Sonia Grewal, Au.D Professional Education Manager Hearing HealthCare Providers 2017 Conference WIDEX CROS & BICROS

Transcription

1 Sonia Grewal, Au.D Professional Education Manager Hearing HealthCare Providers 2017 Conference WIDEX CROS & BICROS

2 AGENDA Overview of CROS/BiCROS CROS Solutions CROS Applications CROS Validation Considerations and Protocol Summary Q&A -

3 EVALUATING ASYMMETRIC HEARING LOSS Is the hearing in each ear normal or impaired? Is the impaired ear aidable or unaidable? Is the unaidable ear due to a technology limitation (insufficient gain for a profound hearing loss) or distortion at the ear/brain?

4 CROS FOR PEOPLE WITH SINGLE SIDED DEAFNESS OR UNAIDABLE HEARING People with SINGLE SIDED DEAFNESS or UNAIDABLE HEARING have a number of problems: Problems hearing sounds coming from a particular direction Problems with speech understanding especially in noise Lifestyle implications Of those seeking help 80% have a hearing loss in their better ear

5 CROS VS BICROS CROS Contralateral routing of signal - One ear is normal or has a mild hearing loss and other ear is not aidable. - Single-sided deafness (SSD) - Poor unilateral word recognition scores BiCROS Bilateral contralateral routing of signal - Bilateral hearing loss but one ear is substantially better than the other

6 Single Sided Deafness (SSD) or Unaidable Hearing Loss Causes Idiopathic sudden HL Acoustic neuroma Temporal bone fracture Meniere s Disease Autoimmune Condition

7 Single Sided Deafness (SSD) or Unaidable Hearing Loss Effects Localization Speech Intelligibility in Noise Quality of Life work, social -

8 Single Sided Deafness (SSD) or Unaidable Hearing Loss Treatment Options CROS/BiCROS wired, wireless, transcranial Bone Anchored Hearing Aid (BAHA) Bone Conduction Aid Cochlear Implant Nothing

9 CROS/BICROS Receiver in the Canal (RIC) or Behind the Ear (BTE) All Levels and various styles

10 CROS CANDIDACY Normal Hearing on the Better Ear No Hearing or Very Limited Hearing on Poorer Ear

11 CROS CROS Hearing Aid Microphone Transmitter Receiver with NO Amplification

12 BICROS CANDIDACY Aidable Hearing Loss on the Better Ear No Hearing or Very Limited Hearing on Poorer Ear

13 BICROS CROS Hearing Aid Microphone Transmitter Receiver WITH Amplification

14 BICROS CANDIDACY Symmetric Hearing Loss Poor speech discrimination (0%)

15 BICROS CROS Hearing Aid Microphone Transmitter Receiver WITH Amplification

16 MODELS AND COMPATIBILITY Excl. CIC Micro

17 WHICH CROS? Receiver-in-the-canal (RIC) Behind-the-ear (BTE)

18 CASE # 1 30 year old male Normal hearing on his right ear No measurable hearing on his left due to trauma Works at LAX and he needs to hear from both ears, otherwise he wouldn t pursue a CROS

19 AUDIOGRAM 100% speech discrimination for right ear 0% speech discrimination for the left ear

20 SELECTION: He was fit with a Fashion BTE in his right ear Open dome with no occlusion He was fit with a Fashion CROS in his left ear Matches the hearing aid Has a VC so he can change the volume in noisier situations

21 CASE # 2 55 year old shop owner Previous binaural hearing aid user Sudden hearing loss in her right ear and her hearing aid no longer helps She likes her current aids because she can put them on and forget them

22 AUDIOGRAM 92% Speech discrimination in her left ear 0% Speech discrimination in her right ear

23 SELECTION: She was fit with a Fusion RIC in her right ear because she is a previous RIC user and wanted to stay with the same style She was fit with a Fusion CROS in her left ear Matches the hearing aid Likes the smaller RIC style versus a larger BTE

24 CASE # 3 72 year old retired police officer Patrols on his neighborhood watch Has a part time job as a security officer at the local arena Long standing hearing loss in his left ear with no hearing in his right as a result of trauma to that ear Wears a power BTE in his left ear

25 AUDIOGRAM 86% speech discrimination in the left ear 0% speech discrimination in the right ear

26 SELECTION Fusion RIC with P receiver for his left ear He has always worn a power BTE because that was the only option He was impressed with the size of the Fusion RIC Fusion CROS for his right ear

27 CASE # 4 19 year old college student First time hearing aid user Gradual decrease in hearing bilaterally Left ear has microtia unable to wear BTE or RIC

28 AUDIOGRAM 0% Speech discrimination for the right ear 96% Speech discrimination for the left ear

29 SELECTION CIC for his left ear Needed a small custom product because of size limitations due to ear deformity Fusion CROS for his right ear Prefers the smaller option RIC option cosmetic concerns

30 CASE # 5 71 year old retired teacher Has only worn hearing aid on worse ear Gradual decrease in hearing bilaterally He is having difficulty communicating in noise

31 AUDIOGRAM 80% Speech discrimination for the right ear 88% Speech discrimination for the left ear

32 DOES THIS USER NEED A CROS? Asymmetric hearing loss with good speech discrimination bilaterally. Now wears binaural RIC hearing aids High power receiver on right Moderate receiver on right

33 VALIDATION CONSIDERATIONS AND PROTOCOLS

34 REAL-EAR INSERTION GAIN REIG determines whether a particular hearing instrument setting achieves a specified insertion gain prescriptive target REAR (Real-Ear Aided Response) - REUR (Real-Ear Unaided Response) = REIG

35 SPEECH MAPPING Provides a direct indication of the audibility of sounds that are important for the user Uses live real time speech

36 AUDIOGRAM

37 MEASURING HEADSHADOW

38 OVERCOMING HEADSHADOW

39 AUDIOGRAM FLIPPED (DEPENDING ON TRANSMITTER SIDE)

40 FACING FRONT

41 VENDOR 2: A COMPARISON

42 VENDOR 3: A COMPARISON

43 SUBJECTIVE MEASURES Word list Hearing in Noise Test (HINT) Soundtracker on better ear Questionnaires Bern Benefit in Single Sided Deafness (BBSS) Functional testing

44 WIDEX CROS - EVIDENCE Speech Hearing in Noise Test Noise BBSS Bern Benefit in Single-Sided Deafness Questionnaire BiCROS Approx. 4dB improvement in Speech Recognition Threshold CROS Approx. 5dB improvement in Speech Recognition Threshold

45 Thank You! More Information: