ANA Discussion Forum
General Category => Hearing Issues => Topic started by: kixit on April 27, 2012, 04:49:51 pm
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I am wondering how good is the hearing on the deaf side with the BAHA? I got the following e-mail from my surgeon this evening:
"I want to make it clear to you, though, that you still will not be able to locate sound after space even with the BAHA. Numerous studies have examined patients' ability to locate sound after BAHA placement for single sided deafness, and patients are not able to do this well. I just did not want you to be disillusioned about what the BAHA can and cannot do for you".
I know the hearing won't be perfect but I was under the impression one could tell where sound is coming from. But he is saying it may not help at all.
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It's like this. The test unit has less clarity and I felt I would be able to pick up some directionality. The first week, it felt there was enough of a difference that I thought I might be able to learn differentiate. I was wrong. Very quickly the brain got used to the device and it all sounded the same. The only time it is different is if I plug the good ear and then radio/tv and the like have a tinny quality but all noise sounds like it is coming from the same place. I simply can't tell the origin of sound.
On the other had, in meetings and other group situations, it is invaluable. Or on the occasions when my wife is driving and I am riding shotgun.
-Tod
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@Tod -- Leapytwins gave me great examples as did you. I thought he was saying it wouldn't help me at all. I am releived. Thanks to all of you for the great information and support ;D
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Thought I'd share some of what I told you - in case there are others with the same question that it might help. Hope you don't mind.
What your doctor is saying is absolutely true, but it doesn't mean you won't "hear" on your deaf side. I say "hear" because a BAHA works through bone conduction and you have the sense you are hearing out of your "bad" ear, but you actually aren't.
What he's talking about is BAHA wearers' inability to determine directionality, not hear someone or something on their deaf side. You will hear, but at times - depending on the situation/environment - you won't know 100% where a sound is coming from. Let me try to explain.
When I'm wearing my BAHA processor on my left (deaf) side and someone is standing on my left side and talking to me I can hear them just as if I weren't deaf on my left. But if I am standing in a bank of elevators (the area where there are several elevators and you are waiting for one) and the elevator that is coming to my floor "dings" I can hear it clearly, but I can't determine if the elevator is behind me, to my left, or to my right. Is this directionality crucial to my life? No. I may look a little strange turning in a circle until I know which elevator "dinged", but it's not a huge deal. I generally laugh when this happens to me; I find it amusing - but I'm greatful I can hear the "ding" at all. When I didn't have a BAHA, if the elevator was on my deaf side I couldn't hear the "ding".
Another example: I'm sitting in my car, my son is the passenger seat (my deaf side) we can carry on a conversation - even with the car radio on - without me having to turn my "good" ear towards him. My BAHA "hears" what he's saying to me. But if I'm in the car and there is an ambulance with it's siren blasting, I can hear the siren - but I have to look in front of me and in my rearview mirror to determine if the ambulance is in front of me or behind me.
Another thing with the BAHA, lots of us (me included) have the perception that we have directionality. In fact, I swore that I did - until a study my neurotologist was doing proved me wrong.
I hear quite well with my BAHA - much, much better than I do without it. It has limitations - like all hearing devices - but they are mainly in loud and/or crowded rooms.
I think your doctor is trying to stress that you shouldn't think a BAHA will give you back your hearing - because it won't. Some people have expectations that are too high, and they can be disappointed. I've actually had people tell me that they didn't "get their hearing back" in their deaf ear. Well, duh! You aren't going to. I think your doc is just trying to get you to realize this - which, in my opinion, tells me he's a great doc.
Jan
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Well said Jan! I am probably one of the few BAHA users around that actually is not totally SSD. My word discrimination is at about 50% and my ENT said I was a good candidate for a BAHA. I am so very glad I got one because now when people talk, instead of the garbage I hear coming into my bad ear, I can hear almost perfectly good with the device. As far as locating sound, unless the sound is in a certain frequency range (in other words, no high freq) I can locate it quite well, with or without my device on. I don't think the device helps me in any which way, but I probably should test that theory out!
