral inner ear deafness. Acta Otolaryngol 2003; 123 (02) 258-260
    CrossrefPubMedGoogle Scholar
  • 34 Hol MK, Kunst SJ, Snik AF, Bosman AJ, Mylanus EA, Cremers CW. Bone-anchored hearing aids in patients with acquired and congenital unilateral inner ear deafness (BAHA CROS): clinical evaluation of 56 cases. Ann Otol Rhinol Laryngol 2010; 119 (07) 447-454
    CrossrefPubMedGoogle Scholar
  • 35 Snapp HA, Hoffer ME, Liu X, Rajguru SM. Effectiveness in rehabilitation of current wireless CROS technology in experienced bone-anchored implant users. Otol Neurotol 2017; 38 (10) 1397-1404
    CrossrefPubMedGoogle Scholar
  • 36 Kochkin S. MarkeTrak VII: obstacles to adult non-user adoption of hearing aids. Hear J 2007; 60 (04) 24-50
    PubMedGoogle Scholar
  • 37 Gallant S, Lee J, Jethanamest D. Skin necrosis in a magnet-based bone-conduction implant. Ear Nose Throat J 2017; 96 (12) 454-455
    CrossrefPubMedGoogle Scholar
  • 38 Van der Gucht K, Vanderveken O, Hamans E, Claes J, Van Rompaey V, Van de Heyning P. Adverse skin reactions following percutaneous bone conduction implant surgery using the linear incision technique with and without subcutaneous tissue reduction. Acta Otolaryngol 2017; 137 (02) 149-153
    CrossrefPubMedGoogle Scholar
  • 39 Dun CA, Faber HT, de Wolf MJ, Mylanus EA, Cremers CW, Hol MK. Assessment of more than 1,000 implanted percutaneous bone conduction devices: skin reactions and implant survival. Otol Neurotol 2012; 33 (02) 192-198
    CrossrefPubMedGoogle Scholar
  • 40 Zeitler DM, Herman BS, Snapp HA, Telischi FF, Angeli SI. Ethnic disparity in skin complications following bone-anchored hearing aid implantation. Ann Otol Rhinol Laryngol 2012; 121 (08) 549-554
    CrossrefPubMedGoogle Scholar
  • 41 Wazen JJ, Spitzer JB, Ghossaini SN. , et al. Transcranial contralateral cochlear stimulation in unilateral deafness. Otol Head Neck Surg 2003; 129 (03) 248-254
    CrossrefPubMedGoogle Scholar
  • 42 Agterberg MJH, Snik AFM, Van de Goor RMG, Hol MKS, Van Opstal AJ. Sound-localization performance of patients with single-sided deafness is not improved when listening with a bone-conduction device. Hear Res 2018 ; (e-pub ahead of print) Doi: 10.1016/j.heares.2018.04.007
    PubMedGoogle Scholar
  • 43 Van Wanrooij MM, Van Opstal AJ. Contribution of head shadow and pinna cues to chronic monaural sound localization. J Neurosci 2004; 24 (17) 4163-4171
    CrossrefPubMedGoogle Scholar
  • 44 Keating P, Rosenior-Patten O, Dahmen JC, Bell O, King AJ. Behavioral training promotes multiple adaptive processes following acute hearing loss. eLife 2016; 5: e12264
    CrossrefPubMedGoogle Scholar
  • 45 Pedley AJ, Kitterick PT. Contralateral routing of signals disrupts monaural level and spectral cues to sound localisation on the horizontal plane. Hear Res 2017; 353: 104-111
    CrossrefPubMedGoogle Scholar
  • 46 Blauert J. Spatial Hearing: The Psychophysics of Human Sound Localization. London, England: The MIT Press; 1997
    Google Scholar
  • 47 Wazen JJ, Ghossaini SN, Spitzer JB, Kuller M. Localization by unilateral BAHA users. Otolaryngol Head Neck Surg 2005; 132 (06) 928-932
    CrossrefPubMedGoogle Scholar
  • 48 Taal CH, van Barneveld DC, Soede W, Briaire JJ, Frijns JH. Benefit of contralateral routing of signals for unilateral cochlear implant users. J Acoust Soc Am 2016; 140 (01) 393
    CrossrefPubMedGoogle Scholar
  • 49 Tillman TW, Carhart R, Nicholls S. Release from multiple maskers in elderly persons. J Speech Hear Res 1973; 16 (01) 152-160
    CrossrefPubMedGoogle Scholar
  • 50 Dillon H. Hearing Aids. In. New York: Thieme; 2001: 434-450
    Google Scholar
  • 51 Arndt S, Laszig R, Aschendorff A. , et al. [Unilateral deafness and cochlear implantation: audiological diagnostic evaluation and outcomes]. HNO 2011; 59 (05) 437-446
    CrossrefPubMedGoogle Scholar
  • 52 Buss E, Dillon MT, Rooth MA. , et al. Effects of cochlear implantation on binaural hearing in adults with unilateral hearing loss. Trends Hear 2018; 22: 2331216518771173
    CrossrefPubMedGoogle Scholar
  • 53 Snapp HA, Fabry DA, Telischi FF, Arheart KL, Angeli SI. A clinical protocol for predicting outcomes with an implantable prosthetic device (Baha) in patients with single-sided deafness. J Am Acad Audiol 2010; 21 (10) 654-6625
    Article in Thieme ConnectPubMedGoogle Scholar
  • 54 Snapp H, Angeli S, Telischi FF, Fabry D. Postoperative validation of bone-anchored implants in the single-sided deafness population. Otol Neurotol 2012; 33 (03) 291-296
    CrossrefPubMedGoogle Scholar