(Last updated Nov 4, 2019)

CROS and BiCROS Hearing Aids

The vast majority of people with hearing loss have what is called symmetrical hearing loss.

Symmetrical hearing loss (as the name implies), means the hearing is symmetrical (the same) in both ears.

Much less common, is single-sided deafness (SSD), where one ear is deaf and the other isn’t.

Single-sided deafness requires a special kind of hearing aid- either a CROS or BiCROS hearing aid.

In this post we’ll discuss everything you need to know about CROS and BiCROS hearing aids- including their benefits and limitations, prices, and some of the latest models available.

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What is a CROS Hearing Aid?

The answer is in the name.

CROS stands for Contralateral Routing of Signals.

Or to put it in layman’s terms- the transfer of a signal (audio) from one ear to the other.

A CROS hearing aid transfers sound from the bad ear to the good ear.

This kind of hearing aid has two parts.

On the bad ear, there is a microphone and transmitter. Their job is to capture sound from that ear, and transmit it to the better ear.

On the good or better ear, there is a receiver, which picks up the signal from the transmitter, and then delivers the sound to that ear.

The animation below helps explain how a CROS hearing aid works

CROS hearing aid graphic

As shown by the animation above, with a CROS system, the unaided (bad) ear, captures sound from that side and transmits it to the hearing ear.

You may be a CROS candidate if…

You have one ear with close to normal hearing and another ear that is considered “unaidable”.

What do we mean by unaidable?

Unaidable means that there is so much damage to the auditory system that using a hearing aid in that ear does not provide any benefit.

You might have one of three problems that prevent you from using a hearing aid in the bad ear:

  • A dead ear, meaning that we can’t get any response from the ear during a hearing test.
  • Very poor ability to understand speech in that ear, even if amplified.
  • Inability to tolerate the loudness of amplified sounds in that ear.

What is a BiCROS Hearing Aid?

A BiCROS hearing aid looks just like a and works in the same way, with one difference-

On the bad ear, there’s still a transmitter that sends signals to the receiver on the better ear.

However, with a BiCROS hearing aid, the receiver that delivers sound to the better ear, also amplifies that sound.

The animation below helps explain how a BiCROS hearing aid works

Bicros hearing system animation

As shown by the animation above, with a BiCROS system, the unaided (bad) ear, captures sound from that side and transmits it to the other ear while also amplifying the sound.

You may be a BiCROS candidate if…

You have one ear with some hearing loss, and another ear that is considered unaidable.

It’s like getting a hearing aid for your good ear, with the extra benefit of also being able to hear sounds from your bad side.

Why not just get the one hearing aid for your better ear?

Well, remember that there’s a large object – your head – in the way between your good ear and your bad ear. Your head blocks your good ear from hearing sounds coming from the direction of your bad ear.

As a result, you may have a hard time understanding people or picking up sounds that come from your bad side, even if you’re wearing a hearing aid on your good ear.

CROS & BiCROS Hearing Aid Pros and Cons

First, let’s talk about the problem with single-sided deafness.

If you have one good ear, and one bad ear, it may not seem like a big deal. After all, doesn’t the good ear allow you to hear everything?

It turns out that having two ears plays a pretty important part in our ability to hear the world around us.

Think about the fact that you have two eyes, and that both eyes working together allows you to see the world in depth.

Having two ears helps you to hear sounds with depth, in the following ways:

  • Better ability to locate where sounds are coming from.
  • More easily separate speech that you want to hear from background noise.

If you have single-sided deafness, you may struggle to hear in noisy places like restaurants. You may also find that you can’t tell the direction that cars are approaching from when you are crossing a parking lot.

Now that you know why single-sided deafness is a big deal, we can talk about the pros and cons of CROS and BiCROS hearing aids.

Pros of CROS and BiCROS hearing aids:

  • You may have improved awareness of sounds that are coming from the side of your bad ear.
  • You may find it easier to understand conversations in noisy environments.
  • When someone talks to you from the side of your bad ear, you may have an easier time understanding the person.
  • You may experience less fatigue when participating in social activities.

Cons of CROS and BiCROS hearing aids:

  • They are less common than traditional hearing aids, so you need to find a hearing care professional who has experience fitting these.
  • You have two devices to keep track of and supply with batteries. People with memory problems or dexterity issues may prefer a simpler solution of wearing just one hearing aid.
  • You need to get the sound balance just right between your transmitter and receiver side. Your hearing care professional can adjust this balance in the manufacturer software
  • You may hear worse in noisy situations where the noise is coming towards your bad ear, because the transmitter picks up the noise and sends it to your good ear. Your hearing care professional can give you the ability to turn off the transmitter at these times.
  • CROS and BiCROS hearing aids cannot fully replace having two ears, because some of the brain circuits involved in binaural hearing require the inputs to come separately from the auditory nerves of each ear. CROS and BiCROS aids only deliver sound into one ear.

CROS & BiCROS Hearing Aid Costs

How much do CROS and BiCROS hearing aids cost?

Just like with traditional hearing aids, the answer is- it depends, but the average retail price for an entire system will be between $3,000-$7,000.

However, you can find CROS & BiCROS hearing aids at .

As compared to a set of traditional hearing aids, there is technically less equipment inside of CROS/BiCROS systems, resulting in (sometimes) a lower wholesale price from the manufacturers, and a lower retail price to you.

On the other hand, CROS and BiCROS hearing aid fittings take a lot of time for a hearing provider. Your hearing provider will likely spend more time programming these devices as compared to traditional hearing aids, and helping you understand how to make the most out of your devices.

So they may end up costing even more than a regular set of hearing aids would- it just depends.

Best CROS & BiCROS Hearing Aids

Because every hearing loss is different, as are user needs, there is no “best” CROS and BiCROS hearing aids.

However, certain systems have more functionality than others, and are requested more often by our customers.

As of November ‘19, we’re seeing many requests for CROS and BiCROS hearing aids that are rechargeable, Bluetooth, and can be small in-the-ear devices.

Below is an overview of our most popular CROS and BiCROS hearing aids.

Starkey Livio

Starkey Livio CROS
Highlights:

  • Available with your choice of lithium-ion rechargeable batteries or disposable batteries
  • Direct to iPhone Bluetooth compatibility
  • Ranging from $2000-$3500 for the entire system (with local care included)

Signia Silk

Signia Silk CROS

Highlights:

  • Available in small in-the-ear models
  • Can be controlled through a smartphone app
  • Ranging from $2000-$3500 for the entire system (with local care included)

Conclusion

Single-sided deafness presents unique challenges and has unique treatment options.

More important than the technology you choose, is that the hearing provider you work with has experience fitting this type of hearing loss- so don’t be afraid to ask them.

While many people are happy with CROS and BiCROS hearing aids, there are significant drawbacks to these systems, so don’t be surprised if they are not a good solution for you, but they are absolutely worth a shot.

A Question For You

Do you have single sided deafness and use CROS or BiCROS hearing aids?

Please share your experiences and insight below!
 

Jeff Hall Jeff Hall Jeff is a California licensed hearing aid dispenser and the President of ZipHearing- one of the largest discount hearing aid suppliers in the United States. Jeff lives in San Diego, CA with his wife and young daughter. You can learn more about hearing aids and watch Jeff on ZipHearing's Youtube channel.

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