Jay
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With what you're saying about directionality and not knowing necessarily where sound is coming from, if a BAHA were to help with that, I would think insurance companies would be more apt to cover the BAHA. With emergency personnel sirens and beeping horns, I'm guessing SSD persons might have more accidents while driving.
Jeez, I'm going to go broke putting my two cents in all the time... ;D
Lisa
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Jay, I didn't realize that you aren't SSD. I learn something new every day!
At one point I thought being SSD was a requirement of the BAHA, but as I was telling this to someone at the ANA Symposium in Chicago (you know me, Jan the BAHA "expert"), my doctor who had just given a talk on "hearing options" was standing next to me. He (very nicely) corrected me. He said that whether or not you are a candidate is based on hearing loss; it's a case by case basis when it comes to deciding who would benefit from a BAHA. I learned something new that day, too ;D
I thought I had 100% directionality with my BAHA and told my doc that numerous times. He said there were no studies, but one day he and a partner of his decided to conduct one and I was invited to participate. I was placed in a sound booth (the kind they use to test your hearing) with speakers all around me - front, back, sides, corners, etc - the door was closed and my back was to the audiologist. She sent sounds with different pitches into the booth and I had to tell her which speaker I thought the sound was coming out of. Two of the sounds I specifically remember were a barking dog and a siren. The test was probably about 15 minutes and I thought I nailed it. The audiologist wouldn't confirm or deny that.
Several months later I asked my doc about the study and he said it showed that the participants did not have directionality with their BAHAs, even though some of them felt they did. When I asked if I was one of them, he just chuckled. Lots of times perception seems like reality, what can I say? :)
Lisa, good point. But the important part is that with the BAHA you know that there is sound - a siren in this case - because you hear it. When you are SSD (or your hearing is compromised) you may not hear the siren at all. My BAHA enables me to hear the siren (or the beeping horns) and alerts me that there is "something" in my vicinity that I need to locate and pay attention to.
Before the BAHA, I would totally ignore someone standing on my "bad" side trying to have a conversation with me unless I knew they were there. I couldn't hear them, so if I didn't physically sense their presence they were in essence "talking to the wall". If I knew they were there, I would turn my body so my good ear could pick up what they were saying to me.
With the BAHA, I can hear people on my "bad" side whether or not I realize they are physically there or not.
Make sense?
Jan
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OK, going to add my 2 cents worth in here (maybe not worth that, but .....). The study done in an audiogram sound-booth with pure tones, cannot be equated to sounds in the "real" world ..... especially human voices, which are multi-frequencies and not pure tones. That being said, I am like Jan, in that I cannot distinguish the direction of elevator "dings" or any electronic sounds because they are pure tones. However, I can distinguish the direction of voices. Do not ask me why or how, but I can.
Having the Ponto BAHA is much safer in all environments, no matter how I hear.
Clarice
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I guess without the BAHA, I may not hear those sirens and horns and could still be a good reason for insurance to cover them. I do have hearing loss and cannot always tell which elevator made that ding and instead have to look for the lit up arrow. I'm trying to be optimistic, but may one day need some sort of hearing device.
Lisa
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I have no ability to locate the source of sounds, with or without my BAHA. It is a problem at first, but you just get used to it. Just wait until one of those electric carts at the airport that carries blue hairs sneaks up behind you and rings the bell at you.
James
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I have been wondering about this myself. Until recently, I thought bone conduction hearing actually bypassed the nerve and went straight to the brain, somehow.
When I had my recent bone conduction test, the audiologist asked me to point to where I thought the tones were coming from. They were all on my right side, which I thought meant I had missed half the sounds! ;D A year and a half ago, I had very different results.
There has to be a good hearing nerve for bone conduction to work. I WISH a BAHA would give me directionality, but I would definitely settle for being able to hear people talk to me, when they are on my left side. I'm starting to feel frustrated and isolated at social gatherings.
