Cochlear Implants

Here's our coverage of the cochlear implant presentation at the SayWhatClub 2007 National Convention. It was a wonderful convention. Our full coverage begins here.

The cochlear implant presentation was especially interesting because representatives of Advanced Bionics and Cochlear Corporation shared a workshop. It was wonderful to see these representatives working together, especially in light of some of bickering and deceptions that have sometimes been associated with brand loyalists.

Advanced Bionics

Tina Childress from Advanced Bionics started the presentation by proclaiming that she has the best job in the world, because she gets to meet lots of people and help educate them about how CI technology can help them deal with hearing loss. She noted that she is something of a technogeek and has all the gadgets. And she volunteered to help people with hooking up various devices to their CIs.

Tina was nearly ready to graduate as an audiologist when her hearing loss began. She completed her education as autoimmune disease quickly destroyed her hearing. She got her first implant in 2000, just a couple of years after her hearing loss was first diagnosed; her second implant was added in 2005.

She was able to talk on the phone and understand speech without lipreading with her first implant; her second improved her ability to localize sound and to hear in the presence of noise.

Tina gave a brief explanation of how we hear, what the most common cause of hearing loss is, and how cochlear implants bypass that cause. We've provided this information on numerous occasions and will refrain from doing so again.

The current Advanced Bionics cochlear implant consists of three parts: (1) the internal hi-res 90k component, (2) the external processor, and (3) the Fidelity 120 computer software that runs the CI.

Advanced Bionics has been using the hi-res 90k internal component since 2003. it includes 16 electrodes which stimulate different regions of the cochlea. The magnet (which holds the headpiece on) can be surgically removed to allow an MRI. And the entire internal component is designed with lots of "head room" to accommodate future software upgrades.

Consumers can choose either the ear level external processor (which resembles a BTE hearing aid) or a body worn processor. Both can use either rechargeable or disposable batteries.

The ear level processor is called Harmony. It looks much like the previous processor (Auria), except that it has a light that provides information about the status of the CI. All of the Auria accessories are compatible with the Harmony, and battery life has been improved by up to 50%. The Harmony includes a T-Mic that sits at the entrance to the ear canal. This improves with sound directionality and also allows users to use a standard telephone or headphones in a normal manner. The Harmony has a second earhook that provides for a direct connection to various electronic devices, such as an iPod. A third earhook, called IConnect, is compatible with the Phonak FM system, and the addition of a SmartLink allows the device to interface with Bluetooth enabled cellular phones.

The body processor, called the Platinum or PSP, is larger and more rugged than the ear level device. It is worn on the clothing and can be wrapped in protective materials for participation in athletics. Some people also find it very comfortable, because there is nothing on the ear.

The Fidelity 120 CI software allows users to hear much more acoustic information than previous versions. An example is the ability to process a wide range of sound volume without having to change programs. It also includes a rapid stimulation rate to increase the information available to the acoustic nerve. It provides for 120 virtual channels, which provides the user with greater frequency discrimination. The large number of channels is obtained from just 16 physical electrodes by accommodating the simultaneous stimulation of adjacent electrodes.

We also have a lot of rehabilitation materials that you can use to practice listening, things like workbooks, a listing of different websites that are good for listening practice, our C, Advocacy, Resources, and Education (CARE) program, and tools for schools. We have audiologists on call from 7AM to 7PM CST Monday through Friday to help you with CI issues. And we have an online community called HearingJourney.com that is much like the SayWhatClub.

Cochlear Corporation

Curtis Humphries from Cochlear Corporation then discussed their product. Curtis is part of the Cochlear Awareness Network (CAN), and is responsible for Cochlear volunteers in the southwest US. Curtis pointed out that over 90% of potential CI candidates don't even know about the CI, so the CI companies have a lot of work to do. Cochlear Corp is working to expand their volunteer network so they can better spread the word. The Cochlear volunteers speak at senior centers, Lions Clubs, community centers, etc.

Curtis remarked that he makes it a point to educate people about CIs at every opportunity. Whenever he gets on a plane, he educates at least three people. He also makes sure that the flight attendants know that he uses a CI.

