Cochlear Implant: When the other hearing devices DO NOT work
Cochlear implant is a life-changing transplant-able hearing device that helps thousands of people across the world to hear better. This is used when the traditional hearing devices fail to provide an optimum level of speech understanding. Unfortunately, there is scarcity of awareness about this device not only in the members of public but also in hearing care professionals (www.bcig.org.uk). Therefore, I decided to include a short post on the basic information about the cochlear implants here. Please do contact us for further information, should it be required.
Ref: Here’s a picture of Cochlear Nucleus Implant available to your healthcare professionals via www.cochlear.com
What is it?
A surgically implanted hearing device for people with hearing impairment who do not get enough benefit from traditional hearing aids and struggle with day-today communication. It is suitable for both children and adults.
The device consists of two parts: external processor that looks like a powerful hearing aid and the internal part that is surgically implanted in the ear. The surgery is performed by an expert ENT Surgeon. Audiologists usually get involved in making the technology work. Speech therapists within the implant team will often train the person with cochlear implant so their brains get accustomed to interpreting the sound coming through the implants.
When should the implant be considered?
Ref: https://www.medel.pro/indications#highFrequency
20 years ago when I first trained in audiology and was involved with cochlear implants, we were only accepting referrals for children and adults who had severe to profound hearing loss in both ears and were only giving them one implant. However, the evidence has since improved and now cochlear implants are also available for mild to severe steep sloping hearing losses. There many individuals who receive bilateral cochlear implants too.
The National Institute for Health and Care Excellence (NICE) Guidance for Cochlear Implants:
The 2019 NICE guidance (TA566) defines who is eligible for a cochlear implant as follows:
For people hearing only sounds that are equal to or louder than 80 dBHL at two or more frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz and 4,000 Hz) bilaterally without acoustic hearing aids.
For adults, a phoneme score of 50% or less on the Arthur Boothroyd word test presented at 70 dBA (in the best aided condition).
For children, speech, language and listening skills not appropriate to age, developmental stage and cognitive ability.
You may generally consider cochlear implants for people who:
Have severe-to-profound sensorineural hearing loss or a steep-sloping hearing loss in both ears.
Get limited benefit from hearing aids.
Are motivated to attend programming sessions, aural rehabilitation sessions and practice listening in daily communication.
Have no medical contraindications.
Children of most ages may benefit from cochlear implants, and there is no upper age limit for cochlear implantation. You may also be able to have a traditional hearing aid on one ear and cochlear implant on the other side.
Who should have it?
There are a lot of reasons why one would struggle to hear better despite having the best hearing technology. Your hearing care professional should be able to optimise the technology for you appropriately by using evidence-based approach. The process of prescription of amplification in the hearing devices should begin with something called Real-Ear-Measurements (REM). Your graph of hearing indicates how much sounds you need in your ear, based on number of researches done in the past on different kinds of hearing losses. REM will show how much sound you have in your ear with the hearing devices. When the amplification is optimised via REM, the outcomes of the hearing device prescription process have been shown to be better in a number of independent studies. These measurements ensure that you get the right amount of sound in the ear with the hearing technology.
Beyond the above verification process, which starts the hearing journey; there are several validation techniques that the audiologists use in order to make sure the hearing devices are helping you much as they can. Sometimes, some additional technology such as remote microphone and TV streamer etc are employed to get the maximum out of your hearing devices.
However, some hearing loss configurations do not enhance the listening ability enough in some children and adults despite the well-fitted and well-monitored hearing devices. This is because either there is a medical issue in the hearing pathway to the brain that hinders the sound transmission or perhaps the residual hearing in the Inner ear is not conducive for optimum sound transmission. When the traditional hearing technology fails, the cochlear implant can prove to be invaluable help.
Modern surgical techniques and technology has meant that the minimum and maximum age for cochlear implants has been continuously challenged. There are several reported cases where cochlear implant surgery has been performed on babies less than a year old and adults over 90 years of age.
How do I get a cochlear implant?
British Cochlear Implant Group (BCIG) has a very helpful list of cochlear implant centers with contact details on their website here: https://www.bcig.org.uk/type/contact-centre/
Cochlear implants are available via NHS. Most hearing care providers in private or NHS settings are able to refer patients directly to the nearest cochlear implant center. If the basic criteria for referral is met, you will be invited for an appointment for further consultation and assessment by the implant team. Cochlear implant teams have highly trained ENT Consultants, audiologists, speech therapists etc who will be able to answer all your questions and even be able to get you to speak with other people who have had implants. Referral to an implant team does not necessitate or guarantee an implant. Once your eligibility to have an implant is confirmed, it is a very open and involved process where the final decision on whether you would have an implant be taken by you, once you have been given all the information.
Cochlear implants are proven to be successful means of hearing improvement in individuals who do not benefit from other traditional forms of hearing devices. If you feel that you may fit the cochlear implant need criteria, the first step is for you contact us or your nearest hearing care professional for more information.
https://www.advancedbionics.com/com/en/home/solutions/marvel/adult.htmlRef: Naida Cochlear Implant by Advanced Bionics-
Important links
https://www.cochlear.com/uk
https://www.advancedbionics.com
https://hearlife.medel.com