At the volume they conducted the test (85 db?) I had 0% speech discrimination in my left ear. But I still think I could have speech discrimination, with amplification, as long as the recruitment didn't hurt too much, which it might. Anyway, I will be giving all that up when I have translab. :'( Probably wouldn't be worth trying to save it via Middle Fossa, and I'd bet radiation would also knock out what hearing I stilll have left in that ear.
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Liz -
for a wonderful explanation of how the BAHA works go here:
http://www.umm.edu/otolaryngology/baha.htm
Jan
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Liz -
for a wonderful explanation of how the BAHA works go here:
http://www.umm.edu/otolaryngology/baha.htm
Jan
Awesome! Thanks, Jan!
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My advide to you is to live with your SSD for at least 2 years before getting BAHA. I got one pretty much right away after reading all the testomonies BAHA has online that make you think it is going to solve all your problems.
I live/work in a very noisy environment and for me it just placed way too much noise to my good hearing nerve. It "over worked" my good nerve. Even tho I had a directional mike (you shapped that on to the processor) so it should have just amplified voices being talked to me, it still picked up on everything and also the directional amp added more white noise.
I had it knocked off a couple times and luckily picked it up before someone stepped on it. You can pin it to your shirt tho.
If you work in an office maybe it'd work well for you and also wear it all the time. I was constantly turning it on and off because of my ever changing noise envvironment.
I now have severe tinnitus and hyperacusis so I wear a ear plug in my good ear most of the time and attempt to read lips and always am aware of my body placement when I have to communicate. I am planning on going out on disability as soon as I can afford it.
Get lots of opinions before you do the BAHA. I know some people love it. But they probably are able to control their environment or don't work/travel for a living like me.
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Sally -
you mention a directional mic. Is your processor the Divino? If so, the upgrade (BP100 aka BP3) is much better than the Divino. Sound is more natural and it works better in noisy/crowded environments.
As for waiting for 2 years after becoming SSD to get a BAHA, I'm not sure I agree with that. I got my BAHA 9 months after becoming SSD and it was the longest 9 months of my life (this includes being pregnant with twins).
Jan
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Also, from what all of my audiologists have told me, the longer a person is SSD, the more the brain adapts (shuts off) to no sound from that side.
Clarice
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How common is it for people with BAHAs to develop hearing sensitivity in their good ear? Does it have a volume control?
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Liz .....
Not quite sure what you mean by developing hearing sensitivity ..... if you mean hyperacusis ..... almost immediately after my first surgery, when I still had 20% useful hearing in my AN ear and excellent/above normal hearing in my good ear, I developed hyperacusis. This did not change when my second surgery 3 years later resulted in me being totally deaf in my AN ear.
Yes, there is a volume control on my Oticon Ponto Pro device.
Clarice
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Liz .....
Not quite sure what you mean by developing hearing sensitivity ..... if you mean hyperacusis ..... almost immediately after my first surgery, when I still had 20% useful hearing in my AN ear and excellent/above normal hearing in my good ear, I developed hyperacusis. This did not change when my second surgery 3 years later resulted in me being totally deaf in my AN ear.
Yes, there is a volume control on my Oticon Ponto Pro device.
Clarice
By hearing sensitivity, I meant hyperacusis. I'm assuming the hyperacusis is in your good ear? I have recruitment in my AN ear. I'm assuming that will go away when I have translab, since it is caused by the hairs in the cochlea, which I will no longer have. I'm planning to ask Dr. Slattery about that, next time I talk to him.
Clarice, when you had translab, did they sever your cochlear nerve as well as your vestibular nerve on the AN side? Is that what they normally do?
Liz
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Oh well - I had a nice reply and my computer decided to reboot spontaneously! Must be I needed to rewrite! So here goes!
Yesterday I got educated. I brought home a Phonak Cros and a Oticon BAHA to test. I am barely 6 months after surgery - and Jan I can't take 6 more! I'm with you!
I didn't "understand" the differences between them until I tried one on - and now I know.
