CROS examination

A product review of CROS systems available to Specsavers. By Jake Tyers, HJVP Specsavers Leicester

I’m sure that the following profile would fit at least one customer in every store’s database:

  • Asymmetrical or unilateral hearing loss.
  • ‘Good ear’ achieves moderate to severe hearing level
  • ‘Bad ear’ has severe to profound loss in high freq. or across spectrum
  • They are keen for information on latest product that could offer better clarity
  • Nothing offers much improvement to what they already have

One particular customer (who will be referred to as Mr AS for this article) returned to our store for an annual visit in late summer 2015. Despite minimal change in hearing level from one year to the next, he still found that the Power canal AIDS that he had worn for five years were vital for communicating with the outside world but offered negligible improvement for work meetings, hearing speech in social environments and from locating direction of speech. He was desperate to try any product that could provide him with any gains and, as a long-standing customer, we arranged several different products for him to take on a trial basis to see if anything fitted the bill.

Firstly, we tried fitting unilaterally the newly released Binax Carat 7 with a power receiver. Unfortunately, REMs weren’t successful due to feedback, so insitugram was carried out instead. Set to NAL 2. Our client noticed an instant improvement in sharpness of speech in the test room and also no feedback when set to 100% gain target. So far, so good – a nice boost in ADV from last purchase and a relieved customer.

‘We are looking to resurrect the CROS by contacting all of our clients with asymmetrical loss and an unaidable ear to come in for a trial ‘test and fit’ day in the near future.’

Mr AS returned after two weeks, with almost no reasonable improvement for hearing at work and at home. Although he had seen an improvement in reduced background noise and sound quality, speech discrimination had not improved greatly.

The same outcome was to be had following trials with another couple of different top-of-the-range power BTEs. In the end we both accepted defeat and refunded the client, who was grateful for the opportunity to try different products. Incidentally, as he walked away from every appointment, he would say: ‘Call me if something new comes along!’.

So, I’m sat having a break, reading an industry magazine and came across a piece about CROS systems that brought to mind this particular customer. The article suggested that the CROS (contra lateral routing of signals) system was now dead! I ran an Internet search on CROS systems and found this obituary for CROS systems: http://www.hearingreview.com/2014/05/back-basics-obituary-cros-hearing-aid-1964-2014/

I was aware of CROS systems from a hearing aid technology module in my university studies but had always resigned myself to the fact that it was a specialist device, outside of the remit of a high street hearing aid purveyor. However, further reading highlighted the benefits of the CROS which matched the needs of Mr AS perfectly.

‘About 20ft in front me, he stopped, turned, and a huge grin was stretched from hearing aid to hearing aid. He could hear conversation from behind, from his bad side, and from distance.’

I contacted a weary Mr AS and asked if he was willing to try one more product. We opted for the Widex Dream 440 Fusion with custom RITE receiver output extender (83dB matrix) and a CROS device for the unaidable right ear.

Pairing of this product wasn’t straightforward as the Widex CROS wasn’t recognised by Widex link. The CROS was paired through hearing aid configuration, after the non-CROS aid had been programmed. Selecting option of BI-CROS pairing (which is necessary for bi-lateral asymmetrical loss) with omni-directionality, we finished the fitting and took a step onto the shop floor. Mr AS walked on ahead as a rambled on for the purpose of providing speech to discriminate. About 20’ft in front me, he stopped, turned, and a huge grin was stretched from hearing aid to hearing aid.

He could hear conversation from behind, from his bad side, and from distance. We walked outside and had a conversation in the presence of a double decker bus and loud street-cleaning caddy, with no difficulty.

Despite the initial success, I withheld celebrations until Mr AS returned for his follow-up as on the previous occasion, he had left with positive omens and returned the hearing aid. But not this time! A delighted Mr AS agreed that he wanted to stick with the Widex BI-CROS.

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