What is a Cochlear Implant?-A cochlear implant is a small electronic device that provides a sense of sound to children and adults who have severe to profound hearing loss and can't hear or understand speech with hearing aids. A cochlear implant does not amplify sound like a hearing aid; it takes sound and bypasses the outer, middle, and inner ear, directly stimulating the hearing nerve fibers that lead to the brain.The cochlear implant system consists of two parts:an internal device which is surgically implanted into the inner ear,and an external component consisting of a head set and speech processor which is programmed to supply sound to the wearer.
Will a Cochlear implant help me?- Many thousands of users (both children and adults) receive tremendous benefit from their cochlear implants. However, there is currently no test or examination that can predict how much benefit an implant will provide a user. Success depends on many things. For example, adults deafened at birth don't seem to do as well as those deafened later in life. Some types of hearing loss respond to the stimulation provided by the implant better than others. Your hearing loss, like your fingerprint, is unique. It's the individual, discrete characteristics of the loss that make it difficult to predict how any one will do with an implant. The only way to know whether you are a candidate for an implant is to be evaluated by a team of professional clinicians headed by an Otolaryngologist (ear nose and throat doctor) who specializes in cochlear implantation.
What kind of doctor do I need to see? - You need to be evaluated by an ear doctor who specializes in cochlear implantation to determine whether you are a candidate. They have many names: otologist, otolaryngologist, Ear, Nose and Throat (ENT). The important thing is they have a specialization in cochlear implants. Many insurance companies require a referral from your primary care physician first so be sure to check before you make your appointment with the cochlear implant specialist.
Why do I need to see an audiologist so often after the implantation? - After all healing from surgery is complete (about 2 weeks) an audiologist will put the external part of the implant in place. At this "hook-up" session the audiologist will make the first of many adjustments to the implant for comfortable loudness levels and fine tuning of each electrode. The following sessions are devoted to making discrete changes in each electrode so as to improve the quality of the sounds you hear. This continues on a regular basis until you and the audiologist agree the settings are optimum.
Does Medicare or Medicaid pay for cochlear implants?-Coverage is provided for eligible Medicare beneficiaries who meet all of the Medicare Coverage Criteria:
Diagnosis of bilateral severe to profound sensorineural hearing impairment with limited benefit from appropriate hearing (or vibrotactile) aids;
Cognitive ability to use auditory clues and a willingness to undergo an extended program of rehabilitation;
Freedom from middle ear infection, an accessible cochlear lumen that is structurally suited to implantation, and freedom from lesions in the auditory nerve and acoustic areas of the central nervous system;
No contraindications to surgery;
The device must be used in accordance with the FDA-approved labeling.
Cochlear Implants may be covered for adults (over 18) for prelinguistically (before the development of language), perilinguistically (during the development of language), and postlinguistically (after language has fully developed) deafened adults. Postlinguistically deafened adults must demonstrate test scores of 40% or less on sentence recognition from tape recorded tests in the patient's best listening condition.
CHILDREN: Cochlear Implants may be covered for prelinguistically and postlinguistically deafened children aged 12 months through 17 years. Bilateral profound sensorineural deafness must be demonstrated by the inability to improve on age appropriate closed-set word identification tasks with amplification.
Should I get one implant or two? It's a good question! Since we started off with two ears, wouldn't two implants be better than one? We know that having two hearing aids helps most people localize sound and helps them understand conversations better in noisy situations like restaurants and theaters. People who have received two implants report that they, too, understand better in noise with both implants, and they can determine from where in the room a voice is coming. Research is underway at many centers across the country (including ours) to learn more about the benefits of two implants, or, binaural implantation. Your physician and audiologist can help you decide what is right for you or your child.