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Frequently Asked Questions about Cochlear Implantation
Hearing starts with sound waves that travel into the ear canal. The sound waves then vibrate the eardrum, which in turn moves the 3 tiny middle ear bones the malleus, incus and stapes. The stapes is attached to the inner ear or cochlea. When the stapes moves it causes the fluid in the cochlea to move as a wave. This wave of fluid movement will move microscopic hairs on cells called "hair cells" which are attached to the hearing or cochlear nerve. When the hair cells are stimulated it produces an electrical impulse or action potential in the hearing nerve, which brings the hearing signal to the cortex of the brain where we are able to process what we hear. Why do people have hearing difficulties? There can be hundreds of reasons as to why someone may have hearing difficulties. A few of them include:
In addition to the reasons why someone may have difficulty hearing, there is often no explanation as to why someone progressively or suddenly loses their hearing. A cochlear implant is truly a medical miracle that allows the restoration of hearing to the majority of patients who have suffered a severe to profound hearing loss in both ears. It consists of an internal electrode that is surgically implanted in the inner ear and stabilized under the skin. The external component is a sound processor that transmits sound to the electrode via a magnetic link. The electrode then stimulates the fibers of the auditory (hearing) nerve, which in turn, transmits sound to the brain. Who is a candidate for a cochlear implant? An adult patient who has severe to profound hearing loss affecting both ears, little to no benefit from hearing aids, and scores less than 50% on sentence recognition tests, is a candidate for a cochlear implant. What is the difference between a cochlear implant and a hearing aid? A cochlear implant bypasses the inner ear and is intended for people who have very little inner ear function left and have a severe to profound hearing loss in both ears. A hearing aid amplifies sound and relies on the hair cell in the inner ear to function and transmit the sound to the hearing nerve. This will benefit someone who has a partially functioning inner ear. Profound hearing loss is when you are unable to hear sounds unless they are very loud at 90 dB or above. It is basically a state of being deaf. Why is a cochlear implant not suitable for everyone? A cochlear implant is not suitable for everyone because not everyone has severe to profound hearing loss. Some people who have difficulty hearing are able to alter their situation in order to hear. For example, someone may have to sit closer to the stage in order to hear a play or maybe turn up the volume in order to hear the radio. Most people with hearing loss can receive significant benefit from hearing aids. Someone who experiences profound hearing loss is unable to hear simply by altering their situation or by using a hearing aid, but they may receive benefit from a cochlear implant.
What are the benefits and limitations of a cochlear implant? The benefit of a cochlear implant can be a dramatic improvement in hearing. The ability to hear environmental sounds, the improved ability to read lips and in many cases to be able to understand speech and conversation without reading lips and recovering the ability to talk on the telephone are all potential benefits of a cochlear implant. Some people will be able to appreciate and listen to music though this often takes a fair amount of time and not everyone will receive that much benefit from an implant. A large number of patients can get back into a normal life, return to work and improve their chances for success. The limitation of a cochlear implant is that not everyone will have a stellar result. For some people who obtain an implant their results may be more limited. Not everyone will be able to use the telephone or understand speech without reading lips, but in most cases the results will be beneficial to the individual receiving the implant. A very small percentage of patients with a cochlear implant may receive no benefit. All natural hearing in the implanted ear in most cases is lost with placement of a cochlear implant, but usually the hearing result obtain more than makes up for that. One of the limitations for those who have dramatic or not so dramatic improvement is that once the external processor is removed, there is still deafness. Please explain the recovery and activation process. After the initial implant, the patient will be required to take it easy for a few days. They may experience some dizziness or pain, which is normal during this time. After one week, the stitches will be removed. The healing process will take between three to six weeks. At the end of this time, the patient will meet with the audiologist who will begin the activation process, which involves hooking up the external components of the cochlear implant. The audiologist will individually program the implant so it is suitable to the patient. Afterwards, the patient will spend the next couple of days working with the implant to find out what is and is not working for them and will meet with the audiologist a total of 3 or 4 times on average to get the implant adjusted so the patient can maximize their benefit. Over time and with use of the implant the hearing tends to get better and better. The patient will need to meet with the audiologist periodically for "tune-ups" of the implant as their hearing changes. What is a Cochlear Implant Evaluation? A cochlear implant evaluation is designed to determine if a patient is a candidate for a cochlear implant. It consists of:
Does Health Insurance cover Cochlear Implants? Most health insurance providers, including Medicare, cover cochlear implants. If you have any questions about your coverage, please check with your health insurance provider. Our financial counselors would be happy to assist you in this regard. How do I arrange for a Cochlear Implant Evaluation? To arrange for an evaluation, simply call 215-662-2784 or 800-789-PENN. For more information concerning Cochlear Implants, please call 800-789-PENN (7366). And, for the hearing impaired, please call our TDD number at 215-662-7564.
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