Part 2: Achieving Binaural Hearing with a Cochlear Implant

For many years, physicist Dr Reinhold Schatzer has been researching the audiological fundamentals of hearing and implantable hearing systems, with a focus on single-sided deafness (SSD).

In the second part of this expert interview, he explains how sound localisation can be restored in patients with single-sided deafness and how rehabilitation contributes to better long-term hearing performance.

HB: Which options do you recommend to get binaural hearing in SSD patients?
RS: The only treatment option to deliver real binaural hearing is a cochlear implant (CI). SSD as an indication for cochlear implantation has been approved in Germany and Austria since 2013.

HB: What is the difference between a CI and other hearing solutions for SSD treatment?
RS: CROS and bone conduction systems redirect sound to the healthy ear; a cochlear implant directly stimulates the deaf ear. It enables binaural hearing, enhances performance in noisy environments, and significantly reduces listening effort. A CI can also improve tinnitus in the deaf ear.

HB: Can a CI restore directional hearing?
RS: Yes, and this is the key advantage of a CI compared to CROS or BAHA systems. A CI can restore sound localisation abilities. Users benefit in many everyday situations, such as in traffic and when understanding speech in noisy environments.

HB: When is the best time for SSD treatment?
RS: For acquired SSD, we have seen good results with a CI even many years after hearing loss, especially when accompanied by auditory training of the implanted ear alone.

HB: Are there any considerations for audio processor fitting?
RS: Complete coverage of the cochlea with the CI electrode and anatomy-based fitting, which utilises the tonotopy of the cochlea and electrode individually, can help achieve the most natural hearing possible. This way, the auditory cues in the CI ear can be aligned with the healthy ear.

HB: So, rehabilitation plays an important role in SSD treatment?
RS: Yes, rehabilitation is crucial for SSD users. Listening exercises streamed directly to the CI can specifically train the implanted ear, significantly improving hearing performance. It also helps users adapt more quickly to the initially unfamiliar sound of the CI.

HB: What is your final conclusion on treating SSD with a cochlear implant?
RS: A cochlear implant is a proven and effective solution for individuals with single-sided deafness. A CI improves hearing performance and sound quality and enhances users’ quality of life.

About the expert:
Dr Reinhold Schatzer is a Senior Research Engineer at MED-EL and an expert in sound coding and signal processing.

*Disclaimer: Cochlear implants for single-sided deafness may not be reimbursed in every country; please check whether they are covered by the healthcare or insurance system in your country of residence.