Name of the Procedure:

Hearing Aid, BICROS, Behind the Ear

• Common Names: BICROS hearing aid, BTE BICROS system
• Medical Terms: Behind the Ear BICROS (Bilateral Contralateral Routing of Signals) hearing aid

Summary

A BICROS hearing aid system is designed for individuals with total hearing loss in one ear and partial hearing loss in the other ear. The device captures sound from the non-hearing ear and routes it to the hearing ear, allowing for improved sound localization and understanding in noisy environments.

Purpose

The BICROS hearing aid addresses:

• Single-sided deafness (total hearing loss in one ear)
• Partial hearing loss in the other ear
• It aims to enhance hearing capabilities, improve sound localization, and facilitate better communication in diverse acoustic environments.

Indications

• Total hearing loss in one ear
• Partial hearing loss in the other ear
• Difficulty understanding speech in noisy situations
• Challenges in sound localization

Patient criteria:

• Adults and children with the specified hearing loss criteria as assessed by an audiologist.

Preparation

• Comprehensive hearing evaluation by an audiologist
• Ear examination to ensure there are no blockages or conditions that might interfere with the device fitting
• No specific fasting or medication adjustments needed

Procedure Description

1. Hearing Evaluation: Audiologist performs tests to determine the extent of hearing loss.
2. Device Selection: Based on evaluation results, a BICROS system is chosen.
3. Fitting: The BTE BICROS hearing aid is custom-fitted to the patient's ear.
4. Programming: The device is programmed to the patient's specific hearing loss profile.
5. Testing and Adjustment: Initial adjustments are made to ensure optimal performance.
6. Instruction: The patient is instructed on how to use and care for the device.

Tools/Equipment: Audiometer, sound level meter, BICROS hearing aid system.

Anesthesia: Not applicable.

Duration

The fitting and initial adjustment process typically takes about 1 to 2 hours.

Setting

• Outpatient clinic
• Audiology center

Personnel

• Audiologist

Risks and Complications

• Common Risks: Minor discomfort or irritation in the ear
• Rare Risks:
  • Feedback issues (whistling sounds)
  • Device malfunction
  • Allergic reactions to materials (uncommon)

Complication Management:

• Adjustments by audiologist
• Replacement or repair of device components

Benefits

• Improved ability to hear and understand speech
• Enhanced sound localization
• Increased confidence and ease in social and noisy environments

Benefits typically realized immediately upon successful fitting and adjustment.

Recovery

• Initial acclimatization period of a few days to weeks
• Ongoing follow-up appointments for adjustments and maintenance
• Daily care instructions provided by the audiologist

Alternatives

• Traditional CROS (Contralateral Routing of Signal) Hearing Aids: For patients with complete loss in one ear and normal hearing in the other.
• Bone-Anchored Hearing Systems: Surgical option that transmits sound vibrations through the skull to the better-hearing ear.

Pros and Cons of Alternatives:

• CROS aids are non-surgical but may not offer the same level of sound amplification.
• Bone-anchored systems can provide better quality of sound transmission but involve surgical intervention.

Patient Experience

During Procedure:

• Comfortable fitting process, typically painless.
• May experience mild discomfort during ear mold fitting.

After Procedure:

• Initial period of adjustment to the sound amplification.
• Patients usually report significant improvement in hearing ability and comfort in social situations.
• Pain management is generally not necessary, but discomfort can be addressed with minor adjustments by the audiologist.