Bone-anchored Hearing Aids in Unilateral Inner Ear Deafness

Bosman, Arjan J.; Hol, Myrthe K. S.; Snik, A.F.M.; Mylanus, Emmanuel A. M.; Cremers, C.W.R.J.

doi:10.1080/000164580310001105

Cited by 124 publications

(146 citation statements)

References 7 publications

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“…Previous free-field localization studies have also shown substantial localization deficits for listeners with a unilateral hearing loss (Angel and Fite, 1901;Jongkees and Van der Veer, 1957;Viehweg and Campbell, 1960;Gatehouse and Cox, 1972;Gatehouse, 1976;Humes et al, 1980;Newton and Hickson, 1981;Newton, 1983;Slattery and Middlebrooks, 1994;Bosman et al, 2003). Some of these studies reported near-normal localization performance in these monaural listeners (Newton, 1983;Slattery and Middlebrooks, 1994), a finding that is not supported by our results (Fig.…”

Section: Discussioncontrasting

confidence: 56%

Contribution of Head Shadow and Pinna Cues to Chronic Monaural Sound Localization

Wanrooij¹,

Opstal²

2004

J. Neurosci.

163

197

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Monaurally deaf people lack the binaural acoustic difference cues in sound level and timing that are needed to encode sound location in the horizontal plane (azimuth). It has been proposed that these people therefore rely on spectral pinna cues of their normal ear to localize sounds. However, the acoustic head-shadow effect (HSE) might also serve as an azimuth cue, despite its ambiguity when absolute sound levels are unknown. Here, we assess the contribution of either cue in the monaural deaf to two-dimensional (2D) sound localization. In a localization test with randomly interleaved sound levels, we show that all monaurally deaf listeners relied heavily on the HSE, whereas binaural control listeners ignore this cue. However, some monaural listeners responded partly to actual sound-source azimuth, regardless of sound level. We show that these listeners extracted azimuth information from their pinna cues. The better monaural listeners were able to localize azimuth on the basis of spectral cues, the better their ability to also localize sound-source elevation. In a subsequent localization experiment with one fixed sound level, monaural listeners rapidly adopted a strategy on the basis of the HSE. We conclude that monaural spectral cues are not sufficient for adequate 2D sound localization under unfamiliar acoustic conditions. Thus, monaural listeners strongly rely on the ambiguous HSE, which may help them to cope with familiar acoustic environments.

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Section: Discussioncontrasting

confidence: 56%

Contribution of Head Shadow and Pinna Cues to Chronic Monaural Sound Localization

Wanrooij¹,

Opstal²

2004

J. Neurosci.

163

197

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“…Results in 9 Nijmegen patients with one normal ear and one deaf ear, fitted with a transcranial BAHA CROS, support this assumption [Bosman et al, 2003]. More data on this appealing application will follow soon.…”

Section: The Baha In Patients With Unilateral Air-bone Gapsupporting

confidence: 53%

Candidacy for the Bone-Anchored Hearing Aid

et al. 2004

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The BAHA (bone-anchored hearing aid) is a bone conduction hearing aid with percutaneous transmission of sound vibrations to the skull. The device has been thoroughly evaluated by various implant groups. These studies showed that, in audiological terms, the BAHA is superior to conventional bone conduction devices. In comparison with air conduction devices, the results are ambiguous. However, a positive effect is found with respect to aural discharge. The most powerful BAHA can be applied to patients with a sensorineural hearing loss component of up to 60 dB HL. It was shown that bilateral BAHA application leads to binaural sound processing. Preliminary results on the application of the BAHA in patients with unilateral conductive hearing loss suggest that stereophonic hearing can be re-established. The application of the BAHA as a transcranial CROS (contralateral routing of signal) device in unilateral deafness minimizes head shadow effects.

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“…In particular speech intelligibility in noise and sound localization improved. In addition, a few authors found that the BAHA CROS was beneficial in specific listening situations, because some of the disadvantages of conventional CROS devices were avoided [Niparko et al, 2003;Bosman et al, 2003]. Obviously, the BAHA CROS is not capable of restoring binaural hearing in patients with unilateral profound hearing loss.…”

Section: Introductionmentioning

confidence: 99%

“…Obviously, the BAHA CROS is not capable of restoring binaural hearing in patients with unilateral profound hearing loss. Nevertheless, these patients' opinions on the BAHA CROS are quite favorable, despite the small differences in measurement results between the aided and unaided conditions [Bosman et al, 2003]. To gain greater insight into the experience and opinions of patients with unilateral inner ear deafness we extended our group of unilateral inner ear deafness patients to 21 individuals.…”

Section: Introductionmentioning

confidence: 99%

Bone-Anchored Hearing Aid in Unilateral Inner Ear Deafness: A Study of 20 Patients

Hol¹,

Bosman²,

Snik³

et al. 2004

Audiol Neurotol

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121

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Objective: To evaluate the benefit of a bone-anchored hearing aid (BAHA) contralateral routing of sound (CROS) in 20 patients with unilateral inner ear deafness. Subjects: 21 patients were recruited; 15 had undergone acoustic neuroma surgery and 6 patients had unilateral profound hearing loss due to other causes; 1 patient was excluded. Only patients with thresholds of better than 25 dB HL (500–2000 Hz) and an air-bone gap of less than 10 dB in the best ear were included. Methods: Evaluation involved audiometric measurements before intervention, when fitted with a conventional CROS and after implementation and quantification of the patients’ subjective benefit with a hearing aid-specific instrument: the Abbreviated Profile of Hearing Aid Benefit (APHAB). Results: Lateralization scores were not significantly different from chance (50%) in any of the three conditions. Measurements of speech perception in noise showed an increase in the signal to noise ratio (S/N ratio) with the conventional CROS (p = 0.001) and with the BAHA CROS compared to the unaided condition when speech was presented at the front with noise on the poor hearing side. On the other hand, a lower S/N ratio was seen with the BAHA CROS (p = 0.003) compared to the unaided situation when noise was presented at the front with speech on the poor hearing side. The patient outcome measure (APHAB) showed improvement, particularly with the BAHA CROS. Conclusions: The poor sound localization results illustrate the inability of patients with unilateral inner ear deafness to localize sounds. The speech-in-noise measurements reflect the benefit of a BAHA CROS in lifting the head shadow while avoiding some of the disadvantages of a conventional CROS. The benefit of the BAHA CROS was most clearly reflected in the patients’ opinion measured with the APHAB.

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Bone-anchored Hearing Aids in Unilateral Inner Ear Deafness

Cited by 124 publications

References 7 publications

Contribution of Head Shadow and Pinna Cues to Chronic Monaural Sound Localization

Contribution of Head Shadow and Pinna Cues to Chronic Monaural Sound Localization

Candidacy for the Bone-Anchored Hearing Aid

Bone-Anchored Hearing Aid in Unilateral Inner Ear Deafness: A Study of 20 Patients

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