A Proposed Protocol: Assessment for Patients with Single-Sided Deafness or Asymmetric Hearing Loss

A Proposed Protocol: Assessment for Patients with Single-Sided Deafness or Asymmetric Hearing Loss

April 21, 2017 In the News

Do you fit bone-conduction hearing aids, contralateral routing of signals (CROS) hearing aids, and/or cochlear implants to your adult patients with single-sided deafness or asymmetric hearing loss (with the four-frequency pure-tone average in the poorer ear being greater than or equal to 70 dB HL)? Curious which one is the best treatment? If so, you may be interested in a consensus paper by Van de Heyning et al (2016). 

These authors believe there is a need for the collection of uniform outcome measures with these treatment modalities in this patient population to help guide treatment recommendations in the future. They, therefore, present a protocol for clinical studies in this area. These recommendations came after two international consensus meetings. 

Using set subject inclusion/exclusion criteria, the authors propose using a randomization scheme in which the patient is given a three-week trial with either a bone-conduction hearing aid (using a headband) or a CROS hearing aid, and then treatment is switched. After both trials, the subject is given a choice to proceed with getting a cochlear implant, using the bone-conduction hearing aid, the CROS hearing aid, or not getting any treatment.

The authors go on to recommend auditory training in the case of a cochlear implant and the collection of the minimum set of outcome measures at suggested assessment time periods. Outcome measures include pure-tone hearing thresholds, sound localization, speech understanding in noise, hours of device use, and the subjective assessment of the hearing loss, tinnitus, and quality of life.

For specific details regarding the protocol proposed by Van de Heyning et al (2016), the reader is referred to the full article.


Van de Heyning P, Távora-Vieira D, Mertens G, Van Rompaey V, Rajan GP, Müller J, Hempel JM, Leander D, Polterauer D, Marx M, Usami SI, Kitoh R, Miyagawa M, Moteki H, Smilsky K, Baumgartner WD, Keintzel TG, Sprinzl GM, Wolf-Magele A, Arndt S, Wesarg T, Zirn S, Baumann U, Weissgerber T, Rader T, Hagen R, Kurz A, Rak K, Stokroos R, George E, Polo R, Medina M, Henkin Y, Hilly O, Ulanovski D, Rajeswaran R, Kameswaran M, Di Gregorio MF, Zernotti ME. (2016) Towards a unified testing framework for single-sided deafness studies: a consensus paper. Audiol Neurotol 21(6):391–398. 

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