That table is wrong in the U.K.
The triangles refer to unmasked BC. Once you use masking and correctly identify which cochlea is hearing the sound you use the open box symbol with the open face to the correct ear.
Normally there would be a Right BC marker on the right graph. The left BC (or No Response) would be marked on the left graph.
Surely that’s a clear case for a wireless Bi-CROS as any chart you’re going to see?
Thanks, I didn’t want to guess so did a Google search.
@Um_bongo thank you for that so according to what you have said it looks like i might fall into the criteria for my hospital been doing some research into hearing aids that might work with the Baha and found this don’t know if you or anyone can help me understand this https://cdn1-originals.webdamdb.com/13512_118632903?cache=1649363373&response-content-disposition=inline;filename=MK604586-gu-bimodal-compatibility-guide.pdf&response-content-type=application/pdf&Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cCo6Ly9jZG4xLW9yaWdpbmFscy53ZWJkYW1kYi5jb20vMTM1MTJfMTE4NjMyOTAzP2NhY2hlPTE2NDkzNjMzNzMmcmVzcG9uc2UtY29udGVudC1kaXNwb3NpdGlvbj1pbmxpbmU7ZmlsZW5hbWU9TUs2MDQ1ODYtZ3UtYmltb2RhbC1jb21wYXRpYmlsaXR5LWd1aWRlLnBkZiZyZXNwb25zZS1jb250ZW50LXR5cGU9YXBwbGljYXRpb24vcGRmIiwiQ29uZGl0aW9uIjp7IkRhdGVMZXNzVGhhbiI6eyJBV1M6RXBvY2hUaW1lIjoyMTQ3NDE0NDAwfX19XX0_&Signature=Zm882wd-4Vu-f-dVDDb26mdWDX6OOS5aLSqvffKYjmh25qE--UrSqNBBKWurpEiv95goLE3xXraDATeN~Cr6Q7tyEgQZb-YMVHgFFdGRnnsOulGl3QQWLa0Ze0DpM2B0tFFnlNMBfUJjDhhAhHSj4bsi4YjEWvj8RPbYg34QzRLifA6oRm4vuS3qw0-2UyuokoUe1GHPRRXQBNgevlEWuVOO-WhXj4yc~dKn0Q8BfPiNA7rq8ypMWed15-hBN9JONo1oWJiVk1OFsU9Tt-YFTrDMqRF-IbJJUUtMuYy29gFmg-RpIzIzHjFEbMVu~bkMXPJDJ~FnjCKtBCjqQezwOQ__&Key-Pair-Id=APKAI2ASI2IOLRFF2RHA
No, the left ear is practically redundant.
The BC triangle symbols on the left chart are inaccurately marked. They are the BC result for the right ear.
The left ear BC is indicated by the open boxes with the left side missing. These show the BC is beyond the recordable level of the Bone Conduction transducer: by the ‘out of range’ arrow indicating no response.
You have negligible cochlear function on the left and a Moderately/Severe Average ski-slope HF loss on your Right.
I’d fit an Oticon More1-3 BiCROS RIC, depending on budget. Forget the LHS surgery - there’s nothing to play with. Also the BAHA option is nonsense due to the transcranial mixing risk in you ‘good’ Right cochlear.
I’d also go and see another Audiologist who can tell their right from their left when testing people with slightly more complex needs than usual. Preferably one who uses a PC based audiometer that they know how to operate.
@Um_bongo thanks for that i’ll get them to redo the bone conduction on my left as that photo was an original test done when i first went there by someone who no longer works with them i think since they changed buildings to a different place. So would be good to get a better idea of what is going on. They won’t do the oticon for me there as they mainly deal in phonak and are only just now getting in some oticon’s as well and being disabled i can’t afford to go much further out than i am already going for appointments at this place as it takes up a whole day going there and i can’t afford to go private with the current change in prices for cost of living and the next place with a good rating on the nhs is much further away
Ok, good to get another test. That one is misleading.
The downside of the Phonak RIC rechargeable system is that the CROS unit only lasts about 12hours. Ok if you’re on a battery.
I’d push for the Oticon if at all possible.
Is that common for anyone?
Lewis, a BBC News Presenter has just got a Cochlear Osia for SSD.
Think he couldn’t use CROS Aids due to having to wear an ear piece for his work.
