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Do you have one "dead" ear?

Quite a few people have one "dead" ear and one "working" ear.

Single sided or unilateral hearing may result from inner ear infections or tumors, Meniere’s disease, head trauma or sudden hearing loss.

If the "good" ear has no hearing loss then the sufferer usually wears no hearing aid, and simply puts up with the problems of hearing just from one side.

People with a "dead" ear but who also have a milder hearing loss in their "best" ear usually wear a hearing aid to improve the hearing on the "good" side.

Sadly neither of these solutions helps overcome the problems of "one sided" hearing - most everyday listening situations depend on two equally functioning ears. Having a conversation around a table, conversation in a car, socialising in restaurants and walking side by side are challenging activities for people with one bad ear. You may often miss hearing someone who speaks on your "dead" side. You may  also need to keep turning your head, or hold it at an odd angle, in order to hear people properly.

However there is now a modern solution which can help those with a "dead" ear to pick up speech and other sounds from the "dead" side. A new product called a "wireless CROS" is now on the market.

As shown in the images below, this consists of :
- a "behind the ear" microphone & radio transmitter in a hearing aid case fitted to the "dead" ear.
- a "behind the ear" radio receiver & tiny loudspeaker in a hearing aid case fitted to the "good" ear

Sounds picked up on the "dead" side are picked up by the microphone on that side. The radio transmitter than sends the sounds by radio to unit fitted to the "good" ear.

The sounds from the "bad" side are then fed into the "good" ear through a slim plastic tube. The "good" ear now can hear sounds from the "bad" side as well as the "good" side.

For many people with one-sided hearing loss, this type of system can improve awareness of surrounding sounds and enhance the ability to participate in conversations.

For example, the man shown below has a "dead" ear but is using a Unitron CROS system and so can now hear conversations from BOTH sides.

(If your "good" ear also has a degree of hearing loss, then the "receiver" unit will be set-up to act as an amplifier too - in other words it will act as a hearing aid for the "good" side. This configuration is called a "biCROS" system. The results of your hearing test will indicate if a CROS or biCROS set-up is needed)

A same-day fitting is often possible if your "good" ear has zero loss or a mild hearing loss, especially at the higher frequencies. This is a very common type of hearing loss, which is often age-related. The nature of this mild loss allows one of the latest "open ear" fittings to be used as part of the "wireless CROS" system.

If you have this mild type of hearing loss then we at Blackminster Hearing Centre can often provide you with a suitable, fully working, digital CROS hearing aid all in a single visit!

The "open fitting" allows sound from the "good" side to enter the "good" ear normally - but the "open fitting" hearing aid will also provide sound from the "bad" side into the "good" ear.

Open fittings also minimise the age-old problem of "occlusion" - the annoying effect which makes your head sound like "it is in a barrel" when you are wearing a hearing aid.

Additionally, open fittings are very comfortable and allow good ventilation of the ear.

This style of hearing aid can usually be worn all day - you can forget that they are there!

Don't worry - these units are very small & discreet ... they are nothing like the old NHS behind-the-ear aids your grandparents may have used!

IMPORTANT: The hearing test may show that your "good" ear has a hearing loss which is not suitable for an "open fitting" but will require custom-made plastics, which will need to be made and then fitted at a later date.

NOTE: Unitron have produced an interesting - but rather technical - overview of CROS systems - click here.
(Caution: This is a large 1.5MB PDF file)

The table below outlines possible product selections and configurations:

RECOMMENDATIONS
TYPE OF HEARING LOSS	BRAND	PRICE
For people with one "dead" ear and one 100% "good" ear which has no loss.	We recommend the Unitron WiFi system for all clients. This system would be configured to operate in CROS mode i.e. the unit fitted to the "good" ear would NOT act as a hearing aid on that side. An "open fitting" - often of the "ready to wear" style - would be usual in these cases.	£1950 total
For people with one "dead" ear and one "better" ear which has just a mild loss, mainly in the high frequencies.	We recommend the Unitron WiFi system for all clients. This system would be configured to operate in biCROS mode i.e. the unit fitted to the "better" ear would also act as a hearing aid on that side. An "open fitting" - often of the "ready to wear" style - would be usual in these cases.	£1950 total
For people with one "dead" ear and one "better" ear which has a moderate or severe loss which requires amplification	We recommend the Unitron WiFi system for most clients For clients with very active & challenging lifestyles we recommend the Phonak Wireless CROS system. A custom-made earmould would be usual in these cases.	£1950 total £2500-£3000 total according to model

The table below outlines the products that we recommend:

PRODUCT	IMAGES	NOTES
Unitron CROS / biCROS system		The Unitron WiFi system is very stylish & discreet and reasonably priced. The system is an excellent general solution for most users.
Phonak CROS / biCROS system		The Phonak wireless system is somewhat bulkier & more expensive than the Unitron system. However the Phonak system is preferred for environments exposed to lots of electrical interference. The Phonak system is also ideal for those customers whose "better" ears have a hearing loss which needs significant assistance i.e. in a biCROS mode. The acoustic processing & noise reduction  systems in the Phonak are highly advanced.

We are often happy to offer our open-fitting CROS systems on a free trial basis for a few days. In this way you can find out if a CROS system provides the improvement that you are seeking .... at absolutely no financial risk!

Technical notes:
1. CROS = "Contralateral Routing of Signal".  BiCROS = Bilateral Contralateral Routing of Signal.
2. We only provide digital CROS & biCROS systems ... we do NOT offer the older analogue technology.
3. We do NOT offer CROS systems which use an unwieldy, clumsy  & ugly cable between the two sides - we feel that we should only offer modern wireless models.
4. Although In-The-Ear wireless CROS & biCROS systems exist, we feel that the current level of technology for this In-The-Ear style is not yet mature enough for general use. In particular, electrical "noise" levels can be unacceptably high.We believe that the Behind-The-Ear models mentioned above are attractive & effective CROS & biCROS solutions.
5. If you work in an environment with a lot of electromagnetic interference then we recommend you order the Phonak solution, as its electrical noise immunity is excellent.
6. We are very reluctant to consider fitting "transcranial CROS" solutions, where a high-power hearing aid blasts sound from the "dead" ear through the skull to reach the "good" ear. Very few clients have a hearing loss and/or lifestyle suitable for this type of CROS system - and only 20% of those clients find the results acceptable.
7. We are happy to consider fitting "Power CROS" systems, where the user has two severely deaf ears - one much worse than the other. The microphone is fitted to the WORST hearing side and the loudspeaker is fitted to the BAD side. This allows a very high power loudspeaker to be used because the chances of feedback ("whistling") are greatly reduced by the great physical separation of microphone & loudspeaker. However this is a very rare configuration.

Please call us to discuss if a CROS or biCROS solution might be of benefit to you. Tel: 01386 830100

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