CROS or hearing aid? Selecting the ideal solution for unilateral CI patients with limited aidable hearing in the contralateral ear

PLoS One. 2024 Feb 23;19(2):e0293811. doi: 10.1371/journal.pone.0293811. eCollection 2024.

Abstract

A hearing aid or a contralateral routing of signal device are options for unilateral cochlear implant listeners with limited hearing in the unimplanted ear; however, it is uncertain which device provides greater benefit beyond unilateral listening alone. Eighteen unilateral cochlear implant listeners participated in this prospective, within-participants, repeated measures study. Participants were tested with the cochlear implant alone, cochlear implant + hearing aid, and cochlear implant + contralateral routing of signal device configurations with a one-month take-home period between each in-person visit. Audiograms, speech perception in noise, and lateralization were evaluated. Subjective feedback was obtained via questionnaires. Marked improvement in speech in noise and non-implanted ear lateralization accuracy were observed with the addition of a contralateral hearing aid. There were no significant differences in speech recognition between listening configurations. However, the chronic device use questionnaires and the final device selection showed a clear preference for the hearing aid in spatial awareness and communication domains. Individuals with limited hearing in their unimplanted ears demonstrate significant improvement with the addition of a contralateral device. Subjective questionnaires somewhat contrast with clinic-based outcome measures, highlighting the delicate decision-making process involved in clinically advising one device or another to maximize communication benefits.

MeSH terms

  • Cochlear Implantation*
  • Cochlear Implants*
  • Hearing
  • Hearing Aids*
  • Humans
  • Prospective Studies
  • Sound Localization*
  • Speech Perception*

Grants and funding

This investigator-initiated study was supported by Advanced Bionics via a research grant and an equipment loan for study conduction. Participants had the choice to keep their preferred study device (a hearing aid or CROS) at the end of the study. The specific roles of the co-authors are articulated in the ’author contributions’ section of this manuscript.