A Listening Effort Based Comparative Analysis of CROS Hearing Aids and Bone-Anchored Hearing Devices for Single-Sided Deafness Patients

Abstract

Single-sided deafness (SSD), characterized by the loss of hearing in one ear while the other ear retains normal hearing, poses significant challenges such as difficulties in speech-in-noise recognition, compromised sound localization, and reduced awareness of sounds in the affected auditory hemifield. Current therapeutic approaches aim to enhance sound processing from the impaired hemifield by redirecting signals to the non-impaired ear. This can be achieved through contralateral-routing-of-signal (CROS) hearing aids utilizing air conduction or bone-anchored (BA) hearing devices utilizing bone conduction. Although individuals with SSD have reported subjective benefits from both BA and CROS devices, objectively measuring and documenting these benefits has proven to be challenging. As a result, the optimal choice between these devices remains uncertain, leading to an ongoing dilemma in the clinical management of SSD. The lack of objective assessments regarding reported reductions in listening effort, as well as differences in funding modalities for each device, contribute to a longstanding controversy. This research project aims to address this controversy by investigating which device yields superior hearing outcomes for SSD patients. Subjective (NASA Task Load Index) and objective (pupillometry) measures were used to evaluate the cognitive effort required by SSD patients during speech-in-noise recognition tasks. The comprehensive results presented in this study expand upon preliminary findings previously reported at the AWC 2022 conference. These findings have the potential to provide the first comprehensive evidence guiding the management of SSD, maximizing patients' benefits, and offering evidence-based justification for funding policies.