Aren't we wasting time with HAs...

Tousi said:
Understood, thanks, Jag. I had, in the inner recesses of my mind, something I saw a while back and that was that of some kind of improvement of the surgical procedure; Jillio jogged my memory on that.
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The array is shorter, as well, creating less trauma.
 
Tousi said:
That's interesting, Jag. Why is it I've always heard that, and it makes sense, too, when one is implanted, what residual hearing there was prior is now gone because during the implantation, the hair cells were destroyed? Are you saying we (maybe just some of us) could hear some in the absence of those hairs?
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Actually 2C residual hearing was previously lost to the harder tips on the electrodes damaging the nerves. However, with the newer CI's *at least I know mine has it* that they are preserving residual hearing with softer tips on the electrodes.


As CI technology progresses they may be able to even guarantee that residual hearing will be preserved. As for me, I wouldnt know if it worked or not, as I waited to implant till my hearing worsened to such a degree that I was not able to hear out of a HA.

One of the reasons why I chose my CI was that it is supposed to *help* preserve residual hearing.
 
Bear said:
Actually 2C residual hearing was previously lost to the harder tips on the electrodes damaging the nerves. However, with the newer CI's *at least I know mine has it* that they are preserving residual hearing with softer tips on the electrodes.


As CI technology progresses they may be able to even guarantee that residual hearing will be preserved. As for me, I wouldnt know if it worked or not, as I waited to implant till my hearing worsened to such a degree that I was not able to hear out of a HA.

One of the reasons why I chose my CI was that it is supposed to *help* preserve residual hearing.
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Yeah you have a point there about the newer models preserving residaual hearing. When I got implanted my loss was already at 115 dbs across all but one or two fequenices so it's proable that I have no residual hearing left in my left ear. I can hear me snapping my fingers when I snap them over my right ear (unaided of course) but not over my left ear. My hearing loss was similar in both ears before my implantation.
 
Bear said:
Actually 2C residual hearing was previously lost to the harder tips on the electrodes damaging the nerves. However, with the newer CI's *at least I know mine has it* that they are preserving residual hearing with softer tips on the electrodes.


As CI technology progresses they may be able to even guarantee that residual hearing will be preserved. As for me, I wouldnt know if it worked or not, as I waited to implant till my hearing worsened to such a degree that I was not able to hear out of a HA.

One of the reasons why I chose my CI was that it is supposed to *help* preserve residual hearing.
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Agreed, Bear. With the newer procedures and devises, it is possible to preserve residual hearing in the lower frequencies, but this is also dependent upon the candidate have a significant amount of residual hearing in the lower frequencies prior to implantation.
 
Bear said:
I cant find anything about it in the AB site but here is a little info on how they are working to preserve residual hearing.

FDA Approves Nucleus Freedom in US

It is in the third paragraph of the article.
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I will go back and find the article I posted an excerpt from sometime today, so that you have the information you need to read it. It is a scientific article from a otolaryngology journal and a pain in the butt to wade through, but I will be glad to provide it for those that want to read it.

It was interesting that the article noted that, while this procedure was successful with select adult candidates, the results with chidlren had yet to be determined.
 
Question: If someone is implanted largely because that person's HA was no longer doing the job, then why is it a big deal that what little residual hearing that is there when the CI will overcome it? This is a very narrow question, I realize but this is all I want to know.
 
Tousi said:
Question: If someone is implanted largely because that person's HA was no longer doing the job, then why is it a big deal that what little residual hearing that is there when the CI will overcome it? This is a very narrow question, I realize but this is all I want to know.
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Good question! I never understood that argument either. I guess there is the "hope" that maybe one day it can be useful. Another thought is that the process is a "point of no return" and it is indeed that.

