Unlike the balance system, there are no collaterals for the hearing apparatus. When polled, patients usually rank single-sided deafness as the most disabling side effect of acoustic neuromas. Interestingly even in patients after surgery who may have been affected by facial nerve paralysis or balance issues, many continue to be more bothered by the hearing loss than the other symptoms. There are several problems with single-sided deafness. One, we require two functioning ears to detect the source of a sound. Human brain uses time and intensity of sound heard in the two ears to detect where sounds come from. Second, because of the head shadow effect, when the source of sound is close to the deaf ear we might not clearly hear the sound. For example when someone is deaf in the right ear he would have a very difficult time conversing while being the driver in the car since the only functioning ear is away from the source of sound. Obviously the reverse is true in British-style cars. Third, hearing in loud noisy environment becomes much more difficult since two ears filter out noise better than one ear.
There are numerous devices that would allow you to hear when people talk to your deaf ear. Unfortunately none can completely replicate having two functioning ears since they simply send the sound from the deaf side to the good ear and not restore hearing to the deaf ear. This means that you would still have problem with detecting where a sound is coming from but would have a much easier time when someone is talking to the deaf ear. The available options for single-sided deafness includes CROS/BICROS hearing aids, Osteointegrated hearing devices AKA BAHA, and the Soundbite device.
Bone anchored hearing aid (BAHA) also known as osteointegrated hearing device: This device has an abutment that is implanted in the skull behind the ear on the deaf side. The hearing processor is then attached to it and the sound is transmitted to the good ear through the bone. Since this device bypasses the external and middle ear apparatus, it could also be used in cases of conductive hearing loss. The surgery for implantation of the abutment is very short and could be done under local anesthesia.
The new BAHA Attract uses an internal magnet instead of a pin going through the skin. This should obviate majority of the skin complications and cosmetic issues with the pin. The sound quality is amazing and you could be tested with the device in the office to see if you appreciate the quality of device and better hearing ability.
- Sound quality is great
- Reputable company that has been supporting the device for a long time
- Most insurances cover the device and surgery
- No device on the better hearing aid
- Can be fitted up to moderate-severe hearing loss in the better ear.
- Requires minor surgery, healing and possible minor complications
- Few insurances (e.g. Medicaid) do not cover the device, some others do not cover the minor audiology cost
- Visible device unless person has long hair
Image courtesy of Cochlear Americas, ©2014