This systematic review from South Korea nicely summarises what we know about SSD (single-sided deafness) and hearing rehabilitation with BAHAs (Bone Anchored Hearing Aids). SSD was defined as a PTA greater than 90 dB and a normal hearing opposite ear (<30 dB). Fourteen studies met inclusion criteria with a total of 296 patients. This is surprising considering the relatively large number of patients with BAHAs. The take home messages for BAHAs in SSD are: (i) there is limited if any benefit for sound localisation. Many of us in the past have been guilty of counselling patients that this is a likely benefit. This is due to the fact that a BAHA doesn’t restore hearing in a deaf ear, but routes it to the good ear. Cochlear implantation on the other hand does help in sound localisation. (ii) BAHAs improve speech discrimination in noise. (iii) Quality of life is improved. Sometimes this occurs even if objective measures such as speech discrimination in noise doesn’t. Good quality studies comparing BAHA and CROS (contralateral routing of signals) hearing aids are lacking. The cost benefit ratio of these interventions is also not adequately studied. The newer generation of BAHAs may continue to tilt the balance against CROS hearing aids in SSD.

Efficacy of bone-anchored hearing aids in single-sided deafness: a systematic review.
Kim G, Ju HM, Lee SH, et al.
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Anand Kasbekar

BMedSci, DOHNS, FRCS (ORL-HNS), DM, Nottingham University Hospitals NHS Trust; Associate, The University of Nottingham; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK.

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