Three Options for Profound Unilateral SNHL: BAHAs, BICROS and Transcranial CROS Hearing Aids
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1 Three Options for Profound Unilateral SNHL: BAHAs, BICROS and Transcranial CROS Hearing Aids Jennifer Jones, CAPT, USAF Travis AFB Malisha Martukovich, CAPT, USAF Lackland AFB
2 Overview Definition/Candidacy Criterion of Profound Unilateral SNHL Three Treatment Options Counseling Fitting Devices Summary
3 Definition/Candidacy Criterion Candidacy Criterion: Patients with Profound Unilateral SNHL, other ear has normal to mild hearing loss through 4000 Hz Medical clearance
4 Bone Anchored Hearing Aids Definition: A hearing aid that is surgically placed that bypasses the outer and middle ear and stimulates the cochlea directly through bone conduction Surgery option Cochlear Product
5 BAHA evaluation Completed prior to surgery Complete audiological evaluation Aided testing with test BAHA in the soundfield Trial period with loaner BAHA
6 BAHA fitting Three months post-op Cleaning of site and device Fitting/Counseling Adjustment of trim pots Quick SIN/ aided soundfield Follow-ups Pediatric Fittings
7 Case Study 16 yr old female, sudden hearing loss AD 20% word discrimination AD, 100% AS BAHA immediately recommended
8 BICROS Definition: Routes acoustic signal from profound SNHL side to better side which may also have hearing loss Pt wears two devices Wireless (Transmits sound via FM signal), BTEs, ITEs
9 BICROS fitting Fit better ear device first Set microphone balance to 3.0 to 6.0 Only give patient one program at initial fitting Add transmitter side Recommend two week follow up
10 Case Study 1 64 yo male, sudden hearing loss AD Fit pt with Interton BICROS BTE hearing aids
11 Case Study 2 57 yo male, sudden hearing loss AS 78% word recognition AS, 100% word recognition AD Originally fit with Siemens Centra ITE AS in 2007 Fit pt with Interton BICROS BTE hearing aids
12 Transcranial CROS Definition: Transmits acoustic signal from profound SNHL side to normal hearing ear via vibrations picked up by the better cochlea Pt wears one device Power ITE to Power CICs
13 Transcranial CROS fitting BTE, ITE or CIC power models Good fit/feedback program is important! Intra-aural attenuation of approximately db gain Follow up in two weeks Starkey Inteli Power D Full Shell Unitron Next power CIC
14 Case Study 64 yo male, sudden hearing loss AS Previously fit with Phonak Savia 311 BTE hearing aid AS Fit with Starkey Intelli Power D FS AS
15 Counseling Important to present all three options Disadvantages and Advantages of each
16 Counseling ASHA Leader 04 November 2008 Will my hearing return? Will I have to wear a hearing aid? Will I lose the hearing in my other ear? How long will I have this hearing loss?
17 Summary Definition/Candidacy Criterion of Profound Unilateral SNHL Three Treatment Options Counseling Fitting Devices
18 59th Medical Wing Providing Great Care Building Warrior Medics
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