CI after Ponto

[Lora]

Good morning.  This is my first post in your forum.  I appreciate your commitment to help others! 

I am 54 and considering options for my SSD (right ear deaf).  My deafness is from Meniere's disease treatment from 19990-2000 and my ear has not been functional since then.  I was fitted with a Ponto Pro in 2012 and it works sort-of-well.  I am a highly functioning person who works full time and sound localization and hearing fatigue are my main problems.  The best way to describe it to others with no hearing difficulty is that I spend A LOT of daily energy trying to hear.  I feel like there must be other hearing options that could better optimize my hearing. 

I am wondering if CI would help me.  I believe a CI might work better than the BAHA from a localization standpoint and understand it takes time and rehab to realize the full potential.  I am hoping someone can speak to these questions:

1.  I am a surgeon and one of the problems with the BAHA is that it when I wear my surgical headlight there is consistent feedback.  To address this I was recently fitted with a BICROS (I was told I have "slight" hearing decrease in my good left ear).  In the OR I now wear the BICROS and this solves the headlight issue but my hearing is much worse with the BICROS and still doesn't fix the localization problem.  I suspect the "slight" hearing loss in my good ear is not really that bad and having a mass object in my good ear worsens my hearing overall. 

2. When something is placed over a cochlear implant (like my surgical headlight headband) does it interfere/feedback?  Or when long hair sweeps over the CI does it "swish" like a regular hearing aid?

3.  Is it possible to have CI surgery after a BAHA?  (I'm no ENT surgeon so I have no idea!)

I am doing my due diligence to get advice from patient experts.  Thank you so very much for your feedback.

 

Lora

[Mary Beth]

@Lora

Welcome to HearPeers!  
 

Your situation is unique so I am going to tag @MED-EL Moderator so they can give you guidance as well.

 

When something touches my CI coil, there is no annoying sound or interference.

 

When hair is on top of my CI coil, there is no annoying sound.

 

My CI processors sit on my ear and the microphones are on the top curved part of the processors.  I can wear my hair cut short in that area so my hair never touches the mics or I can wear my hair long in that area so my hair covers the mics.  Both of these options work great for me and I never hear any annoying hair sound.  The only hair cut that doesn’t work great for me is if my hair ends are cut so they just touch the mics.  Then I do hear an annoying hair sound.

 

Wishing you the best on your journey. Please keep us posted.

[MED-EL Moderator]

Hi @Mary Beth, thanks for tagging us! 

@Lora welcome to the HearPeers forum! I'd suggest you get in touch with your local MED-EL team for more information as well, as they are most experienced and best informed. I'll send you a direct message for this. 

Best, Verena 

[Lora]

Hello HearPeers members,

I would like to provide an update on my situation and ask for any advice about further surgical options.  I visited a new Otolaryngologist yesterday and was given the option of an Osia or a Cochlear Implant; I am considering both options.  His assessment was that at my age the better sound quality of the Osia seemed the superior option.  I am attracted, however, to the ability of a CI to restore my localization which is a big problem.  Both devices would improve on the BAHA (Oticon Ponto Pro) that I have now in terms of the external "hair swishing" (there is a medical term for this that I cannot remember). 

Is there anyone on this forum who has had a bone anchored hearing aid for SSD and then converted to a CI or Osia?  I realize the Osia is very new. 

Thank you very much,

Lora Hebert

 

[Mary Beth]

@Lora

This link will explain the benefits of a CI over a bone system for SSD.

https://blog.medel.pro/binaural-hearing-cochlear-implant-single-sided-deafness/
 

I had used a BiCROS system for years which sent sound from my dead ear to my other ear.  So I have experience with all sound being processed by one side.  Now that I have bilateral CIs and have two separate ears processing sound, I can notice a HUGE benefit of processing sound with two separate ears.  
 

Wishing you the best!

[Julie Lowe]

Hi Lora, I had a Ponto BAHA for almost 4 years for SSD. I had my BAHA removed (just the post, the part in your skull remains) and was implanted with a cochlear implant a few weeks ago. I'm being activated on 4/16!

[Mary Beth]

@Julie Lowe

Exciting!  Congratulations on your CI!  Which processor did you choose?