Curtis was three years old when he lost his hearing. His first hearing aid had a big headset, much like a pair of large headphones. Later he had BTEs, and they were a big improvement. Then about five years ago his audiologist told him that there is no hearing aid that is powerful enough to do much for his left ear. He was depressed about if for awhile. But then he thought about a cochlear implant. He didn't know much about them, but he went to Johns Hopkins for an evaluation, and he soon had a CI!

At his hookup the first thing he heard were the fans for the air conditioning system. People's voices sounded like Donald Duck for awhile. But things soon became more normal, and Curtis had several of the "Aha!" moment so familiar to CI users.

If you qualify for a CI and aren't getting great results with your hearing aids. Curtis urges you to think seriously about the cochlear implant.

Curtis upgraded to the Freedom processor about a year and a half ago, and it was a significant improvement over the previous system. It has four programs.

One is called Beam and provides a more directional input than the standard program, The user can adjust the distance and angle of maximum sensitivity. It is designed to improve understanding in noisy situations, so it's great for places like restaurants.

His second program is ADRO, which has increased dynamic range. This is designed for situations that are sometimes loud and sometimes soft, so it's really good for music and movies.

A third program has automatic sensitivity adjustment, so it adjusts to provide the user with a good volume, regardless of the volume of the actual sound in the environment.

Curtis noted that many people just put their CI on and leave it alone. He urges people to explore their programs and use the best one for each situation. It takes a bit of effort, but the results are well worth it!

One of Curtis' goals when he first got his implant was to be able to use the phone. So he did a lot of practicing. He found the CapTel to be very beneficial, because he could hear the words and then read them on the screen.

But that wasn't an option when he was traveling. So he tried a cell phone and a neckloop. That worked quite well, because it allowed him to hear with both ears. And my using a setting on his CI that activated both the telecoil and the microphone, he was also able to hear sounds in his environment (including his own voice). [Ed. Note that Curtis wears a hearing aid in his other ear.]

Curtis has since told lots of people about the use of a neckloop with a cell phone, and many report very positive results.

Curtis reports that after several months of using the neckloop, he was able to use the phone by just holding it to his ear in the normal fashion. And, he noted, prior to his implant he had never used a telephone!

One nice feature of the Cochlear processor is that it is water resistant. It's not waterproof, so don't leave it in a glass of water overnight. But it is water resistant, so it won't be bothered by rain, perspiration, etc.

Curtis thinks that the name "Freedom" is very appropriate, because that's what it has given him. Visit Cochlear at www.cochlear.com

Q&A

Q For Tina: Now that you are bilateral, do you find that your ears provide about the same information?
A: I still consider my first implant to be my primary implant. Remember I have five years of additional experience with that one, so it's not surprising that I rely on it more.

Q: I notice that after I'm on a plane for a while, my CI doesn't sound as loud. Why is that?
A: That's probably fatigue in the auditory nerve. After exposure to noise for a long time, it sort of turns down the gain.

Q: You mentioned removing the magnet for an MRI. How is that done?
A: The surgeon makes a small incision and removes the magnet. It's really that simple. After the MRI, the magnet is reinserted and the incision sewn up.

Q: If I'm in an accident and am rushed to a hospital, how do the medical people know I have a CI?
A: The best way is for you to wear a medic alert bracelet or carry a card. But even if you don't, they'll probably find your CI if you're wearing it.

Q: Do implant centers have a brand preference, like hearing aid dispensers and audiologists do?
A: It varies, but many do.

Q: Are there people who have two different brands of CIs on the right and left side? If so, do they have any special problems?
A: There are a few people nationwide who have two different brands. And I don't think there are any special problems. There are a lot more people who have different generations of implants from the same manufacturer, which can be very different. And they don't have any special problems, either.

Q: How about using a CI on one side and a hearing aid on the other?
A: They used to tell you to NOT wear your hearing aid, at least for awhile. I think that's changing now, and many people are wearing one of each. We've learned that it's very important to continue stimulating both ears.

Q: What is a typical CI lifespan, and what happens if a CI fails?
A: The internal components of both companies are guaranteed for 10 years, and very few fail within that time period. Cochlear Corporation has been making CIs for 25 years and their total failure rate is about 2%