Are you a candidate for cochlear implantation?
Unlike hearing aids, determining the candidacy of a cochlear implant involves many factors.
Receiving a diagnosis of hearing loss can cause conflicting emotions. On the one hand, the patient now has an answer that validates all of their experiences and struggles. On the other hand, they now have to go through the process of managing their hearing loss. The sheer number of hearing aid options alone is enough to overwhelm. But another question can complicate things: is a cochlear implant right for me? In reality, for most patients, the answer will be no. But it’s important to understand why and how it works, in order to make the most informed decision.
Who needs a cochlear implant?
The reason most people don’t need a cochlear implant is that modern hearing aids are very versatile. Hearing aids on the market today are powerful enough to easily provide appropriate amplification for severe hearing loss. They are also sophisticated enough to provide a clear signal in most environments. But they have their limits. And that’s where cochlear implants come in.
Simply put, hearing aids can’t be that loud. If a person’s hearing exceeds the output limit of the hearing aid, they will not benefit. Especially for people with profound hearing loss, cochlear implants are the best solution. Due to how cochlear implants work, which will be discussed in more detail in the next section, they are not subject to the same output limitations as hearing aids. Thus, they can provide audibility for any degree of loss.
The other factor is clarity. Some people may have hearing loss that matches the output range of a hearing aid, but are completely unable to understand speech. For example, a person may have moderate to severe hearing loss, but only 30% word recognition. So even though the hearing aid makes it easier for them to hear the sound, the speech is still garbled and unintelligible. It would be like listening to a loud, fuzzy radio. Again, this type of patient would benefit greatly from a cochlear implant, as studies show that it can help significantly improve speech understanding. Ultimately, if a patient no longer benefits from properly fitting hearing aids, they become a candidate for a cochlear implant.
How does a cochlear implant work?
When a sound wave approaches the ear, it is channeled through the ear canal to the eardrum. The eardrum vibrates in a specific pattern, which moves the middle ear bones (ossicles). The ossicles then vibrate the fluid in the cochlea, which is the organ of hearing. The vibrating fluid stimulates the sensory cells in the cochlea, generating an electrical impulse for the auditory nerve. This is how we hear. However, if the sensory cells or the nerve are damaged, this prevents the signal from reaching the brain properly, resulting in hearing loss.
For those with a cochlear implant, the idea is basically to completely bypass the ear, as it is too damaged. Instead, an array of electrodes is inserted into the cochlea, directly stimulating the auditory nerve. A processor connects to the implant via a magnet, collecting and modifying sound, much like a hearing aid would. There is no acoustic signal, so the output limit is not a problem. The signal doesn’t have to pass through the ear, so there isn’t as much distortion. Cochlear implants are also convenient to use, with some being rechargeable and many being Bluetooth compatible. They can also come with accessories, just like hearing aids. An elegant solution for those who need it most.
What are the Qualifications?
Unlike hearing aids, determining the candidacy of a cochlear implant involves many factors. First, of course, is the hearing test itself. Applicants must have some degree of hearing loss and a speech recognition ability of 40% or less. Your hearing care professional will know the specific numbers. But you must also be a good candidate for surgery. Although cochlear implant placement is a quick and safe outpatient procedure at any age, the surgeon should still check that it is safe to perform the operation and that there are no abnormalities. anatomical features that would prevent placement. The other big factor is social support. You will need someone to take care of you during surgery and while you recover. There are also several follow-up appointments with the audiologist, which are necessary to obtain good results.
Cochlear implants are a wonderful invention that can greatly improve the quality of life of those who receive them. Feel free to discuss the option with your audiologist if you think it may be right for you. NBF
By Jeff Lane, Au. D.
The Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a Doctor of Audiology passionate about improving the lives of others. Dr. Lane can be reached at 928-522-0500 or [email protected]