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Single-Sided Deafness (SSD)

Single-Sided Deafness (SSD)

JAAA Editorial: The American Academy of Audiology Honors Committee: A Mechanism to Acknowledge Those in Audiology Who Have Gone Above and Beyond in Their Contribution to the Profession


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Volume 30, Number 7,
July/August 2019

Patricia Gaffney, AuD  Chair, Academy Honors Committee
Devin L. McCaslin, PhD 
• Deputy Editor, Journal of the American Academy of Audiology

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

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). 

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Single-Sided Deafness, Cochlear Implants, and Speech Understanding

Zeitler et al (2015) reported on nine people (ages 12 to 63 years) with single-sided deafness (SSD) and normal hearing in the other ear, all of whom underwent cochlear implantation in the SSD ear. With regard to post-op speech understanding in noise, the authors report “one of our aims was to assess the value of a CI for SSD patients when the listening environment simulated a ‘real world’ situation, that is, listening in a restaurant where the talker was on the side of the CI.

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Electromagnetic Transduction and Bone-Conduction Implants

Reinfeldt et al (2015) reported on six patients implanted with a new direct drive, active, transcutaneous bone-conduction implant (BCI) from Sweden. The device is a low-profile device and uses electromagnetic transduction across the skin—importantly not requiring a percutaneous abutment (screw attachment through the skin). The results indicated 10 to 41 dB improvement from 250 to 8000 Hz, improved SRT of 27 dB, and statistically significant APHAB improvements in 3 of 4 subscales.

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Cochlear Implants, Normal Hearing, and Single-Sided Deafness

Many reports in the literature have demonstrated that cochlear implants are a reasonable, successful, and viable option for people with severe-to-profound unilateral hearing loss (Arndt et al 2011; Baguley, 2010; Buechner et al 2010; Popelka et al 2010; Van Zon et al 2015; Van De Heyning et al 2008).

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CROS and BiCROS Hearing Aids

Contralateral routing of signal (CROS) amplification systems are intended to be used when (essentially) one ear is normal or has a mild/moderate hearing loss (i.e., is generally a candidate for amplification) and the other ear is (more-or-less) not “aidable.” CROS hearing aids might be recommended for single-sided deafness (SSD) or for people with very poor unilateral word recognition scores.

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Comparing CROS Hearing Aids and Bone-Anchored Hearing Devices

Finbow et al (2015) evaluated 8 adults with single-sided deafness (SSD) with regard to contralateral routing of signal (CROS) and bone-anchored hearing devices (BHADs). The authors report CROS and BAHDs are the two main interventions used to treat SSD, although they also report cochlear implants (CIs) have also been used to treat SSD.

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