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Treatment of Single-Sided Deafness Improves Hearing; Quality of Life:Your Health


By Rallie McAllister, M.D., MPH, MSEH


If you think about it, there's a perfectly logical reason why humans have two ears -- we need a functioning pair to hear properly.


Unfortunately, millions of Americans have less than perfect hearing in both ears. Each year, an estimated 60,000 people in the United States experience a complete loss of hearing in one ear, a condition known as single-sided deafness.


Normally, sound waves enter the ear canal and travel to the middle ear, where they strike the eardrum. The resulting vibrations ripple through fluid in the spiral-shaped cochlea of the inner ear. In response, thousands of tiny, hair-like nerve cells fire off electrical impulses to the brain, where they are interpreted as sound.


Damage to the middle or inner ear can result in hearing loss, which can be characterized as one of two types. Conductive hearing loss occurs when the path of sound waves through the middle ear is blocked by the presence of fluid, or by defects in the structure of the ear.


In individuals with sensorineural hearing loss, or nerve deafness, the hair-like nerve cells lining the inner ear are damaged and incapable of transmitting signals to the brain. The condition can strike suddenly at any age, or may develop gradually with aging.


While it is occasionally the result of chicken pox, measles or other infectious diseases, it may also occur after long-term exposure to loud noise, traumatic head injury, or as an unavoidable consequence of brain surgery. When this type of hearing loss occurs in one ear, the result is single-sided deafness.


Regardless of the cause, single-sided deafness can pose a number of problems. Many affected individuals experience an acoustic phenomenon referred to as the "head shadow effect," in which they're incapable of hearing sounds originating from the same side as the deaf ear.


At the age of 41, Nancy Muller of Tecumseh, Calif., suffered single-sided deafness following the surgical removal of a tumor from the acoustic nerve in her brain. Her life immediately changed in ways she never could have imagined.


Crossing streets and parking lots safely became a major challenge. Even driving was more difficult. "If I didn't see a car approaching on the side of my deaf ear, I wouldn't even know it was there," she explained. "I could hear horns and sirens, but I couldn't tell which direction the sounds were coming from."


Although less dangerous, Muller found the social implications of single-sided deafness equally frustrating. Carrying on a normal conversation became practically impossible. "I couldn't hear what people were saying unless they were standing close to my good ear," she said. "It was embarrassing to ask people to repeat themselves over and over."


Fortunately, Muller's doctor advised her to consider a new treatment, known as the Baha system. Unlike traditional hearing aids that merely amplify sounds, the Baha system uses a process known as bone conduction.


The device consists of a small titanium fixture that is implanted in the skull behind the deaf ear, and a removable, digital sound processor with a built-in directional microphone.

According to Katrina Stidham, M.D., a specialist in neurotology and skull-based surgery at the California Ear Institute in San Ramon, Calif., "The Baha processor works by picking up sound on the side of the deaf ear and conducting it through the skull to the cochlea of the working ear. The result is great clarity and quality of sound."


Implanting the titanium fixture requires surgery, which typically takes less than an hour and is performed on an outpatient basis.


"The surgery consists of making a U-shaped incision in the scalp, and placing a titanium abutment, or screw, in the skull," said Stidham.


Following the procedure, new bone growth occurs around the implant, securing it firmly in place. This process, called osteointegration, normally takes about 90 days.


Once the healing process is completed, the patient is ready to attach the sound processor to the titanium abutment. The device can be easily removed for showering or sleeping, or whenever it's not needed.


Compared to traditional bone-conducting hearing aids, the Baha is not only more comfortable, it's also less noticeable. The device comes in four colors designed to blend inconspicuously with blond, black, brunette or gray hair.


Four months after her surgery, Nancy Muller was fitted with her own Baha sound processor. "The minute it was attached, the difference was incredible," she said. "I can hear sounds from every direction now. It's almost like having normal hearing again."


Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is http://www.rallieonhealth.com.
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