@Um_bongo I am currently using phonak cros 2 with a nathos auto m so no rechargeable option there. They did give me a nathos nova pr which i use in not very busy or noisy situations and when i am streaming or watching tv but the rest of the time i wear my cros aids as with just a single aid in noisy environments and with traffic sound i don’t hear people on my left if i wear just the nathos nova pr and I’ve tried the partnermic and if they move more than 20 meters away it cuts off.
Ideally i would love to have the option of being able to stream and answer the phone etc to both ears in a bicros option as the sound quality on the nova is so much better in every way and have tried pushing for the oticon as it as the twinlink technology and would be able to do that but they will not budge on that. So i think at my annual ent appointment i will ask about getting the bone conduction test redone for the left ear and take things from there and see what happens
Not sure there’s a hard and fast rule, but the risk is that you’d hear all the latent interference from the BAHA unit, the limits of the driver, the phase/processing delay and the ‘mush’ of it passing through the skull.
VS. a phase matched signal from both devices operating across the audible spectrum with all tuning and balancing done by one system.
I can’t form a perfect analogy but I think it would be like listening to a music signal through the floor from downstairs with bare feet: while having one ear wearing a Bang and Olufsen headphone playing the same music.
Fair enough: the BiCROS is still probably your best option in my book.
Like I said there’s better systems out there, but doing what you’re doing is going to give you about the best interim. Definitely get the test done though, the one above is simply misleading.
@Um_bongo thanks for that will def get the test done again for bone conduction and depending on what that shows I may see if I can try again for the oticon
We use the little carrots. Do you think they put the triangles there to indicate that the bone vibrator was on the left? There’s a lot of argument on this side of the pond about using side-specific unmasked symbols at all and some are converting to little hats in honour of ‘assume no interaural attenuation’. That doesn’t feel quite right to me either, but the carrots confuse non-audiologists into thinking there is hearing in situations where there isn’t but masking could not be done for whatever reason.
I was assuming that LRav wanted the BAHA for single-sided deafness cros-routing rather than trying to aid the left. Is it not used that way in the UK?
Even if the transducer was on the Left ear it refers to the function of the Right cochlear; therefore it should be marked as a right ear. Showing it on the LH chart just confuses the situation as there’s absolutely no hearing on that side.
As to BAHA, there’s been a move to minimal surgical intervention in most areas of ENT here to keep waiting lists down. I’ve seen transcranial options, but I’m not familiar with the criteria or success rate. The old BC function aids were pretty rubbish in delivering clarity though.
I thought the BAHA option might have been considered as it looks like there’s a functioning cochlear on that ear from that left audiogram.
I’m happy to be educated on it but it just seems like a really ‘messy’ solution unless you’ve got an ipsi-lateral cochlear which is doing ok, but sitting inside of an infected/wet EAM.
Hi @Neville and @Um_bongo thanks for this i was considering the Baha because i was alway told it was just the nerve endings that where dead and have always assumed bone conduction was ok because I have had some level of feeling like vibrating in that side. I was also considering the Baha because I have a genetic condition which means I have short Eustachian tubes which means any irritation causes a high chance of infection. My left ear because it has the shortest Eustachian tube is far more likely to get irritation and is becoming far less tolerant to having anything in it. the last test for bone conduction on the audiogram is confusing so will get a new one done and see what it shows from there
I wouldn’t know to educate. I have no patients using it this way. It’s just in my head as “option” and it’s always been my impression that in the US this is done fairly regularly, except more commonly when the other ear is normal. The manufacturers always bring it up as well. My first instinct would be CROS, too.
That’s common for everyone and BC even if you can hear it, you get vibration at higher volume!
I use an Osia baha. However, my diagnosis is nothing close to the OP’s. I have hearing in both ears. However, I have heard of SSD folks using a baha. Cochlear baha Attract & OSIA System Support Group | Facebook
I’ll add that one of the reasons I was approved for a baha to begin with was because I have eustachian tube dysfunction. Again, the OP’s situation is worse than mine. But given a functioning auditory nerve, a baha does circumvent a lot of eustachian tube blockage hearing issues.
I’d suggest that lrav look into this at least with a knowledgeable ENT who’s up to date on baha technology. Many aren’t. Maybe this won’t work. I don’t see up front why it might not be a good option.
Does nothing if the cochlear doesn’t work to a degree tho. Can’t just have a nerve functioning.
That’s the thing: There’s nothing in the Audiogram to suggest this is the case. By every measure there, the left Ear is dead, but that’s why the audiogram is misleading to the inexperienced eye (some ENT’s too).