Hi, my name is dr sarah beatty and i'm a fourth year audiology extern here at the house clinic
i'm here to talk with you guys today about what to expect at your cochlear implant candidacy
evaluation appointment so first and foremost let's start with what is a cochlear implant
a cochlear implant is a device that helps people with moderately severe
to profound sensory neural hearing loss it consists of two parts an internal implant
and an external speech processor let's take a deeper look at these two components
so the internal implant is surgically implanted by a physician and to your inner ear or to
be specific your cochlea it's a 90 minute outpatient procedure under general anesthesia
the external sound processor magnetizes to the internal implant and it picks up the sound via
a microphone and then transmits that sound to the internal implant in order for you to be able to
hear with the cochlear implant you have to wear the external component without it you do not hear
so first let's take a look at how we normally hear so there are three components of your ear
there's your outer middle and inner ear the sound travels through your outer ear
down your ear canal and it vibrates your tympanic membrane or ear drum that vibration of the eardrum
causes the three tiny bones on your ear or your middle ear to vibrate which then
causes the fluid and your cochlea to displace which stimulates the hair cells in your cochlea
which sends the signal up to your auditory nerve and to your brain to allow you to hear
because we ultimately hear with our brain not our ears
now one thing to note when we look at normal hearing people versus people with hearing loss
is people with hearing loss people with normal hearing as you can see in this picture have
numerous hair cells in your cochlea and when those hair cells are stimulated
they cause the nerve to be stimulated sending that signal to the brain if you take a look at
the picture with the damaged cochlear hair cells you can see there's not as many hair
cells so if you don't have enough hair cells to be stimulated the signal cannot be sent to the brain
how is a cochlear implant different from a hearing aid well first and foremost a hearing aid
is sending signal to your through your ear via acoustical stimulation the sound travels down
your ear canal through the middle ear and it stimulates those hair cells and your cochlea
which then cause the auditory nerve to fire and send the signal to your brain
when we look at cochlear implants cochlear implants are bypassing our outer and our middle
ear and they're even bypassing our hair cells they're directly stimulating the auditory nerve
the sound electrically stimulates the auditory nerve and bypasses all the other parts so when
we think about hearing aids in comparison to cochlear implants it's important to understand
that the stimulation type is completely different hearing aids is acoustic and cochlear implants is
electrical stimulation so taking a closer look here at how we hear with hearing aids
you can see in this visual you have the hearing aid the sound is picked up by the microphones
on the hearing aid and processed in the hearing aid the sound then travels down your ear canal
causes that tympanic membrane to vibrate and the three little bones to also vibrate
and then it stimulates our cochlea the sound does once the sound reaches our cochlea it stimulates
those hair cells which activate the auditory nerve and send the signal ultimately up to the brain
if we look at how we hear with the cochlear implant it's a little bit
different as i mentioned earlier the sound is picked up by the cochlear implant microphones
it's processed then it's sent to the headpiece which magnetizes to your internal implant
that signal is sent to the internal implant and electrical signals stimulate the auditory nerve
the signals from the auditory nerve are then sent to the brain
so ultimately what is the goal of a cochlear implant evaluation appointment
our goal as audiologists is to see if you are a candidate for a cochlear implant
what will happen at this appointment is your audiologist will first and foremost get to know
you and your history with hearing loss and your history with using hearing aids your hearing aids
will be assessed to ensure that they're providing the appropriate amount of amplification for you
if it's determined that your hearing aids aren't providing the appropriate amount of amplification
you'll be fit with some hearing aids from the clinic to borrow during the appointment
following that you'll be taken to a sound booth for a series of tests with your hearing aids on
during this testing you'll be asked to repeat back words sentences and you'll be asked to respond
when you hear the tone or the beep if you have balance issues or are 65 years
old or older you will also undergo a balanced test following your evaluation appointment
so what happens if it is determined that you are a cochlear implant candidate your audiologist
will review with you realistic expectations with the cochlear implant they'll go over the
cdc recommended vaccinations prior to surgery you'll choose the device and manufacturer you
