Unaidable hearing loss in one ear?

@Raudrive said:

Wow, your bad ear still works. If your audiologist knows this and has not talked about aiding that ear…not a good audiologist.

There could be a host of reasons why you wouldn’t directly aid that ear; aside from the stated difficulty. Transcranial CROS signals aren’t always going to be beneficial to the other cochlea. Where there’s 50dB + difference between the ears, you have to be pretty judicious in the application of gain to the poorer side: if you don’t, the risk is that you’ll corrupt the hearing in the better ear.

That’s interesting, My feeling is that the CROS helps in quiet situations and with some directional environmental awareness, but in loud noise it may make clarity worse? Seems to over amplify background noise and transfer. I’m finding I prefer not to use it when home alone to improve the battery life of my right HA.

But, if as suggested, a high power aid was added for the left with a custom mold and properly programmed, wouldn’t there be a supportive benefit to hearing and no overamplification impact to the right aided ear?

@Steph said:

My feeling is that the CROS helps in quiet situations and with some directional environmental awareness, but in loud noise it may make clarity worse? Seems to over amplify background noise and transfer.

You’re right, that’s it with CROS/BiCROS aids, understood as non-invasive devices from the same manufacturer as HA on the better ear.

@Um_bongo has told about transcranial CROS, which is invasive bone conduction device. It’s good for some, but after very judicious examination, and still relies on the better side. On the other hand, CI gave you real stimulation of the left cochlear nerve.

@Steph said:

But, if as suggested, a high power aid was added for the left with a custom mold and properly programmed, wouldn’t there be a supportive benefit to hearing and no overamplification impact to the right aided ear?

The only way to assess this is simply trying the HA at least for 6 months.

@Steph said:

But, if as suggested, a high power aid was added for the left with a custom mold and properly programmed, wouldn’t there be a supportive benefit to hearing and no overamplification impact to the right aided ear?

The difficulty is that in order for you to hear anything on the worse ear the sound pressure intensity needs to be a couple of thousand times more than the other ear. Your audiogram is a log scale: every 3dB is a doubling of power, so the amount of sound needed just for you to start hearing is huge relative to your better cochlea.

On the other hand, if the transcranial bit is set up properly, there’s a possibility that it can be of benefit as a transcranial CROS, even if there’s no real benefit to the local ear.

“If the patient becomes a cochlear implant candidate, nearly all protocols will
want to implant the poor ear first.”

When I became a CI recipient they implanted my good ear first…. They wouldn’t implant my worst ear. Maybe this situation might change with the Nexa internals. But I’m not holding my breath…

Not to ‘dis’ this example, but nobody ‘normally’ fits a BiCROS on 15dB asymmetry - that’s utter nonsense (unless there’s another overriding clinical reason). The gap would normally be nearer 50dB. That’s a troll ‘scenario’ looking for comment in my book.

Also, the bit about being ‘salesmanship’ is tripe too - a pair of aids would usually (in my pricing) run at a higher cost than a single aid and CROS transmitter.

Umm, which comment are you referring to? Which example is a troll example?

@Um_bongo said:

Not to ‘dis’ this example, but nobody ‘normally’ fits a BiCROS on 15dB asymmetry - that’s utter nonsense (unless there’s another overriding clinical reason).

Thanks for your input.I thought that the cause of prescribing BiCROS was 8% PB Max in the poorer ear. So, I understand that in your opinion that shouldn’t be a good justification for that solution?

@Steph said:

Umm, which comment are you referring to? Which example is a troll example?

This is for screen from LinkedIn about patient with 8% PB Max in the poorer ear.