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Cochlear Implants - Who Are the Candidates?

Professional Services Coordinator
Bionic Ear Association
Advanced Bionics
Santa Clarita, CA


May is Better Hearing Month and it is, therefore, a perfect time to reflect on the technical advances in the treatment of hearing loss.

Today, children are identified with hearing loss at birth as a result of several state mandated newborn screening programs. Hearing health care professionals can provide even better rehabilitation options for hearing loss with new forms of digital and implantable hearing aid technology. However, one of the most remarkable advancements we have seen to date is the development of the cochlear implant and the profound impact it has had on patients lives.

A cochlear implant is a prosthetic device surgically implanted into the cochlea (inner ear) providing direct electrical stimulation to the auditory nerve. Cochlear implants are the only FDA approved treatment for severe and profound sensorineural hearing loss. Cochlear implants are not hearing aids. For many patients with severe to profound hearing loss, hearing aids provide amplification, but speech understanding remains poor due to distortion within their own damaged hearing system.

In contrast, cochlear implants bypass the damaged hearing systems, and directly stimulate the hearing nerve, providing the opportunity for significantly improved speech understanding.

In the 1980s single channel cochlear implant technology was originally FDA approved, with the goal of providing sound awareness to profoundly hearing impaired patients. Today, with multi channel implants and advanced digital processing, the vast majority of cochlear implant patients have gone way beyond basic sound awareness, and are achieving remarkable levels of speech understanding, many cochlear implant patients today are even communicating effectively on the telephone.

The next frontier in cochlear implant research is looking to improve speech understanding in noise and to provide patients with greater music appreciation through high resolution sound processing and through bilateral (both ears) cochlear implants.

A recent clinical trial showed that adult cochlear implant users improved speech understanding from 21% with hearing aids to 84% with their cochlear implant. For many individuals, that is the difference between having to use a keyboard-based telephone device (TTY) rather than a phone. Nonetheless, assistive listening devices (ALDs) and hearing aids used in the non-implanted ear provide many patients maximal use of their residual hearing, and allow the opportunity to hear comfortably in many difficult listening environments.

Many children born today with significant hearing loss are identified and implanted by 12 months of age. As a result, many of them develop age appropriate speech and language skills, and sit beside their normal hearing peers in mainstream classrooms with little assistance.

Adult cochlear implant candidates include; those who experience sudden hearing loss, those who have hearing loss dues to a history of occupational or industrial noise exposure, those with ear disease (such as Menieres disease or meningitis), those with progressive hearing losses, and many other hearing loss origins. For these adults, they no longer have to slip into a world of isolation as their ability to communicate via hearing becomes a constant struggle.

Cochlear implants have improved the quality of life for 75,000 people with severe to profound hearing loss across the world. However, only 5% of people with severe to profound hearing loss have received cochlear implants. The majority of cochlear implant candidates continue to struggle with their hearing loss and their ability to communicate. It is important that individuals living with hearing loss, hearing health care providers, and family and friends are aware of the benefits cochlear implants can provide, to help present the opportunity of cochlear implantation, to appropriate candidates. Cochlear implants greatly improve the quality of life.

Who is a candidate for a cochlear implant?

Todays candidates include adults with severe hearing loss defined as 70 dB hearing loss or worse, and aided speech understanding abilities 50% or less on open set sentences (please see your hearing healthcare professional for detailed explanation of these measures). In the year 2000, the FDA approved implantation for children as young as 12 months. In addition, adults well into their 90s have received cochlear implants.

Cochlear implant centers are located across the United States. These centers efficiently determine cochlear implant candidacy through comprehensive medical and audiologic evaluations. Cochlear implant centers, along with manufacturers, can assist with insurance submissions and appeals. Cochlear implants are typically covered by private insurance companies, as well as Medicare and Medicaid. Through collaboration of all parties involved, patients will be prepared with the necessary tools to overcome their hearing disabilities, maximize their hearing potential, and achieve independence.

Imagine the possibilities!

For Better Hearing Month, if you would like to obtain more information for yourself or a loved one regarding cochlear implants, please CLICK HERE. Fill in the form and SUBMIT it (by clicking SUBMIT at the bottom of the form) and well connect you with an implant center, other cochlear implant users, and help with insurance and reimbursement claims for the process.

For more information on cochlear implants, you can also visit the Advanced Bionics website at www.bionicear.com or contact the Bionic Ear Association directly at info@advancedbionics.com (1-800-678-2575).

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