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iowaboy

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We had our daughter's first visit with the CI team. They did behavioral testing and it matched her ABR with no response across the board. From an audiology standpoint, she's a candidate for implants. Next comes the medical testing. Quite a few decisions to be made.

1. To implant or not implant. (Pending medical testing) still undecided but leaning towards yes.

2. Unilateral or bilateral. Not sure why anyone would go unilateral if they're bilateral candidates and have the funds. Maybe there's a theory about saving an ear for future advancements, but thats kind of sketchy to me.

3. Both full implants or one long, one short. Our implant center is participating in a study that looks at performance with one "long" and one "short" implant. The short implant is not thought to be as invasive and potentially saves any residual hearing for future technological advancements. They say preliminary results show no difference, but they've only enrolled 12 subjects. That and she supposedly has no hearing to start with, so saving residual seems odd.

4. Cochlear or Advanced Bionics. The implant center gives us the choice of either. Cochlear seems to win the PR game, but AB seems to hold its own with technology. Seems like a toss up.
 
. Unilateral or bilateral. Not sure why anyone would go unilateral if they're bilateral candidates and have the funds. Maybe there's a theory about saving an ear for future advancements, but thats kind of sketchy to me.
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Did the ABR/behavorial testing show a bilateral nonresponsive loss across the board? If so, I wouldn't hesistate at ALL for bilateral implantation. She won't benifit at all (not even from a "background noise or localization) from a HA. If it's clearly and blatently obvious......implant them BOTH!
 
To answer your questions...

1) Strictly up to you as her parent.

2) Bilateral is the way to go but remember the cost factors. It is not a cheap endeavor. One is expensive enough and two makes it very expensive.

3) If there is no hearing to preserve, then go for the most stimulus all said and done. The means the long array.

4) Go with your gut feeling. One really can't go wrong.
 
Ugh, I wrte a very long reply, and it disappeared. I'll try again...

First, if you desire a spoken language outcome, I would go ahead with the CI. Yes, a profoundly deaf person can learn spoken language through hearing aids, but it will be a much longer, harder process.

Second, how much residual hearing is there to save? Is it likely that it is usable hearing for speech? If not, I would go bilateral. What good is saving an ear for technology if the the technology won't be useful because the ear hasn't received stimulation for 20 years?

Third, long vs short array...well, here are my thoughts. Again, how much residual hearing is there? Is there a point in trying to save it? I spoke to the surgeon at The House Ear Institute about hybrid-short arrays and he said, that in his experience, they don't save residual hearing at any better rate than traditional CI's. And, they have the con of not having a full insertion.

Lastly, my family went with Advanced Bionics and we are going to go with them again. We believe they have better technology, both in the internal device and in the speech processing strategies. We believe that is way more important than size or gadgets.
 
Thanks for the replies. The decisions have seemingly obvious answers, but I thought I would lay them out here for discussion. AB vs Cochlear doesn't have an obvious answer, and I'm glad we're still 6 mos + from implantation because I'd change my mind daily. But, you can't go wrong either way, I guess.

I'm curious if anyone here has had any facial nerve problems from the surgery. Our potential implant center said they've never seen it there.
 
iowaboy said:
Thanks for the replies. The decisions have seemingly obvious answers, but I thought I would lay them out here for discussion. AB vs Cochlear doesn't have an obvious answer, and I'm glad we're still 6 mos + from implantation because I'd change my mind daily. But, you can't go wrong either way, I guess.

I'm curious if anyone here has had any facial nerve problems from the surgery. Our potential implant center said they've never seen it there.
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It is possible but my daughter's ENT has never had a facial nerve complication in his 20 years of surgery. NONE.
 
Yes, a profoundly deaf person can learn spoken language through hearing aids, but it will be a much longer, harder process.
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faire jour just to clarify, iowaboy's daughter has a deep profound (ie not even any enviromental sound awareness with HA ) loss. So a CI seems to be THE only answer.
Absolutly nothing wrong with opting for implantation in that case.
 
deafdyke said:
faire jour just to clarify, iowaboy's daughter has a deep profound (ie not even any enviromental sound awareness with HA ) loss. So a CI seems to be THE only answer.
Absolutly nothing wrong with opting for implantation in that case.
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There is nothing wrong with opting for implantation for ANY candidate.
 
Iowaboy,

If you do decide on the implants I would ask the surgeon if the facial nerve will be monitored. I think this is always done but I would ask anyway. I did not have any facial nerve problems after the surgery but my jaw was stiff on the side of the implant for the first day.
 
Absolutly nothing wrong with opting for implantation in that case.
There is nothing wrong with opting for implantation for ANY candidate.
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faire jour that was NOT an attack on your choices. My comment simply was that there's absolutly nothing wrong whatsoever with bilateral implantation if hearing aids do not help at all. Even some Deaf extremists might support that.
It's not like a right off the bat canidate is treating the CI like the newest "gotta have technology"
 
deafdyke said:
faire jour that was NOT an attack on your choices. My comment simply was that there's absolutly nothing wrong whatsoever with bilateral implantation if hearing aids do not help at all. Even some Deaf extremists might support that.
It's not like a right off the bat canidate is treating the CI like the newest "gotta have technology"
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I didn't think that statement was about me, but it is clearly reflective of your attitude towards implantation. I disagree with you. I believe that kids deserve to have the best technology for their hearing loss, in both ears. You do not.
 
ut it is clearly reflective of your attitude towards implantation. I disagree with you. I believe that kids deserve to have the best technology for their hearing loss, in both ears. You do not.
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Um no. Not at all. I am pro bilateral implantation when a bimodal approach no longer works.
I reconize that what works for one person with hearing loss, may not work for another....that's pretty much a fact, and that's probaly a big reason why bilateral implantation will never be really common.
It will be seen.....but assuming that the latest cutting edge hearing technology is best for everyone isn't the best course of thinking.
 
Actually I wanted to clarify......if someone has one CI, and relatively low speech perception with that CI plus a hearing aid....then yes, they should be able to get implanted.
But if they have high speech perception with a CI, and some speech perception with HA,, and that combo works pretty well.....
 
deafdyke said:
Actually I wanted to clarify......if someone has one CI, and relatively low speech perception with that CI plus a hearing aid....then yes, they should be able to get implanted.
But if they have high speech perception with a CI, and some speech perception with HA,, and that combo works pretty well.....
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I disagree. Why should my daughter have greater than 96% discrimination in one ear and 20% in the other? Why not give her the device that will give her high 90's in both? It doesn't make sense to me...
 
Thats why we let candidacy be handed down from MDs, PhDs, and AuDs. :) But everyone's opinion is appreciated.

On a slightly off topic note, my daughter started signing "milk". There's a whole lot of happy around here for a little tiny squeezing hand.
 
Deafdyke, yes the CI + HA can work well but when you have a child who is learning to speak it may not be the best thing. Their brains are still developing the two signals can be hard for the brain to interpret. This can happen even in adults. The last time I went for a mapping I acutally did better in noise without the hearing aid.
 
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