The Effect of Contralateral Routing of Signal Devices on the Quality of Life of Unilateral Cochlear Implant Recipients and Their Frequent Communication Partners

Purpose: Unilateral cochlear implant (CI) recipients with limited hearing in the contralateral ear are deprived of the advantages of binaural hearing. To address speech recognition challenges arising from the head shadow effect, a contralateral routing of signal (CROS) device can be used; however, less is known of the broader impact of a CROS device on an individual's quality of life (QoL) or that of their frequent communication partners (FCPs). This preliminary study aimed to evaluate the impact of CROS on speech recognition in noise and its influence on the QoL of unilateral CI recipients and their FCPs. Method: This preliminary study enrolled seven adult unilateral CI recipients and their FCPs. All CI recipients were fitted with CROS devices during their initial appointments. Speech recognition testing was conducted in noise with and without the CROS device in a sound booth before a take-home trial. Participants used the CROS devices for approximately 1 year, with device fitting occurring before and continuing during the COVID-19 pandemic. Participants completed two QoL questionnaires, the Auditory Performance and Satisfaction Scale for Single-Sided Deafness (APS-SSD) and the Nijmegen Cochlear Implant Questionnaire (NCIQ), twice: once prior to CROS device use and once after the take-home trial. Additionally, the FCPs of each CI recipient completed the Significant Other Scale of Hearing Disability (SOS-HEAR) Questionnaire twice, once before and once after extended CROS device use. Results: When noise was directed toward the CI ear and speech toward the non- CI ear, speech recognition improved by 32% with the CROS device (p = .001). CI recipients reported significant median improvement in the "general" domain of the APS-SSD after the take-home trial (Wilcoxon Z = 12.0, p < .05). FCPs reported a significant median reduction in concerns related to their partner's hearing when the CI recipient used the CROS device (Wilcoxon Z = 2.0, p < .05). Conclusions: This preliminary study demonstrates the benefit of CROS devices for unilateral CI recipients in noisy environments. Additionally, it highlights the positive impact of CROS devices on the QoL of both CI recipients and their FCPs. These findings emphasize the importance of considering CROS devices as a valuable solution for unilateral CI recipients to enhance their hearing experience, overall well-being, and that of their FCPs.