I have Single Sided/Unilateral Hearing Loss with Word Recognition Score (WRS) of 25% in my 70dB loss left ear, and approx. 85% WRS in my 10dB loss right ear. Hearing Loss is sensorineural; and the loss suddenly happened 10 years ago.
CROS set-up did not work, so Audiologist is trying 2 Phonak P90 Lumity hearing aids in both my “bad” ear, and in my perfectly hearing ear; as well as adding latest Roger Mic to serve like a CROS transmitter.
Just having the HAs in both my ears somehow “feels” like I have better hearing than from CROS set-up; however does anyone know if there is any actual reasoning or scientific proof that this is a better solution & set-up for unilateral SSHL?
Buying two top-tier HAs is going to cost me a lot more money than a CROS transmitter + 1 top-tier hearing aid, so need to consider if it’s actually worth it , although personally I cannot put a price on getting back workable hearing in background noise, and will pay for whatever is needed.
Highly appreciate any advice, comments or experiences you may have. Thanks.
It makes sense that you could hear better with two hearing aids as they work together. I would think they would be most helpful in noisy situations as the directional mics complement each other. The proof is in the pudding though. Whether you notice a difference is what’s important.
Which CROS system didn’t work, and specifically why?
With that degree of asymmetry, you’re likely to get some contralateral masking to the better cochlear from the powerful signal being sent across your skull to the poorer ear. In reality the poorer ear is good for some directionality and environmental sounds but not speech - I’d say you were on a hiding to nothing trying to get any form of symmetry going on. Once the resultant (aided) hearing level is more than 6dB difference across the head, the dominant ear is going to be doing practically all the work.
Put simply, you can’t turn up the poor side enough to balance the situation without causing a plethora of other issues: none of which aid directionality or improve your articulation index (level of speech).
Also, have you tried a decentish ITC Directional in the poorer ear?
I also have unilateral loss but not as large a discrepancy as OP.
I’ve also been trying to decide whether an aid on my good/normal ear would result in better hearing/outcome overall - I’m not comparing to CROS of course since my bad ear is not all that bad, but comparing to just a single hearing aid on bad ear.
I’m trying to make sure I’m understanding what you are saying - are you saying if there is >6 dB difference between ears it’s going to be difficult to correct without aiding both sides and thus synchronizing/getting full binaural effects? Or, in my case, since the aid in bad ear can basically bring it back to “normal” hearing range, is that matched enough? I know I would just have to try a second aid to really know but just curious what you think
Not quite, I’m saying that unless the aided response is within 6dB, (actually 3dB would be better) then binaural stereo summation is lost and with it your binaural directional field.
So you basically want to hear at a similarish level across both ears to hear speech well in background noise. Your asymmetry is obviously nothing like as bad as the OP, but you’re probably well aware of the issues in background noise. Even aided, the OP’s loss would do well to get to your unaided levels.
A friend deaf in one ear/cochlear implant in the other had severe issues with balance.
He said that it was due to using a hearing aid in only one ear.
I used to have issues identifying where sound was coming from (conversation; diesel loaders on construction sites) until I got my current Phonaks. They have directional microphones.
Hi um_bongo, Thanks for your reply.
Regarding your question about my CROS experience, it’s a little complex, and explanation is a bit long-winded; but please bear with me : )
- I have trialled top-level (P90 etc.) CROS + HA set-ups for 2~3 month stints (rental) a couple of times. Most recently with the Signia AX (IX was not available); but also Phonak Lumity last year.
- The issue is that the sounds transferred from the CROS transmitter into the Hearing Aid (HA) in my “good” ear is too weak to overcome the incoming natural background sounds also coming into the good ear. Even with a HA + closed dome fitting in the good ear, natural background sound (even elevator, asphalt road, kitchen fan level) still enters, and overcomes the CROS signal.
- If I increase the transmitted sounds to a higher HA volume level, it also transfers all the non-speech noises too (cos can’t be 100% filtered out; unlike natural hearing); and unfortunately also the increased volume blocks out all the natural better sound coming into my good ear. As a result I “lose” hearing by my good ear to accommodate far less-than-perfect digital signal coming from the CROS transmitter on bad hearing side.
- In a perfectly quiet environment the CROS set-up worked to some level to overcome the head-shadow effect (for faint speech coming to my bad side, that I can only slightly hear in my good ear, CROS increased volume up a few decibels, although not significantly). However, personally I do not feel (yet) there was sufficient hearing benefits to pay US$8000 or so just for this hearing support option.
- This is a personal opinion and experience based on my specific hearing loss stats and environments I live/work in; and aware from the numerous CROS testimonials on the web that CROS “works” for many. I have actually tried and trialled various CROS set-up over 5 separate times, over the last 10 years, with each updates in HA technology, and each time with the hope it will “work for me this time”
If you or anyone in this channel can advise on how I and my Audiologist can get better results with CROS set-up to meet my expectations (i.e. not perfect hearing, but a noticeable improved hearing experience for my SSHL), highly appreciated. I am still willing and motivated to keep chasing the Holy Grail of obtaining better hearing! Thank you.
BTW, still not worked out how best to utilize the additional Roger2 Mic Stick properly. Unless I literally hang it on or right in-front of the person speaking, I never get to pick-up their voice in background noise. So far, turning my head and good ear to them seems to be more effective , but far from sufficient or workable.
