Cochlear Implants
Your Cochlear Implant Specialists In Los Angeles
All around the world, millions of people of every age are affected by hearing loss. Hearing aids represent the most common solution for helping to restore hearing loss and enrich the quality of life of those who wear them.
But when is a cochlear implant needed? To put it simply, hearing implants are often the proper solution to difficult hearing challenges when hearing aids do not adequately address hearing loss.
Both children and adults looking for improved hearing clarity and more natural sound turn to our audiologist at Pacific Hearing Inc to facilitate better communication and better hearing through the use of cochlear implants.
The cochlear implant advantage involves helping elevate speech and language processing for children as young as six to twelve years old on up to adolescents and adults. Also, these implants can be used only in one ear for single-sided deafness (unilateral) or in both ears (bilateral).
Although cochlear implant technology has been around for about 50 years, most people do not understand what cochlear implants are and how they are used.
Why Choose Pacific Hearing Inc for Your Hearing Health Care?
#1: Experience and Expertise
Our team of professionals have extensive knowledge in diagnosing and treating complex hearing disorders.
#2: Collaborative Care
A multidisciplinary approach to comprehensive care is the core value of Pacific Hearing Inc. Our cochlear implant surgeon, specialized cochlear implant audiologist, vestibular audiologists, brain health neurologists, auditory verbal therapy, and speech therapy partners meet routinely to discuss and tailor treatment for each individual patient.
#3: Accessible care
#4: Support
We have an in-house team to help schedule your visits and ensure a timely, seamless process where the patient feels well informed and part of the decision process. Our goal is to also create a Pacific Hearing Inc. cochlear implant recipient community where we host gatherings and classes that will range from hearing aid technology and cochlear implants, to speechreading and communication strategies.
#5: Innovation
#6: Second opinions
What Is a Cochlear Implant?
Cochlear implant technology development began in the 1960s and became FDA approved for adults in 1984, and for children in 1990. The cochlear implant is an electronic device that is implanted into the inner ear (the cochlea) and is used to restore hearing in patients who no longer benefit from traditional hearing aids or have hearing loss in just one ear. For children, cochlear implants are FDA approved for infants as young as 9 months old, and can often be approved off-label at even younger ages (which is routine in other parts of the world). Candidacy for this miraculous device has dramatically expanded over the past decade, offering better access to speech and language, environmental sounds, and music, to those who are struggling.
Though a cochlear implant does not re-create normal hearing, it can give a hearing-impaired person auditory understanding of the world and help people understand speech again. While hearing aids amplify sound and deliver it to a damaged hearing system, the cochlear implant bypasses the damaged inner ear structures to deliver sound directly to the hearing nerve. Research and development have improved the sound quality of these devices and created smaller external speech processors over time. As a result, patients benefit from future advancements in technology without subsequent surgeries because the manufacturers ensure the new speech processors are compatible with older internal devices. It is also important to note that the cochlear implant is not a “quick fix” and involves time, patience, and practice to meet your listening goals. Our team will guide patients through their follow-up programming visits and rehabilitation program.
Cochlear implants are covered by insurance policies including Medicare, Medicaid, private insurance carriers, and vocational rehabilitation. Candidacy criteria may be specified by specific insurance plans, and our team can help guide a patient through that process.
How a Cochlear Implant Works
A cochlear implant is made up of equipment worn on the outside of the ear and equipment surgically placed inside the ear. During surgery, a cut is made behind the ear and the internal pieces (receiver and electrode array) are secured under the skin. The electrode array is delicately placed into the cochlea, stimulating the hearing nerve when turned on.
1. External hardware (includes microphone, speech processor, coil/cable and battery)
- The microphone captures sound in the environment.
- The speech processor converts the environmental sound into a digital signal.
- The signal is sent through the cable to the transmitting coil.
2. Internal receiver
- The signal is sent across the skin to the implant, where it is converted to electrical energy and decoded.
