1. Case Presentation Beth Burlage

2. Case History, 1991 51-year-old male No family history of hearing loss or noise exposure Wife (then ) complains of difficulty with his hearing and communication Business man, necessary to properly hear in meetings Audiogram presents slightly asymmetrical SNHL

3. Audiogram, 1991

4. ABR Results, 1991

5. Additional tests… No immitance testing was performed Reflexes? SRT=rollover? ENT referred patient for MRI Patient did not seek additional testing or treatment for 5 years Returned in August 1996 Audiogram presented more asymmetrical SNHL

6. Audiogram, 1996

7. Diagnosis MRI showed a small acoustic neuroma on the left side  Acoustic neuroma –An acoustic neuroma is a benign tumor, that is usually slow growing and expands at its site of origin. The most common first symptom is hearing loss in the tumor ear. The cause is unknown.  Continued tumor growth can be life threatening. The treatment options are observation, surgical removal or radiation. Surgery was chosen over observation, which was initially successful, however, a few weeks after the surgery, the patient lost all hearing sensitivity in his left ear

8. Audiogram, 1999

9. Treatment Suggested bi-CROS hearing aids  Bi-CROS (Contralateral Routing of Signal) are for people who are deaf in one ear and are hard of hearing in their other ear. The “hearing aid” on the deaf ear basically consists of a microphone and a transmitter. The transmitter sends these sounds to the “hearing aid” on the good ear.  The Bi-CROS unit combines the signals from both ears and then feeds them into the hard of hearing ear via a normal tightly-fitting ear mold, as otherwise there could be problems with feedback.

10. Treatment Did not want to wear 2 hearing aids “if deaf in one ear” Wanted the most discreet hearing aid possible  Fit for 1 CIC in Right ear

11. Outcome After a few programming adjustments, the patient was very happy with his hearing aid However, found it “uncomfortable” to talk on the phone with hearing aid in Would take out the hearing aid to talk on the phone, as a result he lost 3 hearing aids in 4 years! Has been without a hearing aid for 1.5 years Compensatory strategies

12. Audiogram, 2007

13. Outcome Fit with Sonic Innovations Open Fit, OTE  Found it more comfortable on the phone  Had issues with feedback Rolled off HF Changed dome tubing and dome size  Happy with the discreet look and overall performance  Less likely to lose!