For the past decade, our staff has been actively involved in providing cochlear implant services. This exciting technology has improved the quality of life for countless adults and children with hearing loss. Our experienced team of surgeons and audiologists are prepared to provide the much-needed services for successful usage of the cochlear implant system. We have a two-step program – one for audiological assessment and cochlear implant programming located at Conley Hearing Care in Oakmont and two for medical assessment and surgical cochlear implantation located at the Eye and Ear Institute in Oakland.
Cochlear implants are safe and effective in helping deaf individuals hear sounds – and for some, depending on their hearing history and age, with proper training this may lead to speech understanding. In 1985, the United States Food and Drug Administration (FDA) approved their use for people with hearing loss. Currently, there are three cochlear implant companies in the United States: Cochlear Americas, Advanced Bionics and Med-El.
Hearing loss is usually the result of damage to special cells in the inner ear (called “hair cells”) which sense changes in sound pressure and trigger nerves to send signals to the brain resulting in the perception of sounds. Even though deaf individuals have damage to these hair cells, there are many usable nerve fibers that can be stimulated by the cochlear implant’s electrical signals.
Thus, a cochlear implant is a device that uses advanced technologies to enable a person with hearing loss to hear sounds. Cochlear implants have two parts - the internal part which is placed in the inner ear during surgery and the external part which can be worn in several ways (like a hearing aid on the ear with a portion going to the head). The internal part has a wire with multiple electrodes on it which is placed in the cochlea, the part of the inner ear responsible for hearing. The external part picks up sound signals, changes them to an electronic signal, and sends this signal across the skin to the internal part.
A cochlear implant is much different from a hearing aid. A hearing aid makes sound louder – called amplification. A cochlear implant electrically stimulates the nerve responsible for hearing. Thus, it is for people with more severe forms of hearing loss than those who can use hearing aids.
People who have cochlear implants tell us that they feel more connected to the world around them. They can hear sounds like birds singing, telephones ringing, and cars approaching - to name but a few. People with the cochlear implant can learn to talk and understand speech – although this depends upon hearing history, age, training and practice. There are two big groups who benefit from cochlear implants – young children born deaf and adults who lose their hearing later in life. Children who benefit the most from cochlear implants are those who have been deaf for a short period of time. That is why we try to identify deaf children at a young age. We have also found that children benefit most when they are in good auditory-oral educational programs and have the support of their family.
Family support is essential in helping you get the most out of your cochlear implant/s. You’ll get better and better results as you use your cochlear implant/s. For adults who have gone deaf after hearing and developing speech, cochlear implants often allow them to hear and understand speech again. Benefits are many and may include the ability to improve their jobs, the opportunity to do more social events, an increased sense of security, and freedom to enjoy hearing events like musical concerts.
As with most medical devices, cochlear implants are expensive. Many insurance carriers provide full or partial coverage. As a courtesy to the families, Conley Hearing Care Cochlear Provider Network will submit paper-work to your insurance carrier for approval. The amount of coverage, however, depends on your specific insurance carrier. Your implant coordinators will work with you to see how much your insurance will cover.
Before a person is considered to be a candidate for a cochlear implant, there are a series of tests that will need to be performed. These include hearing tests, x-rays of the inner ear, medical tests, and speech testing. Because cochlear implants are intended to be permanent, these tests are important to determine who is likely to benefit. As directed by the FDA, all candidates must have recently tried hearing aids.
Cochlear implant surgery is done at Eye and Ear Institute by a cochlear implant surgeon. Surgery is done under general anesthesia and you are completely asleep for the procedure. The whole process takes a couple of hours. Typically, a small amount of hair is shaved above and behind the ear. The internal part of the cochlear implant is designed to last a lifetime. The external devices will need to be upgraded periodically.
Cochlear implant surgery has been performed for over 30 years and is considered safe and effective. The risks of cochlear implant surgery include those of general anesthesia as well as risks unique to ear operation – including infection, bleeding, facial nerve injury (the nerve which moves your face is located very close to the inner ear), leakage of fluid from around your brain (called a CSF leak), dizziness after surgery, rupture of the ear drum, and failure to be able to put the cochlear implant in place. While these all can occur, they are very rare, occurring in less than 1 out of 100 people.
Approximately three to four weeks following surgery, the person returns to Conley Hearing Care Cochlear Provider Network for fitting and activation of the cochlear implant. This is the first time the person will be able to hear with the cochlear implant. The cochlear implant audiologist will use a computer to set the levels that allow comfortable hearing for each electrode. These levels are unique for each person. The person returns often during their first six months to adjust the programs which run the implant. These frequent visits are necessary since it takes time for the ear to adjust to the new sounds. There will also be several evaluations of benefit with the implant. These typically occur at 3 months, 6 months, and 12 months following activation of the implant. After the first year, evaluations should be done annually to ensure continued benefit with the cochlear implant.
For adults who have been without hearing, therapy is needed for successful use of the cochlear implant. Adults who have developed speech before they lost their hearing typically have many years of sound memories to draw upon and usually learn to recognize sound as speech in a short period of time. Therapy consists of listening to sounds, words, phrases, sentences, and conversations, and practicing using different techniques to communicate better.
Since each person’s brain and inner ear is different, it is difficult to predict how well an individual will perform with a cochlear implant. While each person’s experience with cochlear implants are different, adults can expect that they will be able to detect everyday sounds in their environment, improve face-to-face communication, and have an increased ability to understand speech through hearing alone (if they were able to do this before they lost their hearing). This often leads to greater confidence to interact and socialize. There are some adults, however, who will still require the use of lip reading and/or sign language to help them understand spoken language. Research does show that the longer the person has had their hearing loss, the more difficult it is for them to benefit from a cochlear implant. We will discuss reasonable expectations with you at the time of the evaluations.