CROS hearing aid?


#1

Hello, I am a Meniere’s patient with sudden unilateral hearing loss. I started a trial of the Oticon OPN 1 about 3 weeks ago and am not finding much improvement in understanding speech. I can certainly hear more but the increase in sound (volume) doesn’t seem to make much of a difference in understanding what the speaker is saying. If the person speaks louder then it definitely helps but only because my right ear is picking up the natural sound as my hearing is very good on that side. It almost defeats the purpose of having the hearing aid. This is all new to me so I’m frustrated. I have an audiologist that I’m working with but wanted to see if anyone could provide their feedback regarding Cros hearing aids. I don’t know if I need to give this hearing aid more time, try a different one, or if I would be better off trying the Cros type of hearing aid. What makes matters more challenging is that fact that I work in an operating room setting where you have multiple conversations going on at once, various noises from machines, and everyone wears a mask so their speech is already muffled. My hearing was perfect just a few months ago so I am scrambling trying to find a solution. I have very little experience with hearing aids so I have nothing to compare my current hearing aid with. Any feedback would be very much appreciated…thank you!


#2

I would be very hesitant to fit a CROS to WRS scores like yours. Do you recall whether, during left ear word recognition testing, there was a noise put into your right ear?


#3

Neville is one of our quality/professional fitters here. I’m not but I agree fully with what he is saying. If the scores are correct, you should be fitted with two aids – possibly, even if the scores aren’t right.

If you look at my audio/wrs, you will see a far worse result in all cases. I wouldn’t be without the second normal aid. It adds a richness and better understanding. It also allows directional microphones to provide full featured results.

If your fitter is agreeing with you, it is likely they are more interested in the sale than the results you should obtain.


#4

I remember a portion of the test where they put some noise in my right ear. I can’t recall 100% if it was done during the word recognition portion of if it was only during the initial part when you are confirming audible tones.


#5

I guess I’m not understanding the rationale for putting a standard hearing aid in an ear with no hearing loss. Can you explain? My audiologist didn’t recommend a CROS device because the word recognition scores were good. Maybe they were good in that setting but it doesn’t seem to be translating into the real world. This was her first Oticon Opn fitting so she doesn’t have much experience programming this particular device. I don’t think she’s just interested in a sale because I have no intention of keeping it beyond the trial period (60 days) if I’m not satisfied, especially since this is the first one I’ve tried. I don’t feel that my expectations are too high. I certainly don’t expect my hearing to be improved to that of my right ear but I shouldn’t have to ask the person to repeat themselves 2 or 3 times when they are right next to me, even after turning my ear directly to them.


#6


#7

If you fit a CROS, you are basically giving up on your left ear and your clarity in that ear may deteriorate over time. Looks like your WRS was done with masking. I would not want to give up on that ear.

I agree that you shouldn’t keep the hearing aid if you do not feel that is it benefitting you. Let the audiologist know your concerns and make some adjustments and try again.

What makes them think your sudden loss was because of Meniere’s?


#8

I was diagnosed with Meniere’s in 2003 by my ENT. My hearing loss at that time was mostly low frequency. Symptoms improved on their own after a few years and my hearing was fine for several years up until a few months ago. My hearing loss has always been accompanied by vertigo and tinnitus. My audiologist said the same thing about the CROS device. She feels that a regular hearing aid could definitely be of benefit and that we shouldn’t give up on that ear. She never mentioned anything about wearing 2 standard hearing aids though. I don’t understand that part.


#9

Well, I think I am at a loss as is Neville. If you click on my WRS scores and then yours you see a huge difference. Yet, I find the bad ear benefits from an aid. You say you’re deaf in the bad ear and I recently had the “good” aid in for service and did almost as well without it. You should do far better.

As to Meniere’s, I had the symptoms and probably had it. My ENT says he only knows one doctor who can fully diagnose it. It is called a disease but it is really more a collection of nasty symptoms that embraces a host of possible causes.

Have you tried aiding the bad ear? Results?


#10

Can you elaborate when you say aiding? I really appreciate all the information as I’m new to this. I’m open to trying anything reasonable. My Otologist wanted to try dex injections but I declined. I got an MRI and ruled out an Acoustic Neuroma. I’m trying chiropractic because some Meneiere’s patients have responded to C1/C2 adjustments when misalignments were found.


#11

Well, frankly I’d trade you ears in a minute. Your WRS scores is what I had before the Meniere’s. Yet, my bad ear gets a lot of benefit from its aid; even with its 16% WRS. So, I just don’t understand why you are giving up on it.


#12

diagoc1 thank you for your very clear postings. You indicate that your Meniere’s diagnosis was 2003 but I assume the audiogram you show is quite recent. Can you estimate how long ago your L hearing started to decline significantly? Is there a chance that you’ve become (perhaps subconsciously) quite skillful in hearing all sounds using your R ear and used to not hearing much with your L ear? If so, this might make your initial experience with a HA in your L ear seem unnatural and maybe even unpleasant.

RE speech understanding. My opinion based on many decades of using HAs and upgrading to new improved instruments every few years: The speech clarifying and especially speech-in-noise capabilities of HAs have always been exaggerated. When I hear folks infer that HAs are analogous to eyeglasses, I sometimes can’t resist saying, “No, HAs are more analogues to wheel chairs, especially for people with substantial hearing loss.” So don’t expect too much.