Personally, it comes down to picking one's poison. I much preferred to hear decently again than worrying about whatever hearing was left. A minor quibble in the scheme of things...
 
sr171soars said:
Good question! I never understood that argument either. I guess there is the "hope" that maybe one day it can be useful. Another thought is that the process is a "point of no return" and it is indeed that.
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My understanding is that after the cochlea operation the possible residual hearing that remains is going to be less than what you started with and with the array in the way the clarity may even be less also. You still going to need some kind of amplification to assist the residual hearing to make it useful.
What companies are trying to do is to make a hybrid implant with a shorter array to just to work on the high frequencies leaving the bass nerves alone and unassisted unless you add a hearing aid to the same case of the external processor. The studies that I read is that they are only about 50% successful. The problem with this approach how is the doctor is going to promise that the remaining residual hearing is going to be stable for the rest of your life and you will not need another operation to hear the lower frequencies with insurance coverage? I think the whole idea is kind of stupid.:eek3:
 
Tousi said:
Question: If someone is implanted largely because that person's HA was no longer doing the job, then why is it a big deal that what little residual hearing that is there when the CI will overcome it? This is a very narrow question, I realize but this is all I want to know.
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I depend on the little residual hearing that I have when I am in the hearing world. Everyone has different ways of process sounds with whatever residual hearing they have. I would be paranoid that if the CI wasnt successful for me and my residual hearing is forever gone. I also dont like the idea of having a magnet in my head. That's my personal preference for myself only. Doesnt mean it applies to others.
 
Tousi said:
Question: If someone is implanted largely because that person's HA was no longer doing the job, then why is it a big deal that what little residual hearing that is there when the CI will overcome it? This is a very narrow question, I realize but this is all I want to know.
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2C it is a very big deal, if someday, they were to devise a way for all of us to be able to hear normally or even better than with a CI, we dont want our chances ruined because we destroyed our natural hearing *residual* do we?


Also with the CI there is no guarantee it will work for you. With preserving residual hearing, there is a chance we could either wait for better hearing aids or a better implant or better something to come out.

Even though my residual hearing worsened to such a degree that the current hearing aids on the market arent helping, isnt it possible that someday they may develop one that will with my degree of loss? If the CI hadnt worked and they dont work towards preserving residual hearing, it may not matter what they develop in the future.
 
Bear said:
2C it is a very big deal, if someday, they were to devise a way for all of us to be able to hear normally or even better than with a CI, we dont want our chances ruined because we destroyed our natural hearing *residual* do we?


Also with the CI there is no guarantee it will work for you. With preserving residual hearing, there is a chance we could either wait for better hearing aids or a better implant or better something to come out.

Even though my residual hearing worsened to such a degree that the current hearing aids on the market arent helping, isnt it possible that someday they may develop one that will with my degree of loss? If the CI hadnt worked and they dont work towards preserving residual hearing, it may not matter what they develop in the future.
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Yes, but isn't that why the worst ear is implanted today and the other one saved for the day when technology provides something better? I think a lot of folks might think this way. I don't think, I, myself would worry about tomorrow if I was in that situation, tho.
 
Tousi said:
That's interesting, Jag. Why is it I've always heard that, and it makes sense, too, when one is implanted, what residual hearing there was prior is now gone because during the implantation, the hair cells were destroyed? Are you saying we (maybe just some of us) could hear some in the absence of those hairs?
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I believe they developed the curved array to presevse some hearing. Not sure exactly why since I really don't think a HA would do that much with what is left. :)

Heres an article on the nucleus hybrid array which would be used for people with high frequency losses. (mine was a reverse slope so even if it had been available 20-30 yrs ago it would not have been of much assistance to me)

http://www.ohsu.edu/nod/documents/week3/Gantz paper.pdf
 
Tousi said:
Yes, but isn't that why the worst ear is implanted today and the other one saved for the day when technology provides something better? I think a lot of folks might think this way. I don't think, I, myself would worry about tomorrow if I was in that situation, tho.
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2C not always in my case the best ear was implanted because my other ear cannot take sound and never could. Everytime I tried to hear anything out of my right ear it would cause me pain. I dont know why this is and neither did my audie, but sound in that ear was and is a big no no lol. So we implanted my *best* ear all these years and Im glad they are working towards residual hearing.
 
Tousi said:
Question: If someone is implanted largely because that person's HA was no longer doing the job, then why is it a big deal that what little residual hearing that is there when the CI will overcome it? This is a very narrow question, I realize but this is all I want to know.
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Amen!
 
