COCHLEAR IMPLANTS

This next blog was written by our Cochlear Implant audiologist, James Griffitts, Au.D. and 4th Year Doctoral student, Meghan Williams.

COCHLEAR IMPLANTS

Have you ever been in a situation where it is quiet, you are wearing your hearing aids, and you just cannot understand what your wife, child, or significant other is saying? Has your audiologist told you that your hearing aids are turned up all the way, and just cannot be turned up anymore? Do you find yourself withdrawing from social situations because even with hearing aids you might not understand someone, and don’t want to embarrass yourself? While these situations can be frustrating for individuals with hearing loss, they may be a sign you are a cochlear (koe-klee-er) implant candidate.

What is a cochlear implant?
A cochlear implant, a small electronic device, is the alternative that can be used when one no longer receives benefit from hearing aids. There are two parts to a cochlear implant: the external component that sits behind the ear, like a hearing aid, and the internal component that is surgically implanted. (National Institute on Deafness and Other Communication Disorders, 2014)

Step-by-step how the cochlear implant works:
In order for an individual with a cochlear implant to “hear,” sound must travel from the external component to the internal component of the device. The external component includes the microphone, speech processor, and transmitter. The microphone gathers sound from the environment and sends it to the speech processor. The information received by the speech processor is then changed into a digital signal and sent to the transmitter and to the internal components of the device. The internal component includes the receiver/stimulator and the electrode array. The receiver/stimulator receives the signal from the transmitter and changes it into electrical impulses that travel along the electrode array. The electrode array activates the auditory nerve and sends the signal to the brain, where it is interpreted as sound. (U.S. Food and Drug Administration, 2014)

Who is a candidate?
Not everyone with hearing loss is a candidate for a cochlear implant. The hearing loss must be due to damage to the hearing nerve, also known as sensorineural hearing loss. For individuals who are 18 years or older, the hearing loss must be in both ears, moderate to profound in severity, and the individual must have limited or no benefit from hearing aids. For children 2-17 years of age, they must have severe to profound sensorineural hearing loss in both ears and receive little or no benefit from hearing aids. Children 12-24 months must have profound hearing loss in both ears and receive little or no benefit from hearing aids. The benefit from hearing aids is evaluated by an audiologist when determining candidacy. (Cochlear Ltd., 2016)

Manufacturers:
There are currently three cochlear implant manufacturers that are FDA approved in the United States, and several other smaller manufactures throughout the world (U.S Food and Drug Administration, 2015). The companies approved in the U.S. are Cochlear Corporation, Advanced Bionics and Med-El. At Sacramento ENT, we currently offer cochlear implants from Cochlear Corporation and Advanced Bionics.

Services provided by Sacramento ENT:
Receiving a cochlear implant begins with a thorough evaluative process. One must undergo a number of tests in order to establish candidacy. These tests include hearing tests, imaging studies including a CT scan and/or MRI scan, and a test of inner ear balance function called a VNG. Other medical tests may be necessary depending on age or health. Once the decision has been met to proceed with the cochlear implant, one of our audiologists will sit down and help reach decisions regarding the colors, sizes, and accessory devices that are included with the implant. Four to six weeks after the device is surgically implanted by our otologist, the patient will be seen by one of our audiologists to provide the external processor and “turn on” the device; this is also known as the initial activation. This appointment is primarily used to begin to re-introduce sound to the patient as well as provide enough knowledge to be able to manage batteries, remote controls and other accessories. It is important to remember that this is the first of multiple appointments with the audiologist. Several follow up appointments will take place within the first few months, at which times the processor settings will be adjusted and fine-tuned. Reaching maximum performance with the cochlear implant can take up to a year or more. These appointments are also used to review and demonstrate accessories such as wireless devices to be used with the phone or television. The audiologist will also monitor your progress with additional auditory tests as well as ensure the device is being used as much as possible as this facilitates faster progress.

Our audiologists are always happy to answer any questions and help with any concerns throughout this process. If you would like more information on candidacy, please contact one of our Cochlear Implant audiologists through the website: www.sacent.com.

References
Cochlear Ltd. (2016). Candidacy. Retrieved from http://www.cochlear. com/wps/wcm/connect/us/for-professionals/products/cochlear-implants /candidacy
National Institute on Deafness and Other Communication Disorders (NIDCD). (2014). Cochlear Implants. Retrieved from https://www.nidcd.nih.gov/health/cochlear-implants#c
U.S. Food and Drug Administration. (2014, June 6). What is a Cochlear Implant? Retrieved from http://www.fda.gov/MedicalDevices/ ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/ucm062823.htm
U.S. Food and Drug Administration. (2015, October 28). Cochlear Implants. Retrieved from http://www.fda.gov/MedicalDevices/Productsand MedicalProcedures/ImplantsandProsthetics/CochlearImplants/

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