1 / 77

Clinic Hearing Aid Comparisons: CROS Technology

Clinic Hearing Aid Comparisons: CROS Technology. Scot Frink, AuD Salem Audiology Clinic California Academy of Audiology September, 2018. Disclaimer. Independent practitioner; do not work for or have any vested interest in any hearing aid manufacturer. Overview.

moodyc
Download Presentation

Clinic Hearing Aid Comparisons: CROS Technology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Clinic Hearing Aid Comparisons: CROS Technology Scot Frink, AuD Salem Audiology Clinic California Academy of Audiology September, 2018

  2. Disclaimer • Independent practitioner; do not work for or have any vested interest in any hearing aid manufacturer.

  3. Overview • Brief review of available CROS / BiCROS Solutions for Single-Sided Deafness • Review of the 2016 – 17 clinical study by Salem Audiology Clinic

  4. Menti Question 1A!

  5. Additional Disclaimer • A weakness of product comparisons is technological turnover. • Since this study was completed, all four manufacturers involved—Signia, Starkey, Phonak, and Widex have all released new product platforms, all CROS compatible, some with significant changes. • Despite this, the information is still relevant.

  6. Salem Audiology Clinical Comparison Studies • 2000: Phonak (Adult utilization of FM technology) • 2005: Phonak, Unitron, Interton (CROS) • 2007: Phonak, Starkey (Feedback control) • 2010: Phonak, Unitron (CROS) • 2014: Phonak, Widex (CROS) • 2015: Superpower BTE vs. RIC • 2016-17: Phonak, Widex, Starkey, Signia (CROS) • 2017-18: AmpCROS Case studies • 2017 (in progress): Unitron, Widex, Signia (Tinnitus) • 2018 (in development): OTC vs. Prescribed comparison

  7. Salem Audiology Clinical Comparison Studies • 2000: Phonak (Adult utilization of FM technology) • 2005: Phonak, Unitron, Interton (CROS) • 2007: Phonak, Starkey (Feedback control) • 2010: Phonak, Unitron (CROS) • 2014: Phonak, Widex (CROS) • 2015: Superpower BTE vs. RIC • 2016-17: Phonak, Widex, Starkey, Signia (CROS) • 2017-18: AmpCROS Case studies • 2017 (in progress): Unitron, Widex, Signia (Tinnitus) • 2018 (in development): OTC vs. Prescribed comparison

  8. Salem Audiology Clinical Comparison Studies • 2000: Phonak (Adult utilization of FM technology) • 2005: Phonak, Unitron, Interton (CROS) • 2007: Phonak, Starkey (Feedback control) • 2010: Phonak, Unitron (CROS) • 2014: Phonak, Widex (CROS) • 2015: Superpower BTE vs. RIC • 2016-17: Phonak, Widex, Starkey, Signia (CROS) • 2017-18: AmpCROS Case studies • 2017 (in progress): Unitron, Widex, Signia (Tinnitus) • 2018 (in development): OTC vs. Prescribed comparison

  9. Salem Audiology Clinical Comparison Studies • 2000: Phonak (Adult utilization of FM technology) • 2005: Phonak, Unitron, Interton (CROS) • 2007: Phonak, Starkey (Feedback control) • 2010: Phonak, Unitron (CROS) • 2014: Phonak, Widex (CROS) • 2015: Superpower BTE vs. RIC • 2016-17: Phonak, Widex, Starkey, Signia (CROS) • 2017-18: AmpCROS Case studies • 2017 (in progress): Unitron, Widex, Signia (Tinnitus) • 2018 (in development): OTC vs. Prescribed comparison

  10. Menti Question 1B!

  11. Candidacy • Very poor or no residual hearing is the worse ear. • Aidable or normal hearing in the better ear • CROS: No amplification to the better ear • BiCROS: At least some amplification to the better ear • I have personally found that most patients prefer BiCRO even if they are truly a CROS candidate

  12. Candidacy • Word Recognition tests • If there is no residual hearing (confirmed) in the worse ear, test only the better ear. • If there is any residual hearing in the worse ear, you must test binaural to avoid causing auditory deprivation and to truly rule the patient a CROS candidate.

  13. Candidacy • Word Recognition tests • Good ear 80%, bad ear 20%, binaural 96% • FIT BINAURAL! • Good ear 80%, bad ear 20%, binaural 64% • FIT CROS! • Good ear 80%, bad ear 20%, binaural 80% • ??? -- Toss up! • Do a trial binaural first to determine perceived benefit • Do a trial BiCROS second if no perceived benefit with binaural • AmpCROS?

  14. Study Results • In 2016, both Starkey and Siemens introduced new CROS technology on their Muse and Primax platforms (respectively). • In addition, both Phonak and Widex have launched newer platforms (Venture and Unique). • How to do this study (four players!)

  15. Methodology • Study participants… • 18 previous users, 10 new users • Ages ranged from 26 to 86. • Hearing loss in the better ear ranged from normal (CROS) to severe (60 sloping to 90).