Last week I had an abysmal experience with a Cochlear BAHA - now I suspect it was because it was a really old model - because this Oticon is worlds of difference from last week! The sound quality if you plug your hearing ear is leaps and bounds above the Cochlear! Not to say Oticon is better - but the Cochlear left me with a horrible taste in my mouth!
Here's what I learned: with the BAHA I could "tell" when my audiologist stood and spoke to me in different places in the room (envision a clock face) and I was able to estimate about where she was. I agree with Clarice - about the "real life" settings being different from an sound booth. PLUS they're only creating a fake - sound only direction - not the "real thing" as it were.
I learned that because the BAHA does NOT use the good ear ear drum (like the Cros does), your brain is able to "sense" direction or sound source as being different because it's your brain. When I put on the Cros and she did the same thing, I could NOT tell where she was.
The Cros would be nice for those that cannot have the surgery to implant the abutment - and it is an amazing device - BUT it has definite drawbacks so far that I can see. Mostly which have to do with its size being quite delicate and the placement on the ear being very light and easy to fall off.
So at this point - I'm leaning towards the BAHA - right now specifically the Oticon Ponto which I have here to demo. (the REALLY cool thing is that I was able to put them both on my husband's ear and show him what I'm hearing!)
Will be testing both all weekend. Will also post in the Cros discussion the specifics about it as well.
Pam
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Pam -
I have a BP100 (Cochlear) which is comparable to the Oticon Ponto Pro. Prior to the BP100 I had a Cochlear Divino, which was good but not nearly as good as the BP100. Before getting my BP100 I demo'd it and the Ponto Pro; chose the BP100.
Liz -
Cochlear processors (BP100 aka BP3, and BP110) have volume controls like the Oticon processors. And I have no sensitivity in my "good" ear.
Jan
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Jan,
Glad to know you don't have hearing sensitivity in your good ear.
I've been wondering - if you have one type of BAHA implant, does it work with other brands of processors? Is the abutment universal?
Liz
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The abutment isn't universal. It used to be, but a couple of years ago Cochlear changed their "equipment" including the abutment. So now you either have to go with Cochlear or Oticon.
So people like me who had the implant over 4 years ago have universal "equipment" and can wear either a Cochlear or an Oticon processor, but newbies have to choose.
Jan
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By hearing sensitivity, I meant hyperacusis. I'm assuming the hyperacusis is in your good ear? I have recruitment in my AN ear. I'm assuming that will go away when I have translab, since it is caused by the hairs in the cochlea, which I will no longer have. I'm planning to ask Dr. Slattery about that, next time I talk to him.
Clarice, when you had translab, did they sever your cochlear nerve as well as your vestibular nerve on the AN side? Is that what they normally do?
Liz
Liz .....
There is an excellent description of each of the treatment options on the ANAUSA home page: http://www.anausa.org/index.php/overview/treatment-options
I am totally deaf in my AN ear so yes, the hyperacusis is in my only hearing ear. It is my understanding that with a translabyrinthine approach to AN removal, all of the inner ear is removed, including the cochlea. That is why those of us having that approach are not candidates for cochlear implants and we are permanently and totally deaf in that ear.
In my case, due to a combination of massive "radium" doses to my nasopharynx area when I was a teenager, and having had three craniotomies, I no longer have working vestibular nerves on either side. Therefore, I am totally dependent upon my vision and sensorineuro motor responses (feet & leg muscles primarily) to maintain my balance. That means in the dark, when I lose my visual assistance, I cannot stay upright with only one of three parts to the balance system available to me.
Clarice
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Most BAHA users aren't candidates for CI's (cochlear implants) - because our hearing loss is different from those who require CIs.
Also, CIs are generally for those who are bilaterally (double-sided) deaf, while BAHAs are generally for those who are unilaterally (single-sided) deaf.
I had the retrosigmoid approach and have no idea if I have a cochlea on my left side or not, but since the BAHA works through bone conduction it doesn't really matter.
Jan