P.S. On the other question, for the last 5 years I have used a “basic” but programmed IIC Starkey for my bad ear. I have no Word Recognition/understanding; but theoretically increases “volume” of noticed sounds on the bad side and provide some level of sound localization + some stimulation of hearing nerves. However, once again, despite the impact of head-shadow effect, generally my good ear normally will pick-up and I take notice anyhow (e.g. if car is coming up on my bad side)
Based on your (um_bongo) comments, I guess this is the best I can expect of this , : (
Ok, there’s a couple of things to try.
1: Get REM done with the full CROS set-up in place on the better ear. And specifically REAR (Real Ear Aided Response) for speech - some call this ‘Live Speech Mapping’. You’ll need a sound source in the room or someone speaking and a background speech/restaurant chatter track available via speakers. When your audiologist runs the test you’ll be able to see how the speech vs the background noise is managed by the aids in different levels of mix and angles of orientation.
They ‘should’ be able to tune the aids on the fly, to enhance your relative hearing experience or better still show how the automatic programming works to deal with it. You can also ask for manual programs with more or less sharpening of the directional field and volume.
Edit: get a recording or find a YouTube clip of the particular gripe - road noise etc. play it at full beans on a phone or Bluetooth speaker in the REM session too.
(Phonak aren’t the only people who make a CROS, or the best CROS……)
If you have no joy with 1,
2: Get another Starkey ITE, possibly Genesis 16 or an Oticon Own 3 (both are plenty because you’re not looking to incorporate fancy binaural features) in the poorer ear. Again ask for the REM to tune the output to balance your better ear and possibly shut off the undesirable parts of the signal that get in the way of your ‘normal’ hearing on the other side. Also, REM with speech over speech/restaurant stimulus is probably the best source material as this will give you the best idea if the aid will work in a real world situation.
Thanks for posting this as I have the same sort of question and in the same place as you. However I do not have the same issues that you have with background overcoming the signal in the Lumity or Nexia Bi-cros I have trialed. Both apps provide ways that help me lower the background effect. I have hearing sensitivity as well.
I do have static with phone calls and also scratchy streaming on both units I’ve trialed. But I’m uncertain if I’m really on the right track with bi-cros or if two devices would be better. Left ear is pretty much done tho in higher frequencies. My audiologist is willing to trial me anything. Word recognition in the left is 36%.
I don’t think I understand fully the concerns about the 6% gap but my audiologist suggested we would be amplifying sounds I could not process.
Yes you want two aids, not one. Wearing just one aid is deranging.
deranging? don’t understand.
I had one; fell broke my leg badly skiing.
My friend had a cochlear implant in his good ear; couldn’t hear at all out of the other one. He said that if he had the right vitamin supplement he wouldn’t have lost his hearing after a prescription drug.
He also said that one hearing aid causes dizziness, and had contributed to my fall and his own dizziness. I still have memories of them straightening my foot around and have the 2 large plates and 14 screws in my right leg.
Thanks. I’ve never heard that word.
My friends cochlear implant in one ear and deafness could have been prevented if they had given him the proper vitamin with his prescription. He would walk down the corridor holding on the wall because he needed support. Fine man who helped me a lot.
In my case I was let go because “there was no work”. Derange. Yup.
Actually I still pick up a lot of sound and noise in the bad left ear in the lower frequencies. So wearing the bi cros with open domes actually works pretty well and I adjusted pretty quickly. Which is to say, I can still tell where sound is coming from but still get the sound from the left side piped to the right HA for processing and amplification.
I cannot tell much difference actually from wearing a 2 ha solution which I am trying now along with the bi cros.
How long have you been trialing the two options? I would also think two HAs would have make more sense then a BiCROS for your loss as you do have hearing that can benefit from a HA in your worse ear. You might need two different models given the difference in loss though.
If you’ve only started trialing the two HAs I would give it some time as your brain may need to get back up to speed processing sound in the worse off ear if it’s not been aided for a while.
The question you always want to ask yourself before transitioning from a hearing aid to a CROS is: “Am I never ever going to get a cochlear implant?”
Yes, my ENT suggested I could be a candidate for that. At the time and now, I don’t see that happening as the bicros works well and if bad ear continues to tank I think (but don’t know) it still would. I am a person who likes to keep options open though.
Hi and I’ve been trialing the Bi-CROS for a month or so and regular HA for the last week. I had a HA is the left for a long time that I wore intermittently. In 2020 I added a second HA because my insurance was expiring. These also I wore intermittently I suppose because my right ear hears reasonably well. Then in 2023 I noticed that I was not hearing as well. Actually much worse. Was not sudden hearing loss in the left ear but outcome was the same. I did steroid shots to restore but no change. So ENT prescribed Bi-CROS. rationale being amplifying sound in left would not improve word recognition (36%) because of nerve damage. So in December I started trial. So yes I may need to get reacclimatized. My audiologist is great—while skeptical of two HA solution she trusts me to identify the best solution. (Almost too much power for lay person)
The longer your ear goes without amplification, the poorer your CI outcomes will be. If you don’t want a CI that’s fine, just be aware that by moving to a CROS you are giving this option up.
ok, and here is what I don’t quite understand. Is it the amplification that matters? Because I am still getting sound past the open dome in the Bi_CROS solution.