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Marga


Marga

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I have a question about the cochlear implant: are there many variations? The audiologist and the ENT told me they are thinking about the Nucleus Hybrid.

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Marga,

In the USA three cochlear implant companies are used. As this is a MedEl forum, you will not get much info on the Nucleus Hybrid here.

Mary Beth

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Thanks Mary Beth: I never realised that there was more than one implant :D.I was too busy with the other side of the story.

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Marga,

Actually there are 2 more, the French one and Chinese which is the newest on the market. Chinese language is different - it is tonal language and it needs additional approach fir understanding.

Regarding Nucleus Hybrid - it depends what are their primary thoughts for thinking about it. As I have not seen your audiogram I would presume that your hearing loss is mainly within the higher frequencies and moderate or better in middle and lower frequinces. Hybrid is, simply described as cochlear implant and hearing aid in one package. It is unique on the market but yet not revolutionary - Med-El has EAS system for partial hearing loss and if there is hearing loss in different areas which is not so significant it would require CI (in whole frequency range) it could be aided with HA also.

One thing is particularly important here - the stability of hearing loss, and the fact that HA is still superior within lower frequency range. If hearing loss is progressive - it can require full spectrum for a few years.

So - neeext question: these were easy one ;)

Let be more serious - hope my answers satisfied, if there are additional thoughts: shoot! ;)

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Ivana: you are right about my hearing. In the higher frequecies I hear nothing, the lower and middle came back partially  after surgery.​ I have in both ears poor speech discrimination.

So probably Nucleus Hybrid would be a good choice?

The more I think about, the more questions I have. Thanks for you input:)

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Dear Marga,

As I have stated already, Med-El also has a system for the partial deafness: EAS.

It is now in its 3rd generation - please read about it. Just please beware currently there are 2nd and 3rd generation on the market.

http://www.medel.com/int/eas-hearing-implant-system

Also, to better understand I could advise you to read some links which will expand your understanding of whole story. The text is little bit older (from 2011) but it's excellent from the general point of view:

http://www.audiologyonline.com/articles/20q-hearing-preservation-with-cochlear-831

and 2nd part:

http://www.audiologyonline.com/articles/20q-hybrid-eas-cochlear-implants-828

Try to understand the concept of different length of the electrodes and hiw the knowledge about making choice developed - this most important for you as well as how many experienced is your operater.

More you find out, more you find how less you know. Proportionally. But this shouldn't discourage us - on the contrary: until there is no end, there is hope for further progress.

Enjoy upgrading your knowledge ;)

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Thanks for the links, Ivana.    I understand a little better now.   Still struggling with unfamiliar terms!

Maureen

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Ivana: thanks for the information. It makes it a little bit more difficult :). I know that the ENT is very well reputated. He has been an ENT since 1989.

How import is the audiologist in this story. What I have understand, they work with Cochlear.

I am not done  reading yet.

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Marga,

The ENT surgeon's expertise is needed for surgery-successfully implanting the electrode array, etc. I drove 5 hours away from home, to work with a great surgeon.

After the surgery, the audiologist's expertise is needed for MAPping (programming) your CI or EAS. It's important to work with a skilled audiologist to get the best results. There will be many appointments.

Mary Beth

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Mary Beth: I will take my time before I do the surgery. I am so long without good hearing, a few months longer is not a problem for me. I also want to talk with the audiologist over different kind of implants. But I have the feeling that they work with Chochlear.

This forum is really very helpful for me, thanks

I understand very well that you drove 5 hours, I would probably the same thing.

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Thanks for the links, Ivana. I understand a little better now. Still struggling with unfamiliar terms!

Maureen

Of course, whole science is here on the board - lot's of ENTs (who do not work audiology field) are nit close familiar with these terms.

So - there is no stupid question, just answers ;)

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Ivana: thanks for the information. It makes it a little bit more difficult :). I know that the ENT is very well reputated. He has been an ENT since 1989.

How import is the audiologist in this story. What I have understand, they work with Cochlear.

I am not done reading yet.

Oh, Marga - neither me nor professor in the text don't insinuate anything. It is the matter of particular agreement - in the hospital where I made my specialty Med-El and Cochlear devices are equally implanted - principle is the same.

Audiologist, especially experienced is extremely important in this matter - practically, all rehabilitation results are up to them; surgeon's job is pure mechanic.

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Mary Beth: I will take my time before I do the surgery. I am so long without good hearing, a few months longer is not a problem for me. I also want to talk with the audiologist over different kind of implants. But I have the feeling that they work with Chochlear.

This forum is really very helpful for me, thanks

I understand very well that you drove 5 hours, I would probably the same thing.

Marga - for your inner feeling it is good that you choose the company which suites you best. Although CI devices are generally same, each one of them has its specialty.

For instance, Med-EL' CIs oftenly are chosen by the people to whom music is important part of their lives. Or else, AB was chosen before by people who work a lo in dust and sweat - they had particular model. And etc.

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Ivana: thanks again:).

It's unfortunate that Nucleus Hybrid is not so long at the market yet. There are not so many reviews.

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Ivana: thanks again:).

It's unfortunate that Nucleus Hybrid is not so long at the market yet. There are not so many reviews.

Mmm...:)

This is one of the most important ENT journal:

http://www.ncbi.nlm.nih.gov/m/pubmed/26152811/?i=1&from=cochlear%20hybrid

It is published a month ago, well known authors, unfortunately I don't have full link - maybe in your local library can help you. ;)

This is one of early Med-El's study but with previous generation of outer unit:

http://www.ncbi.nlm.nih.gov/m/pubmed/18000465/?i=5&from=med-el%20duet

This is the study where bilateral EAS effects where investigated: http://www.ncbi.nlm.nih.gov/m/pubmed/19955731/?i=3&from=med-el%20duet

And, this is also very fresh - speech comparison, study done with med-el's Duet device.

http://www.ncbi.nlm.nih.gov/m/pubmed/25989069/?i=1&from=med-el%20duet

Are you still with me? :P:D

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Hi Ivana,

I'm still here. Thanks for the links. I suppose a tricky question would be whether to attempt to preserve some low frequency hearing with a EAS Sonnet/Synchrony in someone with progressive otosclerosis or to just go with a deeper electrode and pure CI since the low frequency loss may disappear as well.

Mary Beth

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Hi Ivana,

I'm still here. Thanks for the links. I suppose a tricky question would be whether to attempt to preserve some low frequency hearing with a EAS Sonnet/Synchrony in someone with progressive otosclerosis or to just go with a deeper electrode and pure CI since the low frequency loss may disappear as well.

Mary Beth

It was tested but it became inefficient - to put shorter electrodes (much shorter than today). Today's are longer, but not as classic.

To preserve lower and middle frequencies asked improved operative techniques for the hearing preservation. This means, less cells are destriyed longer period of time yoor hearing is preserved. Si, actually this is the best approach to evaluate surgeon's hand: once you enter into cochlea, it's a brief moment - not makin' a barbecue there.

On the other side, researches showed that hearing is better rehabilitated if the person is implanted before - while cells are more alive and neural path are not lost. Cognition needs some time and effort to be created.

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Thanks for the links Ivana.

I have no questions right now. :)

;):D

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