CI or BAHA for SSD

[artkup]

Are there any users out there with cochlear implants who have hearing loss on only one side?  If so, I would love to know of your experiences, and how you decided on a CI rather than a BAHA.

[jpl2ci]

Art, I am a bilateral CI but maybe I can shed some light on your question. BAHA is just another form of a hearing aid, using bone to conduct the sound to your inner ear. A CI completely bypasses the inner ear and uses direct electrical stimulation on the cochlea to create sound. Separate but equal. I hope this helps. John

[Adam]

Art, have you been recommended one over the other for your type of hearing loss? If so which? what concerns do you have?

 

Adam

[artkup]

Adam -  Yes, I have been recommended the CI over the BAHA.  The questions I have relate to the fact that I am SSD and have one (almost) perfectly functioning ear.  While I appreciate that the CI is a god-send for those who have bilateral hearing loss, for those of us with one working cochlea, I question whether the BAHA may, in reality, be the better solution.  The timing and the quality of the electrical impulse via the CI, from what I understand, are different from the acoustic signal I will be receiving in my good ear.  I'm concerned that the brain may have trouble processing these differences. While the brain works hard to interpret the new CI signals for bilateral patients, and seems to do it successfully, I am concerned that with a good ear "to fall back on" may result on the brain becoming lazy and not doing the necessary work to translate successfully.

 

My ENT and AuD are both recommending the CI route, but I'm concerned for issues raised above and also for the fact that they have no experience programming the CI for SSD patients as I will be their first.  Any advice will be greatly appreciated.

 

Art

[Ivana Marinac]

Hi Art,

 

I know you have one another topic so I can not remember if you have written there what is your level of hearing loss?

 

Also - can you tell us why do you want an assistance for your ear? People have various reasons so it is not good idea for me to predict. I would like to hear from you.

 

Last, there are some articles who are discussing benefit of BAHA solely, mainly comparison is with other middle ear implants not CI so it is hard to say but the core essence for the understanding the problem is that CI stimulates your "sleepy" cochlea. BAHA works on other base - it sends signal from contralateral side to the health cochlea so there is also problem of possible delay of processing signal and "head-shaddow" effect.

 

Just a thought.

[hadron]

Art,

Glad to see you are researching your options.

See the International Journal of Otolaryngology article "New Criteria of Indication and Selection of Patients to Cochlear Implant" at http://www.hindawi.com/journals/ijol/2011/573968/

Cochlear implantation is now considered a treatment modality available for patients with single-sided deafness.

There are interesting studies being performed.

S. Arndt, A. Aschendorff, R. Laszig et al., “Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus,” Otology and Neurotology, vol. 32, no. 1, pp. 39–47, 2011. View at Publisher · View at Google Scholar · View at PubMed

There is also clinical trails: ClinicalTrials.gov Identifier: NCT01749592 at: http://clinicaltrials.gov/show/NCT01749592

As the left and right hemisphere are specialized for different auditory tasks, the proposed clinical trial aims at 1) demonstrating different consequences of right or left-sided deafness for the affected individual (auditory deficits and plastic changes) and 2) answering the question if auditory deficits and plastic changes caused by SSD can be partially reversed by cochlear implantation of the deaf ear.

For the sound that's coming from your deaf side, are you better off:

(1) transferring the sound to your good ear (cochlea) via bone conduction with the BAHA; or
(2) actually hearing the CI sound in your currently deaf ear with a CI.

The CI solution to SSD looks very promising and active but has just started in the U.S. I am assuming you have a working cochlea in your deaf ear.

The BAHA solution to SSD has been around longer and is a good quick fix.

You may want to check out the BAHA Users Support Forum at: http://www.baha-users-support.com

Good Luck.

[Adam]

I would have to say we dont give our brains enough credit. I am pretty sure it could figure things out.

 

about 4 years ago i had to have a Labrynthectomy. They removed the entire vestibular or balance center from my left ear. My surgeon told me that I would go through hell for a while but my brain would recognize that half of my balance was missing and would take over and compensate for the inner ear. That pretty much is what happened. i had to relearn how to walk as right after the surgery, i could not even sit up on my own.

Well my brain kicked in and now I am back to doing martial arts and running ultra marathons.

 

 

[artkup]

Ivana - my left ear is fully functional.  My right ear is almost completely deaf though I do seem to have some extremely slight ability to hear. I actually thought it was totally deaf though I seemed to pick up certain signals at quite high dB thresholds.  My AuD has my latest audiograms. Effectively, deaf in that ear, though technically some very slight hearing.  Zero word recognition in the "deaf" ear.

