CROS and Baha-Which Type of Hearing Assistance Is Better?

Baha routes sound more efficiently, and the patient receives a clearer, stronger sound in the hearing impaired ear than with traditional or transcranial CROS, agreed Dr. Wazen. The device creates less distortion, resulting in a more pure and natural sound, he said.

One recent study (Otol Neurotol 2006; 27:172-82) of 23 patients with unilateral deafness conducted by Dr. Niparko and his colleagues found that Baha used for single-sided deafness provided greater benefits for patients than CROS. Advantages of Baha were related to averting the interference of speech signals delivered to the better ear, as occurs with conventional CROS amplification, while alleviating the negative head-shadow effects of unilateral deafness. Additionally, patients with moderate sensorineural hearing loss in the functioning ear had less trouble hearing background noise and experienced greater improvements in speech understanding when using a Baha.

In addition to sound quality, another advantage of Baha is that it doesn’t require an ear mold and can be worn off the ear, said Dr. Murray. It’s much more comfortable for patients and more easily disguised.

Patients also don’t have to worry about losing the device during physical activity because the titanium fixture becomes embedded in the bone, and the Baha snaps soundly to titanium abutment, she said.

From the perspective of my experience, patients are happiest with the Baha, said Dr. Murray, adding that most CROS patients come back to the office for other alternatives.

Dr. Wazen and his colleagues have also found that most patients prefer a Baha system over the traditional CROS. Most of the time we use the Baha, said Dr. Wazen. In a recent study (Otolaryngol Head Neck Surg. 2003;129:248-54), he and his colleagues studied 30 patients who received a CROS hearing aid for a one-month period and then switched to the Baha system. Patients reported a significant improvement in speech intelligibility in noise, greater improvement in perceived benefit, increased satisfaction, and better quality of life with Baha than with CROS.

While Baha generally provides the best hearing of the three options, patients should understand the post behind the ear that holds the device in place can be difficult to maintain.

-Darius Kohan, MD

Cost can also be a factor for patients when choosing Baha. Because the Baha interfacing components are surgically placed, the device is generally covered by insurance, said Dr. Murray. The price of the Baha will vary by center, she said, but the current cost is roughly $10,000, excluding the associated operative costs.