  16. Methodology • Each patient utilized each CROS system for 2-3 weeks, returning weekly for adjustments and counseling. • Upon completion of each trial, patients fill out subjective surveys on each product, evaluation perception of many areas…

  17. Methodology • Subjective survey analyzed… • Sound Quality for Speech • Sound Quality for Music • Perception of Localization Improvement • Performance in Background Noise • Battery Life • Cosmetics • Ease of use • Feedback

  18. Methodology • Objective testing was also completed, evaluating WRS in quiet when presented 90° azimuth to the poorer side • Both sides off • Better ear on (i.e. Aid only) • Both sides on (i.e. CROS transmission utilized). • Presentation at 65dBSPL, 25 words per run.

  19. Study Results: Objective Measures

  20. Study Results: Objective Measures

  21. Study Results: Objective Measures

  22. Study Results: Objective Measures

  23. Study Results: Objective Measures

  24. Study Results: Objective Measures

  25. Study Results: Subjective Survey • Sound Quality for Speech • 18 preferred Widex • 7 preferred Phonak • 2 preferred Signia • 1 preferred Starkey

  26. Study Results: Subjective Survey • Sound Quality for Music • 15 preferred Widex (broader dynamic range) • 10 preferred Starkey (2nd chip?) • 4 preferred Phonak • None preferred Signia

  27. Study Results: Subjective Survey • Perception of Localization Improvement • 14 preferred Phonak • 11 preferred Widex • 3 preferred Signia • 1 preferred Starkey

  28. Study Results: Subjective Survey • Performance in Background Noise • 17 preferred Phonak (Speech in Loud Noise Algorithm) • Available at the v70 and v90 levels, not at v50 or v30 • 9 preferred Widex • 2 preferred Signia • None preferred Starkey

  29. Study Results: Subjective Survey • Battery Life • 10 preferred Widex • 8 preferred Signia • 5 preferred Phonak • 5 preferred Starkey

  30. Study Results: Subjective Survey • Cosmetics • 14 preferred Phonak • 8 preferred Starkey • 3 preferred Widex • 3 preferred Signia

  31. Study Results: Subjective Survey • Ease of use (controls) • 9 preferred Signia • 8 preferred Starkey • 8 preferred Phonak • 3 preferred Widex

  32. Study Results: Subjective Survey • Feedback • 12 preferred Phonak • 6 preferred Starkey • 6 preferred Widex • 4 preferred Signia

  33. Study Results: Subjective Survey • Overall Results • 19 preferred Widex • 6 preferred Phonak • 2 preferred Signia • 1 preferred Starkey • However…

  34. Study Results: Subjective Survey • Purchasing Patterns… • 10 purchased Widex • 10 purchased Phonak • 4 purchased Starkey • 4 preferred Signia • Pricing was equal to eliminate that effect

  35. Study Results • Reasons for specific purchases • Cosmetics • Control manipulation • Specific sound qualities (music) • Specific features (Zen Sounds) • Reserve gain (Phonak Naida)

  36. Study Results • Summary of findings • Widex performed exceptionally, but wasn’t always the best choice • What to do when—specific choices based on options available.

  37. Study Results • Widex strengths • Best performance for WRS (46% improvement) • Good performance for music • Best battery life and tinnitus options • Widex weaknesses • Limited form factors (312 BTE, 312 RIC, 13 BTE) • Difficult manual controls / Ease of use

  38. Study Results • Phonak strengths • Good performance for WRS • Best perception of performance in BGN. • The most form factors offered (675 BTE, 13 BTE & RIC, 312 BTE & RIC, FS ITE, ITC) • Best perception of cosmetics • Phonak weaknesses • Battery life (but improved) • Limited tinnitus options

  39. Study Results • Starkey strengths • Better performance for music • Good for each of use / manual controls • Starkey weaknesses • Lowest improvement in WRS • Lowest perception of performance in BGN • Limited form factors (RIC and BTE) • Limited tinnitus options

  40. Study Results • Signia strengths • Best ease of use • Good for tinnitus options • Signia weaknesses • Poorer cosmetics • Limited form factors (312 RIC—at that time)

  41. Study Summary • Each manufacturer have their strengths and weaknesses. • Widex: Speech clarity, music, tinnitus • Phonak: Background noise, cosmetics, form factors. • New product introductions may change this • Rechargeable options (Starkey, Phonak) • Own speech quality (Signia)

  42. Menti Question 1C!

  43. Verification: CROS transmission Procedure: Real Ear or VSM • Place patient at 90 degrees azimuth, with the “dead” ear facing the presentation speaker(s). • Place the probe mic in the better ear, on the far side from the presentations speaker(s). • Measure as follows: • Unaided (both sides off) • Aided (better ear on only) • Aided with CROS • Repeat with face-to-face, 0 degrees azimuth

  44. Verification: CROS transmission Procedure: Sound Field • Place patient at 90 degrees azimuth, with the “dead” ear facing the presentation speaker(s). • Measure puretones and speech as follows: • Unaided (both sides off) • Aided (better ear on only) • Aided with CROS • Repeat with face-to-face, 0 degrees azimuth

  45. Verification: Sample #1

  46. Verification: Sample #1 Speech Discrimination Unaided: 88%

  47. Verification: Sample #1 Speech Discrimination Unaided: 88% Aid Only: 92%

  48. Verification: Sample #1 Speech Discrimination Unaided: 88% Aid Only: 92% Aid w/CROS: 100%

  49. Verification: Sample #1 Speech Discrimination Unaided: 88% Aid Only: 92% Aid w/CROS: 100%

  50. Verification: Sample #2

More Related