 

With respect to why I want my hearing restored is that I can't function in social or work environments where there is any noise. There is a trend in the US for open environments in the work place so there is generally quite a bit of background noise. I have also had a few close calls crossing the street here in NYC as bicycles don't necessarily follow the traffic directions so the CI could help on this front as well.  I also would like to be able to hear a fuller sound in music though I don't believe any of these modalities will help in that regard.

 

Anthony - thank you for the articles.  I was also referred to this journal that seems quite promising: http://www.karger.com/Article/Pdf/327760

It has several articles directly related to my questions including a first person account of an SSD patient with a CI.

 

Thanks for all of your help.  If anyone knows of other first person accounts of SSD and CI, I would love to "hear" from them.

 

Thanks again,

 

Art

[kdehrkoop]

Art,

 

First I am glad you posted this... I was in the same boat that you were and can completely understand your concerns and apprehensions. I also have been diagnosed with Single Sided Deafness and received a CI rather than a BAHA. My surgery was 9 months ago. I was also the first person for the hospital and clinic that I went to as well so they didn't know how this would work for me either. In fact my doctors were pretty worried at first. I would consider this surgery as being successful but I am also pretty realistic. I do not consider myself having 'normal' hearing but I know I hear better than I would with a BAHA which is what my goal was to hear the best that I can with an assistive device. First, I can localize sounds which is huge which you cannot do with BAHA device.

 

I recall worrying about how my brain would actually interpt what it was hearing. The doctors send me all these simulations about what they believed my sounds would be like. What the doctor's did not plan on was how elastic one's brain is so it can understand and interpt the sounds to make one good sound. They originally thought I would hear normal in one ear and like a computer in another. It's important to remember while there are lots of studies on CI and hearing however, the scientists do not understand and they can't replicate how a person with SSD with CI hears like at this point in time.

 

I am so grateful that I did this surgery. My experience has been a great one. The most often question I get is about music and yes, I hear music. This surgery has allowed me to be more social as I can have conversation without 'guessing' so much about what is being said and worrying about where I sit so I can hear the best. Please email me if you have questions or what to discuss this further. Good luck with your decision.

 

 

 

[Ivana Marinac]

Hi Kristin,

 

It was very interesting to read your opinion. And very valuable also.

 

CI implantation in SSD patients is right now procedure, I would say - still in diapers. A world needs courage of people who are willing to test uncharted lands in chase for a more contentful life.

 

Can you please explain little bit further in what way this changed your life - in real situations: where and when you found your decision particularly correct?

I am asking this from you so people can find themselves in these circumstances - so they can choose whether this is what they are hoping for?

[kenstee]

Considering a Baha and live in the USA? Better read this first...

 

The US Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule that would change the classification of the Cochlear™ Baha® Implant System under Medicare, treating it as a hearing aid subject to exclusion from typically covered benefits. One can assume that this will apply to ALL brands.

If adopted, the rule would:

 

- Significantly limit access to this technology for Medicare patients
- Interfere with the ability of current Baha Implant System users on Medicare to maintain and upgrade their equipment

 

If this change does come to pass it has serious implications for those approaching or over 65. In addition, if you are younger and you get a Baha implant now, it's maintenance, repairs, upgrades will NOT be covered by Medicare when you become eligible. Also, one can imagine that down-the-road all insurance carriers will re-classify Baha as a hearing aid - most hearing aids are currently NOT covered by just about all insurance companies..

[Garyn]

On 9/25/2013 at 9:42 AM, artkup said:

Adam -  Yes, I have been recommended the CI over the BAHA.  The questions I have relate to the fact that I am SSD and have one (almost) perfectly functioning ear.  While I appreciate that the CI is a god-send for those who have bilateral hearing loss, for those of us with one working cochlea, I question whether the BAHA may, in reality, be the better solution.  The timing and the quality of the electrical impulse via the CI, from what I understand, are different from the acoustic signal I will be receiving in my good ear.  I'm concerned that the brain may have trouble processing these differences. While the brain works hard to interpret the new CI signals for bilateral patients, and seems to do it successfully, I am concerned that with a good ear "to fall back on" may result on the brain becoming lazy and not doing the necessary work to translate successfully.

 

My ENT and AuD are both recommending the CI route, but I'm concerned for issues raised above and also for the fact that they have no experience programming the CI for SSD patients as I will be their first.  Any advice will be greatly appreciated.

