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The continuous improvement in cochlear implant technology and a commitment to research and rehabilitation has enabled specialists in Penn's Department of Otorhinolaryngology: Head and Neck Surgery to offer an alternative to individuals with severe-to-profound hearing loss who no longer benefit from a hearing aid.

“Cochlear implant surgery is simple, safe, and its benefits are well established. Patients are extremely gratified that they are able to better communicate, enjoy music and be more independent,” says Michael J. Ruckenstein, MD, otorhinolaryngologist and director of the implantable devices program at Penn. “Often, elderly patients, their physicians or caregivers, believe deafness is a byproduct of aging. Age should not be considered a contraindication for cochlear implant surgery.”

There are approximately 22 million hearing impaired persons in the United States, and more than 600,000 are adults who have a severe-to-profound sensorineural hearing loss in both ears. Most are individuals who once had normal hearing and had developed normal speech and language.

Evaluation and Surgery
An audiologist performs the non-medical preoperative evaluation and postoperative activation of the implant. “An audiogram, a partial balance study and an evaluation of the patient's communication are conducted to determine if the patient is eligible for a cochlear implant. According to FDA criteria, the patient must have severe-to-profound sensorineural hearing loss and cannot have greater than 40 percent sentence understanding in the best-aided condition,” explains Michelle Montes, MS, cochlear implant audiologist at Penn.

During surgery, an electrode is placed in the ear under the skin. This electrode provides an electrical signal to directly stimulate the hearing nerves bypassing the inner ear that is no longer functioning. An external processor worn behind the ear, translates the surrounding sounds into signals that can be sent to the hearing nerve and be recognized by the brain as sound. The processors are most commonly worn at ear level much like a hearing aid with a compact radio frequency transmitter kept in place on the head with a magnet. The processor is easily removed when showering, sleeping or when participating in water sports.

At Penn, patients are able to choose from one of the three FDA approved devices. “Each device is different and requires its own expertise and software. We are comfortable working with all three implants and patients can select the one that best meets their individual needs,” says Dr. Ruckenstein who together with his colleague Douglas Bigelow, MD, otorhinolaryngologist at Penn, perform approximately one to two cochlear implant surgeries each week.

Rehabilitation
Four weeks after surgery patients receive the external processor and programming begins. “Generally, the earlier age of onset of the individual's deafness, whether or not they acquired speech and language, and the longer the duration of deafness, the more rehabilitation they require,” explains Montes.

Many patients gain use of the phone, go to the movies or theater, and are able to function in conversations in noisy environments. Others don't acquire the ability to use the phone but still participate in conversations, public meetings and more.

Research and Future Enhancements
Otorhinolaryngologists at Penn were one of the first in North America to perform cochlear implant surgery in the 1980s and continue to be involved with all major research efforts in this field. An upcoming clinical study will examine the efficacy of a combination conventional hearing aid and cochlear implant. This new hybrid implant/hearing aid will attempt to optimize hearing for severely hearing impaired patients who have poor results from their hearing aids or do not meet the FDA criteria for implantation.

Experts also anticipate beginning initial studies for the totally implantable cochlear implant in the next year or two. More research continues to look at improving sound processing strategies and the benefits of bilateral cochlear implants.

For more information concerning Cochlear Implants, please call 1-800-789-PENN (7366). And, for the hearing impaired, please call our TDD number at 215-662-7564.

 

	Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.