would like to go with and you'll set goals for your hearing with the cochlear implant
what factors can affect your outcomes with a cochlear implant
there have been numerous research studies to show that there are these five factors that can
affect your outcomes with a cochlear implant one of those is your duration of hearing loss
how long you've had hearing loss another factor is the status of your inner ear and hearing nerve
this is why your physician will request that you get imaging done prior to surgery to ensure the
status of your inner ear and hearing nerve is appropriate another factor that can affect your
outcomes is the age of onset of your hearing loss or when you are diagnosed with your hearing loss
along those same lines your age at the time of implantation can also affect your outcomes and
lastly any other related medical conditions can also affect your outcomes with a cochlear
implant so always be sure be sure to share all of your health concerns with your audiologist
and your physician so what is your commitment with the cochlear implant if you choose if you
are a cochlear implant candidate and you choose to go through with a cochlear implant
what what is that process going to look like for you
well one thing to know is it's not an instant flip of the switch and you're good to go there is
a series of follow-up visits as well as oral rehabilitation exercises
so in regards to visits we recommend or you will see your audiologist for five visits following
surgery which is spread out over the year you'll also have annual follow-up visits after that year
in regards to our rehabilitation exercises these will be especially important at first because we
have to retrain your brain to hear and also to make sense of that electrical stimulation
from the cochlear implant rl rehabilitation exercises can include reading aloud listening
to books on tape and apps but don't worry your audiologist will give you a whole packet of
different activities you can choose from the other commitment is it's really important that with
a cochlear implant that you wear it all waking hours we want to make sure that you're using it
all weekend hours because that helps your brain be able to adjust to getting used to that sound
so what are the cdc vaccination recommendations prior to surgery the cdc recommends two vaccines
prior to surgery as a preventative measure these vaccines are prevnar 13 and pneumovax 23. prior to
your appointment for your evaluation we recommend that you please call your primary care provider
to see if you've received these vaccinations and if so bring in the records of them if you've not
received them and need a prescription to get them we'll provide that to you at your appointment time
so how do you select your cochlear implant manufacturer well there are three different
cochlear implant manufacturers cochlear americas advanced bionics and metal one thing to know
is that one manufacturer is not superior to the other all three offer safe and effective devices
so one thing to know when choosing your cochlear implant manufacturers
is to know that there are commonalities among all three one commonality is that you'll get two sound
processors regardless of the manufacturer so at your time of surgery you'll get two process
sound processors that's the external component the reason for that is we want to always make
sure that you have a backup processor we never want you to be without your ears
another thing to know is that all three cochlear implant manufacturers are mri compatible
additionally all three manufacturers have bluetooth capabilities they all have apps for
your smartphone and they all have diff um similar assistive listening devices and accessories
so if they have all of this in common and they're all safe and effective how do i choose my cochlear
implant manufacturer well it really comes down to what features are important to you based on your
lifestyle and your listening goals for example some manufacturers have compatible hearing aids
some have different style sound processors it really comes down to what
you're most drawn to and what's important for your lifestyle
for additional information on cochlear implant manufacturers you'll see listed here the phone
numbers and emails you're more than welcome to reach out to these manufacturers to get
more information and we highly recommend you do your research before you come in
so how can you prepare for your cochlear implant evaluation appointment first and foremost
come to your evaluation appointment with your hearing aids and vaccination records
we want to see that you've had those two vaccines that the cdc recommends
additionally understand that you're going to undergo testing with your hearing needs to
determine if you're a cochlear implant candidate if you are determined to be a candidate you will
select your manufacturer and learn more about realistic expectations with a cochlear implant
come prepared with any questions you may have we look forward to seeing you
hi i'm erin associate director of education and global hearing health here at the house
institute foundation thank you for watching our video if you would like to support
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