January 3, 2012

Cochlear Implants

Parker,-Molly-NEWBy Dr. Molly Parker
Parker Audiology, PC

Cochlear Implants (CIs) are often touted as the cure for deafness. This may be true, but success varies. Typically, I recommend an evaluation for a CI if word discrimination is very poor and the individual has significant hearing loss,
1) If the individual cannot benefit from hearing aids.
2) If the individual is interested in pursuing additional evaluation.
3) There are contraindications such as risk for heart problems, stroke and general health of the individual.

Age should not factor in this decision. Typically, extensive audiology testing and a consult with an ear, nose, throat physician (ENT) is necessary to determine candidacy. Insurance coverage is important since the out of pocket cost is estimated at $50,000-$100,000.

The process of fitting a CI involves surgery that generally lasts two to three hours. The device itself has two parts: the microphone/processor and the receiver/electrode array. The mic/processor looks like a large hearing aid and transmits the sound to a magnet (the circular disk) that sits above the ear. The receiver/electrode array receives the signal. The electrode sends a stronger signal to the auditory (hearing) nerve. To receive the signal through the electrode, the inner ear is partially or wholly destroyed by the electrode array itself. The CI surgery is not reversible. Many people with CIs wear their regular hearing aids on their other ear, to receive some sound awareness when the CI is removed.

The success of the CI varies on the age of the individual being implanted, their experience with sound in general, how long it has been since they have heard any sound, how dependent they are on sound, the structure of their inner ear, and how willing they are to learn to hear sound and use the device. Programming the device may require several follow ups over the first few years. Losing the processer (the hearing aid portion) is a major loss and costs several thousands of dollars to replace it.

An adult CI patient generally has greater success if they recently lost their hearing and used hearing aids faithfully throughout their adult lives. However, for the individual who has grown up using sign language, never uses their hearing aids, CIs would likely provide less benefit—perhaps only some sound awareness. Some of the success is also dependent on how healthy the hearing nerve is. For example, the individual who has one “dead” ear and one ear that has a severe hearing loss, the CI would likely be implanted in the better since the auditory nerve is likely more healthy.

For young children, it is desirable to implant very young to give that child experience with sound during the critical stages of learning speech and language, less than two years old. Many of these recipients have positive results, however it is difficult to determine what the level of success each child will obtain. It is generally agreed that the child will hear better with the CI than with hearing aids alone.

If you think you might be a CI candidate, call your physician for a referral and receive audiologic testing at Parker Audiology.