Surgically Implantable Hearing Devices

Cochlear Implants

What is a Cochlear Implant?

A cochlear implant is designed to help restore hearing in adults and children with severe to profound sensorineural hearing loss or "nerve deafness". A cochlear implant transforms sound into electrical impulses which stimulate the hearing nerve, and can be perceived by the brain as sound.

Candidacy

Cochlear implantation is currently FDA approved for one ear. To find out if you are a cochlear implant candidate please call and schedule an appointment to be evaluated. Your physician and audiologist will work with you to determine candidacy for implantation. Cochlear implantation requires extensive time commitment and follow-up is critical. Therefore, motivational issues are considered in determining eligibility for cochlear implantation. According to Cochlear Corporation the following guidelines have been established by the Food & Drug Administration (FDA) for cochlear implant candidacy:

How Cochlear Implants Work 

1. Sound is received by the microphone in the speech processor.
2. The sound is analyzed and encoded into digital signals by an internal chip.
3. Coded signals are then sent to the transmitter through a thin cord.
4. The transmitter sends the code across the skin to the internal implant where it is converted to electronic signals.
5. Electronic signals are sent to the electrode array that is implanted in the cochlea and stimulate the hearing nerve fibers.
6. Signals then travel to the brain where they are recognized as sounds and produce a hearing sensation.

Surgery

Cochlear implant surgery generally takes two to three hours and is completed under general anesthesia on an inpatient or outpatient basis. The surgery involves insertion of the electrode array into the cochlea through an incision behind the ear. Your otolaryngologist will discuss with you the full procedures involved.

Activation

Your audiologist will activate your implant approximately four to six weeks after the surgery to allow for sufficient healing. Expect this initial stimulation process to take from 3 hours in one sitting to up to 9 hours over the course of several weeks.

Our office currently offers Cochlear products exclusively. The Nucleus 5 system specifically. For more information on these products please visit http://products.cochlearamericas.com/cochlear-implants

Subsequent mapping appointments are scheduled as needed. Following initial stimulation and mapping visits with your physician and audiologist will occur at six months, and then annually thereafter.

Your Audiologist's Role

• The audiologist on your team will create a unique program called a MAP for your speech processor that will allow you to hear. This MAP will be made available to you at your activation and may be fine-tuned or modified as you gain more experience with hearing.
• You will then be fit with your speech processor, which may be a behind-the-ear unit or a body worn processor.
• Your audiologist will instruct you with regard to the use and maintenance of your speech processor, advise you regarding accessories and handle equipment repairs.
• Your audiologist will also help you come up with helpful strategies to get the most out of your cochlear implant system

We offer aural rehabilitation services.

Individuals receiving cochlear implants may need to develop new listening skills. Aural rehabilitation refers to the process of learning these new skills. Aural rehabilitation is a crucial component of cochlear implant success. If we are unable to meet your needs in this area, we will help connect you to the appropriate resource. Multiple sessions may be needed to fully appreciate the skills afforded by aural rehabilitation. Also you may wish to take advantage of assistive listening devices.

Please contact us for more information or to schedule an appointment for cochlear implant evaluation.

For more information about Cochlear Implants please visit www.cochlearamericas.com

Bone-Anchored Hearing Aid (BAHA)

What is BAHA?The Baha® system utilizes your body’s natural ability to conduct sound. Bone, like air, can conduct sound vibrations. For people with hearing loss, this provides another pathway to perceive sound. 

Typical hearing aids rely on air conduction and a functioning middle ear. In cases where the middle ear function may be blocked, damaged or occluded, the Baha system may be a better option as it bypasses the middle ear altogether. Instead, sound is sent around the damaged or problematic area, naturally stimulating the cochlea through bone conduction. Once the cochlea receives these sound vibrations, the organ ‘hears’ in the same manner as through air conduction; the sound is converted into neural signals and is transferred to the brain, allowing a Baha recipient to perceive sound

Candidacy:

The Baha® system is recommended for three different types of hearing loss with specific audiological indications: 

1. Conductive hearing loss

A conductive loss may be caused by a congenital or other acquired malformation of the middle or external ear resulting in a missing or incomplete ear canal (atresia).

Causes of hearing losses can be congenital (present at birth) or acquired, and include:

• Malformation of the ear canal or middle ear
• Infection of the ear canal resulting in chronic draining ears

2. Mixed hearing loss

A combination of sensorineural (inner ear or nerve loss) and conductive loss. Baha may provide limited benefit to these individuals, depending upon the status of the inner ear/nerve, as it relies on transmitting vibration signals to a relatively healthy inner ear.

3. Single sided deafness (SSD™)

In the U.S. alone, over 60,000 people per year become victims of SSD™ through sudden deafness caused by: Viral infections

• Viral Infections
• Meniere’s disease
• Trauma
• Measles
• Chicken pox
• Acoustic neuroma (often through surgical intervention)

Surgery

A titanium post, referred to as an abutment, is skillfully implanted in the bone behind the ear by your surgeon. Following the surgery a period of 4-8 weeks is necessary to allow for complete healing of the sit and growth of bone around the abutment. This will allow the abutment to fit securely and transmit sound vibrations most effectively. Your physician will advise you specifically when you will be ready for the fitting of your sound processor. He will also answer any questions you have regarding your Baha surgery and provide ongoing care.

Fitting

Once the abutment site is sufficiently healed and your physician provides clearance, your audiologist will fit your sound processor. This small unit attaches to your abutment, converting sound into vibrations that are transmitted to your inner ear. 

Your audiologist will...

• instruct you regarding all facets of use, care and maintenance of your sound processor
• make necessary adjustments to the sound quality
• will be your resource for any concerns regarding your sound processor
• process repairs

Ultimately your physician and audiologist will determine your candidacy for the Baha system. 

The minimum recommended age for implantation is five years, as the bones in the skull must be strong enough to secure the implant and transfer vibrations. As an alternative, young children may utilize a soft headband to secure the Baha sound processor until they meet surgical candidacy requirements. 

Important Tips

• The Baha sound processor is not waterproof and should not be worn when bathing/showering, swimming or during any activity where there is a risk of moisture exposure.
• Because the Baha sits in the hair, it is succeptible to moisture from perspiration and condensation. To ensure proper functioning, it is important to utilize the hearing aid dehumidifier that your audiologists provides you.
• It is extremely important to keep the abutment site clean and free from debris. Your audiologist will provide a tool which may be used for this purpose. 
• Often, debris may accumulate in the connector on the sound processor. It is important to also clean this area regularly to ensure the optimal function of the device.
• If you experience pain or tenderness after your abutment site is completely healed, please contact our office for an appointment with your physician.
• The sound processor should be removed if you are to undergo an MRI
• The sound processor will whistle if touched or in contact with any object (e.g. hat, hood, scarf). If this occurs, try repositioning the sound processor by rotating it slightly or, when feasible, remove the object that is making contact with the sound processor.

For more detailed information about Bone Achored Hearing Aids please visit http://products.cochlearamericas.com/baha