[Julie Lowe]

@Mary Beth

Thank you, Mary Beth! I go to a two-processor clinic, so I chose the Sonnet 2 and Rondo 3. I can't wait to try them out! I've been SSD for about 4 years and I'm excited to get some sound back into that ear.

[Mary Beth]

@Julie Lowe

My right ear processed no sound at all following a surgery for Ménière’s.  So all sound came into my left hearing aid only for 24 years.  When my right ear was implanted, I wondered what it would hear.  At activation I was hoping to hear all the beeps and that the beeps did not all sound the same.  And that is exactly what happened.  I was so happy!  So my right ear started with static and beeps which quickly aligned to syllables people were speaking.  A few hours later speech started to arrive.  Aural rehab helped me a lot!  My right CI ear is amazing!  Check out our rehab topic for lots of ideas.  Wishing you the best.

[Lora]

Julie,

I have been off-line for some time and am just checking back in with Hear Peers.  For some reason I did not get prompted about your response to my post.  Thank you so much!  I've been looking for someone to talk to with SSD who had a BAHA and then went to CI.

Can you update me on your progress with your CI?  I see you had it placed in April.  I am still apprehensive about moving forward with a CI so have not had surgery.  Just this last week, however,  I flew 3 hours to consult with another ENT to get his opinion and he too recommended the CI.  He said  "You've got nothing to lose" meaning my hearing is so bad in that ear anyway but I feel I DO have something to lose if electronic hearing is more difficult for me than the BAHA.  I like the idea of leaving the screw "in case". 

This ENT (who places CI and also has bilateral CIs himself) tells me the CI will not help much in the operating room (which is where I struggle the most) but will best the best option for me.  While I know his hearing loss is not exactly the same as mine I greatly valued his professional opinion.

Thank you Julie!

Lora Hebert

[Tim]

@Julie Lowe @Lora I know this is an old thread but I just ran across it I'm also one of the people that transitioned from a BAHA to an to a CI.  Very nice to meet you Julie and I look forward to hearing more about your journey as you are much further down the road.

I've posted enough here elsewhere to not be worth repeating myself in detail but will try to sketch it out in rough form.

~2010 started losing my hearing in one ear, no clear cause

2015 Decline prompted a recommendation for a CI.  Insurance rejected repeatedly due to being FDA label for SSD.

2016 Had a BAHA surgery. Modest benefit, constant skin irritation

2022 Continued hearing decline, decided to investigate upgrade options or the OSIA, realized CI was now FDA approved for SSD and gave it another try.  Insurance approved quickly.

December 2022 - Outer part of bone conduction abutment removed leaving a good "hole" in my head.  (3 weeks was a little tight for the timeline for healing up the wound.  Surgeon said if it was not sufficiently healed he would reschedule surgery.)

January 2023 - Surgery and activation.

I'm about 7 weeks post-activation.  Like some others, my tinnitus while using is much better. Mine is nowhere near as bad Jared's case of tinnitus but I notice its absence.

I'm trying to put in a couple hours of focused rehab work every on top of wearing it every day.  I can tell that things are slowly getting better.  Celebrating little victories and seeing progress in various rehab practices.

Coming out of Covid isolation and remote working, I knew I needed to do something. 

One of my key reasons for doing it now instead of waiting was concern about losing hearing in my good ear.  I have no reason to believe it is any more likely for me than anyone else but I don't want to be in the position of having neither. Delaying might be a little beneficial in terms of technology and options but this is counterbalanced by the longer the wait, generally the more effort needed for rehab.

The lower half of my bone conduction post is still there but given how little the benefit was, I just don't even thing about it as a "backup plan" - the CI is already working better than the bone conduction did (albeit very differently!)

One piece of advice might be to try to pick a time for your surgery and activation based on work schedule.  The first few weeks after activation the CI was more hindrance than help. I had daily Zoom staff meetings and during these meetings I described the CI as being like a squawking chicken trying to echo whatever anyone was saying.  As a college professor I wanted to do things in December so I could make use of the holidays or do it in the early Summer.  That didn't work but I was able to adjust my teaching load to make it more manageable. 

Lora, I would be happy to help answer any questions about the bone conduction to CI transition for you or anyone else that runs across this in HearPeers. The community has been so helpful for me and I'm glad to be able to return the favor.