I have no experience with Meniere’s or CROS HAs. But when my hearing started to deteriorate, my R loss was substantial and my L loss was minimal. I wore one HA on my R ear for many years, and that seemed to work OK.

This forum has many anecdotes and opinions such as mine, and I’m confident that you can decide which if any might be applicable and maybe helpful for your situation.


#13

Yes, the audiogram I posted above is from February of this year. The loss started about a month or so prior and coincided with some vertigo and tinnitus. It was not a gradual loss. I’ve had my Meniere’s monitored over the years which included hearing tests. My hearing was excellent in both ears for several years before this happened. I’m thinking maybe it’s harder to get used to the way the hearing aid sounds when my other ear is still taking in natural sounds with no loss. There is always going to be that contrast. Perhaps that makes it harder for the brain to get used to it. I have no clue. I am going back to my audiologist to see what can be done. Since this is my first hearing aid I don’t have anything to compare it to so trying others may be the way to go. Something definitely seems off because I’ve seen plenty of folks with much more severe losses on here who seem to do just fine. I was just shopping with my wife earlier today and again I struggled having a simple conversation while walking with her on my left. I can’t make out at least one or two words in every sentence and have to ask her to repeat. There wasn’t a lot of background noise either. This seems like basic stuff to me. I can hear her voice but the words are not clear at all. Very disappointing.


#14


#15

This was my initial hearing test from 2003. My hearing has definitely fluctuated. It started here and after a few years went back to normal. I had a test done in 2013 that showed no loss at all. I’ve been really hoping that my hearing would go back to normal again but I’m certainly not counting on it.


#16

Hey @diagoc1,
I would also be an advocate for fitting a single hearing aid, not a CROS. There is a tremendous amount of usable hearing and I would definitely try to use it to it’s fullest potential. Going the CROS route - you are essentially telling your body to abandon the left ear and there is a risk the neural pathways will deteriorate further due to lack of stimulation.

I would stick with the hearing aid route - but give it time. This is a huge processing change for your nervous system and it needs time to adapt to the new signals.

Question - when you were fit with the hearing aid did they use real ear measurements? This would have involved them placing a small tube in your ear and then measure various sounds and speech (usually someone talking about carrots) to insure a proper prescription. If this was not done then the hearing aid was not fit properly and that could be part of the problem.


#17

Thanks so much for your feedback. They sprayed a soft material in my ear and waited until it dried to create a customized mold which seems to fit very comfortably. I haven’t had any issues with hissing or feedback. My own voice sounds different but I understand this is common and definitely something I don’t mind as long as the hearing aid is providing some real benefit. For me the most basic test is being able to carry on a simple conversation in an open (not noisy) environment without having to move so the speaker is facing my good ear. I’m not expecting to hear well in a noisy restaurant or during a game where there are other people talking all around. I’m talking about a very simple one on one conversation in an open space with little to no background noise. I chose the Oticon OPN 1 because it is supposed to be one of the best so I’m surprised to be struggling with what I find to be a very reasonable expectation. My trial period is only 60 days so I am hoping my audiologist can tweak some of the settings in hopes making some fine tuning adjustments. Otherwise I will try a different hearing aid and keep my fingers crossed.


#18

Sorry, I just wanted to reiterate my previous question as it is very important. Did they perform real ear measurements? A small tube is placed in the ear canal (which is attached to a microphone) and sound pressure is measured in your ear canal. Without the test the audiologist or hearing aid dispenser cannot reliably and accurately set your gain prescription for your hearing loss. Without insuring the prescription is set you cannot have an accurate trial of a hearing aid. I cannot stress the importance of real ear measurements enough. Do some googling of real ear measurements and you should find some videos/images to see if you had it done. Judging by your last response I am guessing it was not done. If your audiologist does not want to complete the measurements then they are not following current best practice protocols and the hearing aid prescription is likely not set properly. There are so many individual variables to take into account with every person, every ear canal - and the chances of getting a prescription correct without measuring the sound pressure in the ear canal is very small.

Until we can be certain the hearing aid is set to your prescription then you cannot have an accurate trial. A fantastic hearing aid provides minimal benefit if it is not fit properly. And sadly the statistics out there show that the percentage of people who are fit using real ear measurements is quite low…very depressing statistic.


#19

Thank you so much for bringing this up again as I misunderstood. I had never heard of Real Ear Measurement and after looking it up I know this was not done. I will definitely be bringing it up to my audiologist during my appointment this week. This was her first fitting with the Oticon OPN so she met with the Oticon rep prior to my fitting and I’m sure he didn’t recommend the need for any verification outside of their own software. This was excellent information. Thanks again for taking the time to provide this information. It’s very much appreciated.


#20

That rather oversimplifies the point though - REM provides a target (or several) you then prescribe the aids: The customer A: hates the target, B: Finds the target is unhelpful in real World situations C: Has better or worse Auditory resolution than would be average for that loss, D has better mental plasticity than average…

OR you prescribe the aid based on the prescription into an ‘average ear’ - you then send the customer out into the World and tell them that the aid is set to a ‘new user’ level which will require modification - come back in a week or so. Use the REM to fault find or do side by side comparisons - it’s good for initial set-ups where the prescription is blind - but that’s rarely the case - especially with in-situ audiometry and feedback gain mapping.