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Considering Cochlear Implants? Find Out If You’re a Candidate

Pacific Hearing Service has been helping Silicon Valley’s residents with expert hearing care since 1977. One of the reasons why we can provide our excellent care here is thanks to the wider group of medical health specialists we partner with.

When you come to Pacific Hearing Service for a hearing evaluation, we strive for the best possible outcomes.

Today, with the advent of innovative technology, even for patients who are not able to benefit from traditional hearing aids, there are still answers.

For people with a severe or profound hearing loss, there is good news. Cochlear implants have come a long way since the 1980s when the FDA approved them to treat adults with a profound hearing loss that could not be helped with standard hearing aids.

Later, in 2000, cochlear implants became available for children beginning at 12 months of age. In the past twenty years, there have been over 100,000 devices implanted in adults and over 65,000 devices implanted in children in the United States alone.

For adults, cochlear implants can be offered when the person has lost all or most of their hearing later in life. This is called being post-lingually deaf since they have already developed speech and language.

Since speech sounds different with a cochlear implant, the person learns how to identify words in a new and different way. This takes time and practice but can lead to a remarkable improvement in speech understanding.

In children, cochlear implants can be prelingual (before speech and language skills development) or postlingual such as in most adults.

Cochlear implants can be a true miracle in children since they are often able to catch up to their peers with normal hearing.

What Are Cochlear Implants and Am I a Candidate?

  • Cochlear implants are surgical implantations of electrodes in the cochlea, a part of the inner ear. The electrodes are stimulated via a sound processor which collects the sound through a microphone, processes it for the person’s specific hearing profile, and transmits the sound to the receiver.

These devices replicate hearing by processing sound into electronic signals. These are the solution for patients when hearing aids will not work.

  • The sound processor is placed behind the ear to process sounds. It does this by digitizing the sound signals and then sending these electrical signals to the receiver.
  • The receiver for these stimulations is placed under the skin, and this sends the sound signals to the electrodes and subsequently to the nerve and brain, enabling the person to hear sounds again.

Cochlear implants will not return hearing to normal, but they can dramatically improve hearing for someone with a severe hearing loss.

It is especially important to realize that having the surgery is only the first step in hearing. The rest is up to the patient and a specially trained audiologist who will work together during the rehabilitation process. In some cases, the involvement of a speech-language pathologist is needed.

Surgical Procedures

Cochlear implants are done under general anesthetic and can often be done as an outpatient. Not every ENT surgeon performs cochlear implants, so it is important to find one who is an experienced cochlear-implant surgeon.

Some of these specialists are referred to as otologists or neuro-otologists and they have additional years of training.

The cochlear implant procedure involves an incision behind the ear and surgery performed in the mastoid bone.  Ask your surgeon what to expect. He or she can best explain the risks of the surgery. Although it is considered safe, all patients should have a full understanding of the rare potential complications.

After the surgery, a series of appointments for the few months following the surgery is required.

It is like getting a fancy new car. If a patient does not learn how to drive it, there is a chance it will just sit in the driveway and never be used to its fullest potential. It is extremely important to have specially trained audiologists available post-operatively. For children in particular, a speech-language pathologist is an important part of the team.

This is because:

  1. The sounds the brain hears are different to what the recipient is used to, and it takes time to learn how to distinguish the different sounds.
  2. Activating the cochlear implant is done in exceedingly small steps by an audiologist, building from soft sounds to regular sounds over time.

The implanted electrodes should last a lifetime. Unlike a hip surgery, there is no need to redo the surgery every ten to twenty years. There may be new sound processors, the outer part of the cochlear implant, available over time.

Who Are Good Candidates?

Many adults benefit from cochlear implants.  We consider your hearing loss profile, medical history, history of hearing aid use, and your current level of word recognition when assessing your candidacy. In 2020, the “60/60” rule was established as a guideline for cochlear implant candidacy.

This rule states that patients should be referred for a cochlear implant evaluation if their word understanding in the better ear is 60% or less and if they have an unaided pure-tone average that is greater than or equal to 60 dB.

Living an Active Life with These Implants

Cochlear implants do not substantially limit everyday activities. Only activities that would place high pressure on the inner ear, such as skydiving or scuba diving, are prohibited.

The external processor can be removed for swimming and showering, and protective headgear is worn for activities such as football or boxing.

 

The Cost of a Cochlear Implant

The cost of these implants is usually covered by your health insurance. A full inquiry can be performed to anticipate what, if any costs, would be incurred.

Find Out If You Are a Good Candidate

The first step to finding any working hearing solution is to have your hearing evaluated by one of our audiologists. If you meet audiometric criteria for an implant, a medical evaluation by a cochlear implant surgeon is the next step. He or she will check for other pathologies that may need an alternative treatment.

At Pacific Hearing Service, we will answer all your questions and go over your options from there.

For people who receive limited benefit from hearing aids, a cochlear implant can change lives.

Thanks to our cochlear implant program, we can safely say that we are one of the top hearing clinics in Silicon Valley, and we will do all we can to help you hear and communicate better. So come see us!

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Deborah Clark, Au.D.

Dr. Deborah Clark has been with Pacific Hearing Service since 1998. In January 2008, she became co-owner working first in the Menlo Park office and now managing the Los Altos office. She is a Fellow of the American Academy of Audiology and is certified by the American Board of Audiology. She was on the board of the Hearing Loss Association of America, California State Association from 2010 – 2013, and served as Vice President.

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