Hearing loss is a prevalent condition affecting millions of people worldwide. According to the World Health Organization (WHO), one in four individuals is expected to have some degree of hearing loss by 2050. In addition to the physical effects, hearing loss can lead to social isolation, depression, and cognitive decline, resulting in a significant burden on individuals and society as a whole. Fortunately, advancements in technology have made it possible for individuals with hearing loss to have access to safe and effective solutions such as Contralateral Routing of Signal (CROS) and Bilateral CROS (BiCROS) hearing aids.
Medical device sponsors and contract research organizations (CROs) can provide valuable insights into the benefits and limitations of these tools, thus leading to better real-world patient selection and counseling. Read on for more information about these types of hearing aids, as well as the current state of clinical research developments for single-sided deafness (SSD).
Contralateral Routing of Signal (CROS) and Bilateral CROS (BiCROS) Hearing Aids: What are They? How Do They Work?
CROS hearing aids are designed for individuals with unilateral hearing loss who have good hearing in one ear but have difficulty hearing in the other. These devices are worn in both ears, with a microphone placed in the ear with impaired hearing. The microphone routes the acoustic signal to a hearing aid worn in the other ear with better hearing, which allows sound on both sides of the head to be heard by a person’s good ear. The primary advantage of this rerouting strategy is the ability to regain access to sound on that side and improve speech perception in noise for speech directed at the poorer hearing ear.
On the other hand, BiCROS aids are designed for individuals with total hearing loss in one ear, as well as moderate hearing loss in the other ear; they are similar to CROS aids but differ in the way they work. BiCROS aids amplify sound from both ears and send it to the better ear, instead of transmitting sound from the poorer hearing side to the better hearing side. This may be beneficial for people with asymmetrical hearing loss or a difference in hearing ability in each ear.
How Do CROS and BiCROS Hearing Aids Differ?
The primary difference between CROS and BiCROS hearing aids is in the way they manage sound. CROS hearing aids reroute sound from the impaired ear to the better hearing ear, while BiCROS hearing aids amplify sound from both ears and send it to the better ear. This means that BiCROS hearing aids can benefit individuals with hearing loss in both ears, even if the loss is asymmetrical or different in each ear. Depending on the model, CROS and BiCROS hearing aids may also offer different features and customization options, such as moisture resistance, improved feedback management, and reducing tinnitus, or ringing in the ears.
The decision between CROS and BiCROS hearing aids depends on your specific hearing loss and needs. If you have unilateral hearing loss, CROS hearing aids may be the best option for you. However, if you have hearing loss in both ears, also known as asymmetrical hearing loss, BiCROS hearing aids may be a better fit. It is essential to consult an audiologist or hearing care professional to evaluate your hearing loss and recommend the best solution for your needs.
CROS and BiCROS: Benefits and Disadvantages
Clinical research has shown that CROS and BiCROS hearing aids can provide significant benefits to individuals with hearing loss by improving listening in noisy environments and being easy to use. The increased usage of these devices has led to recent technological improvements in hearing aid technology and design, which have allowed for seamless between-ear signal transmissions, better noise reduction, and automatic adaptive directionality for improved signal-to-noise ratio. The result is improved speech intelligibility for a wide range of noises, greater quality of hearing, as well as advantages over cochlear implants or bone-anchored hearing devices, including ease of use, non-invasiveness, and better aesthetics to reduce the stigma associated with hearing aids.
However, there are some limitations to the use of CROS and BiCROS hearing aids. One significant drawback is the inability to restore binaural hearing. Binaural hearing is the ability to hear with both ears, which is essential for sound localization and spatial orientation. CROS and BiCROS devices do not restore this type of hearing, and as a result, may not work well in noisy environments. Additionally, the use of these devices may require some adjustment on the part of the wearer, although real ear measurements can help ensure proper fitting and effectiveness. Despite these limitations, CROS and BiCROS devices can be a valuable tool for managing hearing loss and improving the quality of life of affected individuals. By allowing individuals with hearing loss to better engage in situational listening, CROS and BiCROS devices can help to reduce the social and emotional consequences of hearing loss and improve overall communication abilities.
Existing Options for Remediating Unilateral Hearing Loss
Currently, there are several options for the remediation of unilateral hearing loss or SSD. These options include bone conduction devices, cochlear implants, and CROS and BiCROS hearing aids. Bone conduction devices work by transmitting sound vibrations through the skull bone to the inner ear, bypassing the damaged ear. In contrast, cochlear implants work by surgically implanting an electronic device in the inner ear and stimulating the auditory nerve. As discussed earlier, CROS and BiCROS hearing aids work by rerouting sound from the impaired ear to the better hearing ear. Another promising option is the use of gene therapy to restore hearing by identifying genes that are responsible for the development and maintenance of the inner ear. By targeting these genes, researchers hope to restore hearing in individuals with SSD.
Current Landscape of Medical Device Development for Single-Sided Deafness (SSD)
Recent research approaches have focused on developing alternative solutions for the remediation of SSD. One promising option is the use of auditory brainstem implants (ABIs), which work by surgically implanting an electrode array directly into the brainstem, bypassing the damaged ear and stimulating the auditory nerve. This technology has been successful in restoring hearing in individuals with SSD who were not candidates for cochlear implants or bone conduction devices. Additionally, researchers have been investigating the use of virtual reality (VR) and augmented reality (AR) technology to improve speech perception in noisy environments. By creating realistic soundscapes, individuals with SSD may be able to better understand speech in noisy environments, improving their communication abilities and quality of life.
Clinical research is ongoing to evaluate the effectiveness of these innovations and to identify the factors that influence the decision to use them. Medical device sponsors and clinical research organizations each play a critical role in this process by investing in the development of new hearing technology that can improve the quality of life for individuals with hearing loss. Investing in this area of medical device research can lead to better patient selection, counseling, and outcomes, ultimately reducing the burden of hearing loss on individuals and society as a whole.
Vial Medical Device CRO: A Trusted Leader in Medical Device Research
Vial is a next-generation, tech-first medical device CRO (contract/clinical research organization) offering a modern technology platform for developing digital solutions to debilitating disorders like hearing loss. Our technology platform is designed to help medical device sponsors conduct trials faster and more efficiently, leading to more rapid regulatory approval and market access.
Vial CRO’s best-in-class ClinOps experts provide the necessary expertise to conduct trials effectively, helping to improve patient outcomes. Our fixed-fee pricing agreements, efficient patient recruitment strategies, and convenient Site Startup App can help streamline the trial process and improve patient outcomes.
To learn more about how our medical device expertise can benefit your next clinical trial, visit Vial Medical Device CRO’s website and connect with a team member today!
