One of the most debilitating adverse effects of acquired single-sided deafness (SSD) is the inability to experience the subtle nuances or “architecture” of music due to the loss of binaural hearing, said David M. Baguley, MBA, PhD, head of service: audiology/hearing implants at Cambridge University Hospitals, in Cambridge, England. Although this degradation is common in SSD patients, it is not unfixable, he stressed. On the technology side of the equation, one can simply recode music from stereo to mono, using either iTunes or other music software. “It’s much easier for people with SSD to process and enjoy mono music,” he said.
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January 2014A more pragmatic solution, he noted, is to stack a pair of stereo speakers on top of each other, so that the sound is coming from one single source in space. “There are also mono headphones available,” he noted.
Another strategy is to help the patient “relearn” how to listen to and appreciate music. This can be done in two ways, Dr. Baguley noted. “One suggestion is that you start completely anew by listening to music that is very simple: one instrument or one voice, for example, that is very melodic,” he said. “This helps you slowly rebuild your ability to experience and enjoy the nuances of music.”
The second approach is to have SSD patients listen to their favorite piece of music, no matter how complex, and coach them in working through the initial disappointment they will feel when that music no longer has the space or architecture it used to have prior to the onset of SSD. “Once you work through that process, your brain slowly ‘fills in’ the missing aural information, and patients begin to experience anew the joys of music,” Dr. Baguley said. “I’ve had success with all of these approaches; it’s just a matter of working through all of them to see which one the patient responds to best.”
Lest clinicians assume such efforts are not as important as tweaking the sound processor of a hearing aid or some other more “clinical” consideration, Dr. Baguley suggested reading accounts of patients who have experienced firsthand the devastating effects of losing the ability to experience music as they once did in a binaural world. He recommended The Train in The Night: A Story of Music and Loss (Vintage, 2012), by Nick Coleman, a widely read UK-based music and arts journalist who wrote eloquently about developing SSD and severe tinnitus.
“I can’t imagine anyone reading this book without it fundamentally changing the way you approach your patients with SSD,” said Dr. Baguley, who recently interviewed Coleman for a UK-based trade journal. In the interview, Coleman commented on how he feels clinicians should manage all patients with the hearing handicap.
“Please, please, please think about the whole person,” he said. “It is absolutely vital that your patient is offered psychological support. They will not begin to get to grips with what has happened to them until they are listened to, heard, and helped in this respect.”