Bear said:
2C not always in my case the best ear was implanted because my other ear cannot take sound and never could. Everytime I tried to hear anything out of my right ear it would cause me pain. I dont know why this is and neither did my audie, but sound in that ear was and is a big no no lol. So we implanted my *best* ear all these years and Im glad they are working towards residual hearing.
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OIC, Bear! You didn't have a choice cuz you don't have three ears! Lol! Glad to hear, tho, that it worked out for ya.
 
john57 said:
My understanding is that after the cochlea operation the possible residual hearing that remains is going to be less than what you started with and with the array in the way the clarity may even be less also. You still going to need some kind of amplification to assist the residual hearing to make it useful.
What companies are trying to do is to make a hybrid implant with a shorter array to just to work on the high frequencies leaving the bass nerves alone and unassisted unless you add a hearing aid to the same case of the external processor. The studies that I read is that they are only about 50% successful. The problem with this approach how is the doctor is going to promise that the remaining residual hearing is going to be stable for the rest of your life and you will not need another operation to hear the lower frequencies with insurance coverage? I think the whole idea is kind of stupid.:eek3:
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Er...when I got mine, they explained to me, with few exceptions to the rule, that I would lose most if not all residual hearing. That was being the "price" (amongst other things) to pay for having a CI. So, I'm not sure what you are getting at about the hybrid CI array as it stands for a person such as myself at this point in time. In other words, it is a moot point for me now having my CI. Whatever the future holds for me by the way of newer and improved technology, my lack of residual hearing is irrelevant now. Obviously in respect to the hybrid, I can't really consider it but other things are being researched and CIs in general are going to get better and better. That will be my focus down the road.

Getting a CI is essentially an either/or proposition in regards to residual hearing (at least at this point in time). I guess it really comes down to the fact if one is successful with a CI, then the residual hearing becomes a moot point. On the other hand, if one isn't successful (depends on one's viewpoint), then not having that "lost" residual hearing really accentuates the "failure". I'm not sure I understand the whole issue of some people's angst about it as one is losing residual hearing no matter what.
 
jillio

I did find that the article that mention about preserving some residual hearing with a standard electrode array. Below is part of the article and the full article can be found here.

Hearing Preservation in Patients With a Cochlear Implant

But even so you still going to lose more of your residual hearing 15db in this case and even with the hybrid it can be total. My point is that getting the cochlear implant should still be view as losing all your residual hearing.


Options for Hearing Preservation
by René H. Gifford and Jon K. Shallop

"Hearing preservation with a cochlear implant is also possible with a conventional long electrode array. It had been assumed that any residual hearing in the implanted ear would be sacrificed due to surgical trauma; however, in some instances, this is no longer the case. Increasingly skilled surgeons employing soft surgical techniques—which may include a smaller cochleostomy or round window insertion and more careful electrode insertion—with thinner electrode arrays and/or perimodiolar electrodes (which also may allow for a relatively atraumatic cochlear insertion) have all helped contribute to hearing preservation with standard cochlear implants.

In the past, cochlear implant patients typically had little or no measurable hearing preoperatively, but today many cochlear implant candidates have significant residual hearing, making hearing preservation possible. Balkany et al. (2006) reported measurable acoustic hearing in 28 standard, perimodiolar cochlear implant recipients, demonstrating a mean change of 15 dB in the pure-tone average (250, 500, and 1000 Hz) and resulting in a mean postoperative pure-tone average of 114 dB HL. At Mayo Clinic in Rochester, six implant recipients (four adults and two children) were implanted with a standard long-electrode device, but in retrospect were generally found to meet the audiologic criteria for an EAS or hybrid device (Gifford et al., 2007). These six individuals demonstrated hearing preservation in the implanted ear that rivals short-electrode EAS or hybrid recipients (see Figure 2 at right).

Yet another variation of EAS is the standard cochlear implant recipient who combines electric hearing with contralateral aided acoustic hearing, commonly referred to as bimodal listening. Though most would not group bimodal listeners into the category of hearing preservation, they are certainly combining the electric and acoustic perception, albeit across ears."
 
john57 said:
Options for Hearing Preservation
by René H. Gifford and Jon K. Shallop
."
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I know Dr. Shallop. He's head of the CI implant section at Mayo. Very nice man, helped me get my CI even after testing showed that I heard to much. Thank goodness for those who listen. :)
 
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