3. Electrode array
- The electrical energy is sent to the electrode array within the cochlea, where it stimulates the hearing nerve.
4. Hearing nerve
- The stimulation of the hearing nerve is perceived as sound in the brain.
ADULT COCHLEAR IMPLANT PROGRAM
The impact of Untreated Hearing Loss on Health
1. Quality of Life
- Increased feelings of loneliness, isolation, and depression
- Less inclined to participate in activities they used to love and often “give up” participating in conversation with friends and family
2. Cognitive decline
- Hearing loss is associated with accelerated cognitive decline and dementia in older adults
3. Depression
- Significant association between hearing impairment and moderate to severe depression
4. Falls
- The brain uses sound cues to maintain spatial orientation and can hone in on spatial orienting landmarks
- People with mild hearing loss of 25 dB or greater are 3x more likely to have a history of falling
5. Every additional 10 dB of HL increases the chances of falling by 1.4 times Heart Health
- The inner ear is extremely sensitive to blood flow
- Studies have shown that a healthy cardiovascular system has a positive effect on hearing – conversely, inadequate blood flow and trauma to the blood vessels of the inner ear can contribute to hearing loss
6. Hypertension
- Significant association between high blood pressure and untreated hearing loss
- Can be an accelerating factor of hearing loss in older adults
7. Diabetes
- Hearing loss is about twice as common in people with diabetes as compared to those without the disease.
- Pre-diabetic adults whose blood glucose is higher than normal have 30% higher rate of hearing loss as compared with those with normal blood sugar
8. Osteoporosis
- This is linked by the demineralization of the three middle ear bones, which may contribute to, or cause, a conductive hearing impairment
WHO IS A COCHLEAR IMPLANT CANDIDATE?
Cochlear implants are recommended when a person cannot hear well with hearing aids, or with significant hearing loss in just one ear. The Food and Drug Administration (FDA) has approved the use of cochlear implants for adults who meet specified criteria. Cochlear implant criteria have expanded over the past years! But, shockingly, only 5% of patients who would benefit from a cochlear implant receive them.
Your cochlear implant team will complete a comprehensive evaluation with optimally fit hearing aids to determine candidacy based on insurance and FDA criteria.
• Medicare criteria is the most conservative. Moderate to profound hearing loss and poor speech understanding in both ears must be present. The ACI Alliance is lobbying to improve access for Medicare patients.• Hybrid Candidacy: Patients who have good, low-frequency hearing and very poor high-frequency hearing benefit from hybrid stimulation (acoustic and electric in the same ear).
• Single Sided Deafness/ Unilateral profound hearing loss: One normal hearing ear and the other ear with profound hearing loss.
• Asymmetric Hearing Loss: Hearing loss in both ears with poorer hearing in the ear to be implanted.
• Traditional criteria for patients 18 years old or older: Limited benefit from amplification, defined by aided speech understanding in both ears with poorer understanding in the ear to be implanted.
• At Pacific Hearing Inc. we are here to advocate for our patients if a cochlear implant is requested for “off label” use and authorization (non-FDA approved).
• Noise induced trauma to the ears
• Hearing loss associated with the aging process
• Ototoxic effects of certain medications
• Hearing loss due to meningitis or infection
• Inherited forms of progressive hearing loss
• Fractures of the skull base that impact hearing
• Severe otosclerosis (abnormal middle ear bone formation) involving the inner ears
The Cochlear Implant Evaluation Process
The purpose of the cochlear implant evaluation is to obtain a comprehensive view of how an individual is performing with optimally fit hearing aids so we can determine if a surgical approach is best suited for the patient. The evaluation does not mean you must have surgery. During the process, we obtain diagnostic information to determine implant candidacy based on FDA criteria. We also work with the patient, the patient’s support system, and our multidisciplinary team to determine the best care for individual. We ensure each patient is well informed and comfortable with their decision. It is strongly recommended to bring a support person to these visits, and we urge you to bring questions about any aspects of our process. If you are determined not to be a cochlear implant candidate at the time of your evaluation, we will explain the thought process and create a plan for your hearing healthcare. We are also able to re-evaluate in the future should a patient’s hearing change and/or FDA criteria expands.
