A patient with sudden profound unilateral sensorineural hearing loss in the left ear has irreversible loss; what is the most logical next step for the audiologist?

A patient with sudden profound unilateral sensorineural hearing loss in the left ear has irreversible loss; what is the most logical next step for the audiologist?

• A. Fit the patient with a power behind-the-ear hearing aid on a trial basis
• B. Suggest the patient enroll in speechreading classes
• C. Try a transcranial CROS hearing-aid with the patient
• D. Make a referral to another otologist for a second opinion

Answer: (C)

When one ear is profoundly deaf and the other ear works, the goal is to regain access to sounds from the deaf side without compromising the functioning ear. A transcranial CROS is built for this situation: a microphone is placed on the deaf ear to pick up sounds from that side, and the signal is transmitted to the functioning ear so the person perceives those sounds through the good ear. This arrangement improves awareness and understanding of sound coming from the left side, especially in real-world listening and in noisy environments, without trying to amplify the left ear directly (which wouldn’t help if its neural processing is irreversibly lost). Other approaches don’t address the core need as effectively. Simply fitting a more powerful hearing aid on the good ear doesn’t help with sounds originating from the deaf side. Lip-reading training can aid communication, but it doesn’t restore access to auditory information. A second medical opinion might be considered in some cases, but with an irreversible left-ear loss, a CROS device is the most logical step to maximize real-world hearing.

When one ear is profoundly deaf and the other ear works, the goal is to regain access to sounds from the deaf side without compromising the functioning ear. A transcranial CROS is built for this situation: a microphone is placed on the deaf ear to pick up sounds from that side, and the signal is transmitted to the functioning ear so the person perceives those sounds through the good ear. This arrangement improves awareness and understanding of sound coming from the left side, especially in real-world listening and in noisy environments, without trying to amplify the left ear directly (which wouldn’t help if its neural processing is irreversibly lost).

Other approaches don’t address the core need as effectively. Simply fitting a more powerful hearing aid on the good ear doesn’t help with sounds originating from the deaf side. Lip-reading training can aid communication, but it doesn’t restore access to auditory information. A second medical opinion might be considered in some cases, but with an irreversible left-ear loss, a CROS device is the most logical step to maximize real-world hearing.