Name of the Procedure:

Common Names: Hearing Aid with Contralateral Routing of Signals (CROS), Monaural Hearing Aid.
Technical Term: Hearing Aid, Contralateral Routing Device, Monaural, Behind the Ear (BTE) (HCPCS Code: V5181).

Summary

This procedure involves fitting a hearing aid device that captures sound from the ear with hearing loss and transmits it to the better-hearing ear. The device is worn behind the ear and is designed for individuals with single-sided deafness or significant hearing loss in one ear.

Purpose

The Contralateral Routing of Signals (CROS) hearing aid is used to improve sound localization and understanding of speech when a person has significant hearing loss in one ear. Its primary goal is to route sounds from the non-hearing side to the hearing side, thereby enhancing overall auditory perception and communication in varied listening environments.

Indications

• Single-sided deafness or significant hearing loss in one ear.
• Difficulty understanding speech originating from the side with the impaired ear.
• Patients must have normal or near-normal hearing in the better ear.

Preparation

• Audiological evaluation to determine the extent of hearing loss and suitability for CROS.
• Counseling session to discuss hearing aid options, expected outcomes, and care routines.
• Typically, no specific medical preparation is required.

Procedure Description

1. Initial Assessment: An audiologist conducts a thorough hearing test and assesses the patient’s hearing in both ears.
2. Device Selection: The appropriate CROS device is chosen based on the assessment.
3. Fitting: The hearing aid device is fitted behind the ear with significant hearing loss.
4. Configuration: The device is programmed to capture sound from the impaired side and transmit it to the better ear.
5. Training: The patient is taught how to use, maintain, and troubleshoot the device.

Duration

The fitting and programming appointment usually takes about 1 to 2 hours.

Setting

This procedure is typically performed in an audiologist's office or a hearing aid clinic.

Personnel

• Audiologist: The primary healthcare professional who assesses, fits, and programs the hearing aid.
• Hearing Aid Specialist: May also be involved in the selection and fitting process.

Risks and Complications

• Initial discomfort or difficulty adjusting to the device.
• Possible feedback or whistling sounds from the device.
• Rarely, skin irritation or allergic reactions from materials in the hearing aid.

Benefits

• Enhanced sound localization and improved speech understanding.
• Better overall communication, especially in social and noisy environments.
• Increased quality of life and ease in daily activities.

Recovery

• Initial Adjustment Period: It may take a few weeks to get used to the new hearing aid.
• Follow-Up Visits: Regular follow-up appointments for adjustments and troubleshooting.
• Care Instructions: Detailed advice on cleaning, battery replacement, and storage.

Alternatives

• BiCROS Hearing Aids: For individuals with hearing loss in both ears, but with one ear performing significantly better.
• Bone Anchored Hearing Aids (BAHA): Suitable for specific types of hearing loss, especially conductive hearing loss.
• Cochlear Implants: For severe-to-profound hearing loss that does not benefit from hearing aids.
• Nothing: Patients may choose to use no assistive device, depending on personal preference.

Patient Experience

During the fitting, patients may feel some manipulation around the ear. After the procedure, there might be an adjustment period where they adapt to the new way of perceiving sound. Audiologists provide support for pain management, comfort, and device troubleshooting.