You should think of the cochlear implant process as the start of a lifelong relationship with the Pacific Hearing Inc. cochlear implant team!
The Evaluation Process
1. Audiologic Cochlear Implant Evaluation
a. The evaluation lasts approximately 90 min
b. You can expect to complete diagnostic testing with and without hearing aids to assess your hearing status
c. You will be provided with counseling and information about hearing loss and cochlear implant benefits and limitations
d. You will discuss your specific aspirations and goals for your hearing journey
2. Balance Assessment
b. This assessment can also help us choose which ear to implant if both ears hear equally. We would choose to not implant the ear with the stronger inner ear of balance
3. Surgical Consultation
b. She will decide if you are medically a cochlear implant candidate
c. She will review the structure of your inner ear via MRI and CT imaging
d. Dr. Voelker will be able to have the meningitis vaccine administered the same day as your consultation – this vaccine is indicated for patients undergoing cochlear implant surgery
4. Brain Health Assessment
a. As one of the leading institutions on studying dementia and Alzheimer’s, we understand the important role cognition plays in cochlear implant outcomes
b. We administer cognitive screeners when indicated and will make appropriate referrals to members of our team at Pacific Hearing Inc.
5. Cochlear Implant Manufacturer Choice
a. We want our patients to make a well-informed decision about the company they will have a life-long relationship with
b. We can connect you with recipient outreach managers from all 3 device companies (or a narrowed down selection) to further review equipment options and resources
Your journey will be organized and guided by our cochlear implant coordinator coordinator and cochlear implant surgery scheduler to ensure the process is seamless and efficient.
The Surgery
The cochlear implant surgery is a 1–2-hour, outpatient procedure (the patient will return home the day of the procedure), that involves making an incision behind the ear.
The mastoid bone is drilled to get to the inner ear and the electrode is placed. Most patients resume their normal activities within days of the surgery.
You will have a post operative visit with Dr. Voelker 1-2 weeks following the surgery. Following cochlear implant surgery, the device will be turned on (activated) by the cochlear implant audiologist after 3 weeks to allow for the swelling to subside and the incision to heal.
What Happens After You Get a Cochlear Implant?
The cochlear implant is not a “quick fix” and involves time, patience, and practice to meet your listening goals. In fact, recipients usually can’t understand speech at the activation visit and may only hear a robotic quality of voice or beeps/static.
This is completely normal! Most patients perceive great benefits by 3 months after their cochlear implant activation visit. With each follow up programming (called mapping) visit with your audiologist, the sound quality improves. You will see your audiologist for your activation, 1 month post activation, 3 months post activation, 6 months post activation, and then annually or as needed.
Auditory training and rehabilitation techniques are a vital part of being a successful cochlear implant recipient. Our team will provide you with a rehabilitation training plan; we also offer to connect you with our auditory verbal therapist partners to schedule virtual or in-person visits, which can put you on a tailored treatment plan for success. Cochlear implantation is a journey for you and your support system.
Hearing loss and cochlear implantation effects the recipient and their loved ones. Our team will guide you through your post implantation visits and rehabilitation. You will have a lifelong, collaborative relationship with your cochlear implant team at Pacific Hearing Inc!
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Learn More About Cochlear Implants From Our Specialist
Cochlear implants are an advanced alternative solution for individuals with severe to profound hearing loss when hearing aids do not provide adequate hearing improvement or facilitate speech and language development. Hearing implants are an important tool utilized by Pacific Hearing Inc to help improve the quality of life for those in and around Los Angeles who qualify for them.
If you, or a loved one, are interested in finding out whether you qualify for cochlear implants or just want to know more about our program, just complete and submit the adjacent form, and our specialist will contact you.