Patients with moderate to severe sensorineural hearing loss may be good candidates for an implantable middle ear device. These devices simulate natural hearing with greater clarity than hearing aids, and have the added bonus of leaving the ear canal open. In addition, feedback and background noise are virtually eliminated.

Several types of devices can be considered implantable hearing devices.

These include:
Cochlear implants
Bone-anchored hearing devices
Middle-ear implantable devices

Dr Jack Shohet, Shohet Ear Associates

Dr. Shohet was the first Orange-County based surgeon to implant middle ear devices. In addition, Shohet Ear Associates is one of only eight sites worldwide and six in the United States engaged in clinical trials of a totally implantable hearing aid.

Cochlear Implants

A Lifelong Solution for Severe to Profound Hearing Loss.

If you or a loved one have hearing loss in both ears and are not able to benefit from hearing aids, a cochlear implant may be a solution. It is designed to help you get back the sounds you’ve been missing by giving you the clarity you need to hear better and understand speech, even in noisy environments.

What is a cochlear implant?

A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear.

The processor sends hearing sensations to the implant, which in turn transmits these signals to the auditory nerve of the brain. The signals are then interpreted as sound.

A cochlear implant system has two main components:

  • The first is an internal component (the receiver stimulator and electrode array) which is placed just under the skin behind the ear by a surgeon.
  • The second is an external component (the headpiece and audio processor) that is worn over the ear and attaches to the surgically placed receiver stimulator with a magnet through the skin.

Who is a cochlear implant good for?

Cochlear implants are designed for people with severe-to-profound sensorineural hearing loss. With this type of hearing loss, the hair cells in the inner ear are damaged and can’t detect sounds properly.

Hearing aid technology helps most patients achieve sound clarity and intelligibility. These are patients who have mild to severe hearing loss and have some remaining healthy sensory hair cells in the inner ear that can transmit sound to the brain using implication amplification.

Cochlear implants, on the other hand, help those who can no longer achieve audibility, loudness comfort and clarity with their hearing aids. And they can be used by people of all ages.

How does a cochlear implant work?
A cochlear implant bypasses the damaged inner ear hair cells and sends electric signals to the brain, where they are interpreted as sound. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain.

What is the procedure?
The process of receiving a cochlear implant involves a routine outpatient surgical procedure under general in which a small incision is made behind the ear to place the implant. It is likely that you will be able to go home later that same day.

What is the overall process?
There are four steps in the cochlear implant process.

  1. Assessment
    First, our medical and audiological team will conduct a routine assessment to ensure you’re a candidate for a cochlear implant and determine if there are any additional factors to consider.
  2. Implantation
    Next, we will schedule your surgery and provide specific pre-and post-surgery instructions. The procedure is straightforward and usually lasts between 1-2 hours under general anesthesia. Patients are usually back on their feet later the same or next day.
  3. Activation
    About two to four weeks after implantation, you’ll have your first fitting. This “activation day” is when the audiologist will turn on your audio processor for the first time and you’ll hear your first new sounds. The audio settings of your processor will be adjusted to fit your hearing preferences.
  4. Rehabilitation
    After activating your processor, it is important to follow up with a rehabilitation program to help you adapt to hearing with your cochlear implant and make the most of your new device. It is recommended patient utilize aural rehabilitation exercises, that can be obtained through either speech therapy or using at-home listening exercises.

If you’re considering a cochlear implant, it’s important to have information and resources at your fingertips. The American Cochlear Implant Alliance (ACIA) is an organization dedicated to providing support and advocacy for people with hearing loss. Visit their website to learn more about Cochlear Implants and find the support you need to make a more informed decision.

Hybrid Cochlear Implants

Two Technologies in One for Mild to Moderate Hearing Loss

Today, there are FDA-approved hybrid devices that bring together the best of two different technologies to preserve and enhance low-frequency hearing while restoring access to high-frequency hearing. For people that have some low-frequency hearing but are unable to benefit from a hearing aid, the device can provide a better hearing solution.

What is a hybrid cochlear implant?
A hybrid cochlear implant is an implanted device that is designed to take advantage of two types of input, acoustic and electric with the goal for better speech understanding, improved hearing in noise and a more natural sound quality.

The hybrid device is composed of a hearing aid portion to provide acoustic stimulation and enhance hearing in the lower frequencies and a cochlear implant to address the higher frequencies of hearing.

Who is a hybrid cochlear implant good for?
A hybrid cochlear implant is for people with mild to moderate hearing loss in the low frequencies and that may have some benefit from traditional amplification but continue to still struggle with word understanding.

The hearing aids offer acoustic amplification to send sounds through the normal hearing pathway and the cochlear implant component of the hybrid device addresses severe to profound hearing loss or deafness and bypasses the impaired hearing system and sends electronic sound signals directly to the brain. When combined, these signals allow a full spectrum of sound.

Bone Anchored Hearing Aids (BAHA)

Bone-anchored hearing devices are used primarily for conductive hearing loss or single-sided deafness. They are popular for hearing rehabilitation in patients with congenital ear malformations or refractory chronic ear disease. A titanium fixture is implanted in the postauricular area. An external sound processor is attached to the abutment at will. A microphone in the processor, which vibrates the bone in the skull by means of the fixture, picks up sound. The sound is transmitted directly to the inner ear on the side with conductive hearing loss or better sensorineural hearing than the other.

Implantable Middle-Ear Hearing Devices

Implantable middle-ear hearing devices were developed to treat conductive and sensorineural hearing loss. These devices improved fidelity by directly stimulating the hearing bones, and they improve comfort by allowing the ear canal to remain open. In addition, most implantable middle-ear devices almost completely eliminate feedback, one of the most annoying adverse effects of conventional aids.

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