If you have hearing loss due to sounds being blocked (conductive hearing loss) or are deaf on one side, you may benefit from a bone-anchored hearing aid (BAHA). With a conventional hearing aid, the sound waves need to travel through your entire auditory system, which includes the outer, middle, and inner ear. With a BAHA, the sound will bypass these parts and stimulate your inner ear directly by providing vibration directly to your head. Surgical approaches to hold the BAHA processor include a magnet attached to your skull under your skin and a small abutment (screw) that provides a direct connection.
Implanted Bone-Anchored Hearing Aid (BAHA)
A cochlear implant is an electronic device that is used to treat severe to profound sensorineural hearing. It is surgically implanted in the inner ear and activated by a device worn outside the ear. Unlike a hearing aid the device bypasses the damaged cochlea (inner ear) and directly stimulates the nerve of hearing, allowing individuals who are severely to profoundly hearing impaired to receive sound. Sensorineural (‘nerve’) hearing loss can usually be ameliorated with hearing aid usage. When the hearing loss is so severe that hearing aids are not adequate, cochlear implantation surgery is an excellent option.
How Do Cochlear Implants Work?
Cochlear implants convert sounds into electrical signals, bypass damaged hair cells in the inner ear, and send these signals to the hearing nerve. The implant consists of a small electronic device, which is surgically implanted under the skin behind the ear and an external speech processor and microphone, which are worn behind the ear. The microphone picks up sound and the speech processor translates it into distinctive electrical signals. These ‘codes’ are transmitted across the skin to the implanted electrodes in the cochlea. The electrodes’ signals stimulate the auditory nerve fibers to send information to the brain where it is interpreted as meaningful sound.
Who is a Cochlear Implant Candidate?
Implants are designed for individuals who cannot attain adequate benefit from a hearing aid. There is no upward age limit for cochlear implantation. To determine if you are a candidate, you will first need a Cochlear Implant Evaluation.
What is a Cochlear Implant Evaluation?
A cochlear implant evaluation assesses whether the patient is an appropriate candidate for this surgery or not. These include in depth hearing tests, as well as speech in noise tests. You will be tested with and without hearing aids during the evaluation.
Cochlear Implant Surgery
Implant surgery is performed under general anesthesia and lasts from two to three hours. An incision is made behind the ear to open the mastoid bone leading to the middle ear. The procedure may be done as an outpatient, or may (rarely) require an overnight stay in the hospital. Your doctor will discuss the details of the surgery with you.
What Can I Expect from An Implant?
Cochlear implants benefits vary from one individual to another. Nearly all users find that cochlear implants help them communicate better through improved lip-reading, and well over half are able to discriminate speech without the use of visual cues. Many implant users are able to use the telephone effectively. For adult implant recipients, shorter duration of deafness is very important for better early implant outcome.
There are many factors that contribute to the degree of benefit a user receives from a cochlear implant, including:
- how long a person has been deaf,
- the number of surviving auditory nerve fibers
- a patient’s motivation to learn to hear
Your team will explain what you can reasonably expect. Before deciding whether your implant is working well, you need to understand clearly how much time you must commit. A very few patients will not benefit from their implant.
Hearing After the Implant
A cochlear implant is usually activated about one week after surgery. Immediate success is rare. It typically takes months to learn to use the cochlear implant and for sounds to seem normal. Our patients have many sessions with the audiologist over the first several months to help make the sound from the implant more comfortable and audible. Counseling and training are ongoing, and many patients also benefit from formal auditory therapy following surgery.
FDA Approval for Implants The U.S. Food and Drug Administration (FDA) regulates cochlear implant devices for both adults and children. Because implantation has been proven to be effective and safe since its first approval for adults in the mid 1980’s, the FDA has expanded criteria and now approves unilateral (one-sided) and bilateral (both sides) cochlear implantation in adults and children as young as age 12 months.
How Much Does a Cochlear Implant Cost?
The total cost of a cochlear implant including evaluation, surgery, the device, and rehabilitation will vary. Because this is not a hearing aid and because it is FDA-approved for hearing restoration, most insurance companies provide benefits that cover the cost. Before you undergo surgery, our office will obtain the insurance precertification that is necessary to ensure that your health insurance company will cover these costs.