SINGLE SIDED DEAFNESS - Left Ear exhibits normal low and mid frequency hearing sensitivity with mild hearing loss noted for the high frequencies. Right Ear exhibits profound sensorineural hearing loss with essentially no measurable hearing
Single Sided Deafness (SSD) program at Penn Medicine
Comprehensive treatment for unique challenges.
"Individuals with Single Sided Deafness are unique from other hearing impaired patients, and face specific challenges." Explains Michael J. Ruckenstein, MD, Professor of Otorhinolaryngology, and Vice Chairman of Penn Otorhinolaryngology – Head and Neck Surgery.
These patients frequently have problems separating background noise from important sounds and meaningful speech, and often have significant difficulty determining the direction of sounds. The end result is compromised spatial awareness, which can impede both overall sound awareness and communication ability. SSD patients also have a higher prevalence of tinnitus.
All of these issues make it challenging for these patients to interact with the world around them and it can also take a significant toll on the patient’s mental health.
To address these challenges, Penn Otorhinolaryngology offers more than the standard hearing impairment treatment options for these patients.
SSD Evaluation at Penn Medicine
There are three categories of SSD patients:
- Patients born with hearing loss in one ear.
- Patients who develop an acoustic neuroma tumor and either the tumor or the resection results in deafness on the affected side.
- Patients who suddenly lose hearing in one ear due to viral infection, vascular event or trauma, or an event that is often idiopathic and unknown. These individuals suffer the most severe psychological impact, because the hearing loss occurs so suddenly.
At Penn Medicine, patients undergo a thorough medical evaluation with a Penn Medicine otorhinolaryngologist and a comprehensive audiologic assessment with an audiologist to determine the patient’s unique condition and identify which treatment best aligns with their needs.
Hannah Kaufman, AuD, explains, "Factors we consider include the hearing status in the contralateral ear, tinnitus in the affected ear, willingness to undergo surgery, and cosmetic concerns."
Treatment Test Drives
For the CROS/BiCROS and even for BAHA, it is possible for patients to experience the impact of these treatments before deciding on their course of care. Patients interested in the CROS/BiCROS are able to take the devices home for a trial period and for patients interested in BAHA, a wearable device that closely approximates the effects of the surgical procedure is available for trial.
The Right Treatments for Single Sided Deafness
"Patients often struggle to find the right treatment for their hearing loss because most hospitals and hearing aid centers neither specialize in SSD treatment, nor offer a full range of SSD treatment options." says Dr. Ruckenstein.
Penn Medicine is one of only a few health systems offering all three major SSD treatment options. These technologies, coupled with the highest-level multidisciplinary experience and expertise, sets the Penn program apart.
- CROS/BiCROS: Contralateral Routing of Signal/Bilateral Routing of Signal
This is a non-surgical option for patients with functional-to-excellent hearing in their non-impaired ear, and who are willing to wear traditional hearing aids. CROS/BiCROS routes sound from the hearing-impaired side of a patient’s head to the better hearing ear. The patient wears two wireless communication devices. A microphone/transmitter is worn in the impaired ear to detect and transmit sound. A receiver, worn in the better ear, obtains hearing information from the transmitter, enabling the patient to become a two-sided listener.
- BAHA: Bone Anchored Hearing Aid
The BAHA system works like CROS/BiCROS, however this device uses the patient’s own cranial bone to transmit sound from the deaf side to the better hearing ear. A titanium abutment is surgically affixed to the temporal bone of the impaired side. After healing, a tiny processor is affixed to the abutment. The processor detects sound and turns it into vibrations which stimulate the contralateral cochlea, allowing the good ear to "eavesdrop" on what is heard from the impaired ear.
As with the CROS/BiCROS, this option is viable for patients with good to excellent hearing in the non-impaired ear.
- Cochlear Implant surgery
Unlike the CROS/BiCROS or BAHA systems that reroute sound from the impaired ear, the cochlear implant addresses single sided deafness by treating the affected ear. During surgery, a receiving/stimulating device connected to an electrode array is placed in the impaired cochlea — restoring hearing for that side.
For patients with severe tinnitus, it may be the best option to consider as it is the only option that addresses the affected ear.
Once an SSD patient is referred to Penn, the team puts all the available options on the table and acts as a compassionate guide to help restore hearing, while patients regain their sense of well being in life and work. "The difference the right treatment makes for these patients is profound," says Dr. Ruckenstein, "That’s what this program is built around."