 

Art

Hi Art,

Did you ever go ahead with the CI? I have SSD on the left side as of 2 years ago, and just had the CI surgery and anxiously awaiting activation day.

I would appreciate anyone to shed light on what to possibly expect on this journey   and does anyone experience anything close to natural hearing with their CCI?

The YouTube videos out there are not encouraging of what a CI may sound like, several interpretations I've heard was that of a demented robot.

Thanks,

Garyn

 

 

[Mary Beth]

Hello

 

At first things sound strange but then our brains figure it out and everything sounds natural again.

 

Wishing you the best

[Sue C]

I am also SSD and got activated this morning about 4 hours ago.  My audiologist explained that because I have a good working ear that it will be some work and time for my brain to adjust to the new CI hearing as my hearing ear may make it more difficult.  So far everything seems SO LOUD, although I can recognize speech, I can not hear what the words are yet only distorted speech.  I stopped at the grocery store on my way home and WOW, it was a little overwhelming.  When I walk it sounds like the Jurasic Park dinosaurs footsteps....Lol!  I had a BAHA removed in preparation for this surgery, my ENT thought I would do well with a CI.  I found the BAHA not very helpful and I seldom wore it, although it was from 2007 and I'm sure the techlonology has gotten better.  What I found with a recent hearing test with an upgraded Oticon (BAHA) processor is in a soundproof room with lots of background speech, with and without the Oticon (BAHA) I pretty much scored the same so opted for the CI.  Good luck to you!

[Mary Beth]

Sue, great to hear you have been activated.  Now the fun begins.  Do you have the Sonnet or Rondo?  You can use some tech to train your CI side alone.

[Sue C]

Thanks Mary Beth, I have both processors, Sonnet and Rondo.  My audiologist set me up with the Sonnet today and next week for my next mapping she will go over the Rondo, she said that may work better for staying on during yoga and going upside down.  Didn't want to overwhelm me with too much for one day.

[Garyn]

45 minutes ago, Sue C said:

I am also SSD and got activated this morning about 4 hours ago.  My audiologist explained that because I have a good working ear that it will be some work and time for my brain to adjust to the new CI hearing as my hearing ear may make it more difficult.  So far everything seems SO LOUD, although I can recognize speech, I can not hear what the words are yet only distorted speech.  I stopped at the grocery store on my way home and WOW, it was a little overwhelming.  When I walk it sounds like the Jurasic Park dinosaurs footsteps....Lol!  I had a BAHA removed in preparation for this surgery, my ENT thought I would do well with a CI.  I found the BAHA not very helpful and I seldom wore it, although it was from 2007 and I'm sure the techlonology has gotten better.  What I found with a recent hearing test with an upgraded Oticon (BAHA) processor is in a soundproof room with lots of background speech, with and without the Oticon (BAHA) I pretty much scored the same so opted for the CI.  Good luck to you!

Thanks for this! I have SSD and had surgery last week. Anxiously awaiting what it will be like to have a sensation of sound on the left side again! (It's been about 3 yrs for me). I'd be curious to know when your able to understand speech! Sounds like all the noise is a bit overwhelming right now?!

[Mary Beth]

Sue,

 

You can use the audio cable that plugs into the FM battery cover on your Sonnet to do aural rehab from your iPad.  That way only your CI side will receive the sound.  I recommend beginning with the ABCLIX app that is free.  Just search for Advanced Bionics in the App Store.

[Sue C]

4 hours ago, Garyn said:

Thanks for this! I have SSD and had surgery last week. Anxiously awaiting what it will be like to have a sensation of sound on the left side again! (It's been about 3 yrs for me). I'd be curious to know when your able to understand speech! Sounds like all the noise is a bit overwhelming right now?!

It's been 11 years for me and it is nice to hear sound again, can't say all the sound sounds good, but that is what I expected.  Some of the sounds are crystal clear like the high treble in a good set of speakers, like water running or silverware clanging (although super loud and piercing) but speech sounds just like a blown speaker or a rattle.  Hope my brain is a quick learner! LOL

[Sue C]

5 hours ago, Mary Beth said:

Sue,

 

You can use the audio cable that plugs into the FM battery cover on your Sonnet to do aural rehab from your iPad.  That way only your CI side will receive the sound.  I recommend beginning with the ABCLIX app that is free.  Just search for Advanced Bionics in the App Store.

Thanks for the tip!  I will check it out.