Why don’t my hearing aids work

Hearing loss can be incredibly frustrating and isolating. If you’ve tried hearing aids but they don’t seem to work, a cochlear implant may be the best solution for you. Cochlear implants are advanced medical devices that can help provide sound to those with severe-to-profound hearing loss. In this blog post, we’ll discuss how cochlear implants work and why they can be more effective than hearing aids. We’ll also cover cochlear implant candidacy and the benefits of cochlear implants. Read on to learn more!

What is a cochlear implant?

A cochlear implant is an electronic device that helps restore partial hearing to those with severe-to-profound hearing loss. It consists of a microphone, speech processor, transmitter and receiver/stimulator, electrodes, and a power source. The microphone picks up sounds from the environment and sends them to the speech processor, which then converts the sounds into electrical signals. These electrical signals are then sent to the transmitter, which sends them to the receiver/stimulator. The receiver/stimulator then converts these signals into electric impulses and sends them along the electrodes placed in the cochlea of the inner ear. This helps stimulate auditory nerves and send sound information to the brain, which  interprets the impulses as sound.

Who is a good candidate for cochlear implants?

Adult cochlear implant candidacy criteria vary not only amongst implant manufacturers but also with insurance carriers (private commercial insurance vs. Medicare coverage)

In general, an adult candidate is 18 years or older, exhibit a moderate to profound sensorineural hearing loss in both ears, has limited benefit from hearing aids (≤ 50% sentence recognition in the implanted ear and ≤60% in the opposite ear or binaurally)

Children ages (2 – 17) should exhibit a severe to profound sensorineural hearing loss in both ears and have experienced limited benefit from binaural hearing instruments, along with Multisyllabic Lexical Neighborhood Test (MLNT) or Lexical Neighborhood Test (LNT) scores ≤ 30%.

Children (9-24 Months) will have profound sensorineural hearing loss in both ears and limited benefit from binaural hearing instruments.

Implantation surgery and the programming process

What happens during cochlear implant surgery?

Cochlear implant surgery takes place in a hospital or clinic. The surgery lasts about two hours. Patients are given medication (general anesthesia) so that they are asleep during the procedure.

The implant electrodes are placed inside the cochlea through an opening in the mastoid bone after the surgeon creates the opening.  Then, the internal processor is inserted between the muscle and bone behind the ear.

The patient is discharged after several hours of observation and can go home to rest. Once the inner ear is healed, the patient returns to the audiologist for activation and programming. This process typically takes place over several sessions with a cochlear implant audiologist and may include fine-tuning of settings such as volume, frequency, or noise filtering.The goal is to get the nerves and brain used to hearing again.

A series of programming appointments takes place during a four-week to six-week period. Early in the recovery process, most people do not understand the sounds coming through the implant. As hearing becomes more sensitive, adjustments to the volume will help accommodate the changes.

Working with your audiologist who administers auditory rehabilitation will help train the brain to interpret sounds in a way that fits with your lifestyle.  A good rehabilitation program develops the person’s ability to detect, imitate and associate meaning with the sounds of spoken language. The program will differ depending on the patient’s experience with hearing.

Hearing Aids VS Cochlear Implants

Use this reference guide to compare hearing aids to cochlear implants.

Hearing Aids Cochlear Implants
Radio Analogy All you need is to fine-tune your radio station and turn up the volume. Your radio receiver is damaged and sounds like static; turning up the volume will only make the static louder. You need a new radio.
Extent and Type of Hearing Loss Hearing loss is mild to profound.

Your type of hearing loss is either “conductive,” meaning it stems from your outer or middle ear, or “sensorineural,” meaning it stems from your inner ear or hearing nerve.

Hearing loss is moderate to profound.

Your type of hearing loss is called “sensorineural,” meaning it stems from your inner ear or hearing nerve.

Speech Understanding Excellent to fair/poor — you are able to understand approximately 50% or more of spoken words during testing. Fair to poor — you are able to understand approximately 50% or less of spoken words during testing.
What the Devices

Do and How They Do It

Hearing aids amplify acoustic sound generally and/or by specific frequencies. A cochlear implant device allows you to hear in a different way. This is called electrical stimulation. A surgically placed implant bypasses your inner ear. It translates acoustic sound into electrical signals. It sends the signals directly to the hearing nerve and then on to the brain.
Timing Generally, it takes approximately two weeks or less for you to adapt to hearing aids. Generally, it takes approximately 6 to 12+ months for you to adapt to a cochlear implant.
Surgery Required? No. Yes — outpatient surgery under general anesthesia.
Risk Little to none. Low to moderate risk, because of the surgical aspect.
Age Limit No upper age limit. No upper age limit.
Insurance Some insurance plans cover the cost. Most insurance plans cover the majority or all of the cost.

Morgan deBlecourt, “Hearing Aids vs. Cochlear Implants: Which Hearing Loss Treatment Is Right for You?”,https://www.dukehealth.org/blog/hearing-aids-vs-cochlear-implants

Bottomline

There are many benefits to cochlear implants that make them a great option for those with severe-to-profound hearing loss. Cochlear implants can help improve speech and listening skills, reduce the need to lip read, and even allow users to hear more natural sound than what a hearing aid can provide. They can also help improve balance and reduce tinnitus, or ringing in the ears.

Overall, cochlear implants are an effective solution for those with severe-to-profound hearing loss who don’t benefit from a hearing aid. Thanks to cochlear implants, people with hearing loss can enjoy improved hearing, better speech understanding, and the ability to connect with others. If you’re considering cochlear implants for yourself or a loved one, talk to your doctor about cochlear implant candidacy and how cochlear implants may be able to help improve your hearing.

Thank you for reading! We hope this blog post was helpful in learning more about cochlear implants, cochlear implant candidacy, and the programming process. By understanding cochlear implants and how they work, you can make an informed decision for yourself or a loved one.

If you have any questions or would like additional information, please contact us. We’d be happy to help in any way we can!

We wish you the best of luck on your cochlear implant journey!

Thank you for reading!

Dr. Meg Kalady

Meg has been practicing audiology for the last 30 years. She received her doctorate in audiology in 2012 from AT Still University. She is board certified in audiology by the American Board of Audiology and licensed in South Carolina and is a Dr. Cliff Au.D. Approved Provider. You can find Meg at Kalady Audiology, SC.
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Dr. Meg Kalady

Meg has been practicing audiology for the last 30 years. She received her doctorate in audiology in 2012 from AT Still University. She is board certified in audiology by the American Board of Audiology and licensed in South Carolina and is a Dr. Cliff Au.D. Approved Provider. You can find Meg at Kalady Audiology, SC.
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