Baha, Ci, Which One? Audi Has Me Confused!

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starkidjupiter

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Shortened post, because I've had to re-type this 4 times because of my computer crashing.

-Severe-profound hearing loss, audiogram attached, slight conductive loss
-Saw CI clinic about possible implantation through Medicare
-Was told speech discrimination was too good for CI but that I was a candidate for BAHA
-Now have appointment on Tuesday the 6th with a specialist about BAHA and possible stapes surgery? (wasn't clear on that or why I would need it)
-I am aware I have mixed loss but I fail to see how a BAHA would help at all.

As far as I'm aware, a BAHA wouldn't help me with sensorineural hearing loss, especially at the levels I'm at. I want to go into this appointment firm about what I need and with good information. Can anyone help me? Any help would be appreciated!

Audogram: was at a link but it won't let me post the link?
ZIFlwu1.jpg
 
I had the same thing happen to me. I was told to get Phonak Niadas and test again for a CI later on.
 
I start out 65db in my left ear and 70db in the right then both slope slowly down to 120Db.
 
C-NICE said:
Have you looked in the Hybrid?
Click to expand...
Medicare won't pay for that anymore than they would pay for a regular one if he doesn't qualify under their terms (which are more strict than private insurance)
 
Couldn't find much info on the Hybrid and if Medicare will pay for it but.. it will pay for BAHA--

Does Medicare cover bone-anchored hearing aids (BAHA)?

Yes. The Centers for Medicare and Medicaid Services (CMS) revised its hearing aid definition so that Auditory Osseointegrated and Auditory Brainstem Implant (ABI) devices and related services are clearly covered under Medicare as prosthetic devices. The revised policy, published on November 10, 2005, resulted from information provided by ASHA's Health Care Economics Committee and coordinated by Robert Fifer.

Change Request 4038, Pub 100-02, Transmittal 39 [PDF] of the CMS Manual System, can be found on the CMS Web site. Effective December 12, 2005, the updated Medicare policy states that prosthetic devices now include "osseointegrated implants to the mastoid process of the temporal bone and auditory brainstem devices."

A revised definition of hearing aids and auditory implants in the Medicare Benefit Policy Manual, Chapter 16, section 100, describes air conduction and bone conduction hearing aids. Now, it also describes specific devices that replace the function of the middle ear, cochlea, or auditory nerve as prosthetic devices that are payable by Medicare.
 
DeafDucky said:
Couldn't find much info on the Hybrid and if Medicare will pay for it but.. it will pay for BAHA-
Click to expand...
I think the hybrid would be treated the same way as a regular CI.

From a sheet my audiologist gave me that she had gotten from John Hopkins
Word Recognition / speech understanding (Aided @ 60db in quiet)
Medicare: <40% in both ears
Private Ins: <60% in better ear, <50% in ear to be implanted
Hybrid (not sure if this is for both Medicare & Private): <60% in ear to be implanted <80% in opposite ear
 
It looks to me that a BAHA would help you (albeit less effectively than a CI might). I would ask if you are able to trial a bone conduction hearing aid first (even if only in the office) to see how you cope with it.

The BAHA would help you with your conductive loss and amplify for you sensorineural loss - if you look at your the [ and ] on your audiogram, your sensorineural hearing is mild-to-moderate - well within the amplification range for a BAHA.
 
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The way to read your audiogram is that [ and ] show the sound you can hear through your inner ear alone and o and x show both your hearing through outer, middle and inner ear. If you have a mixed loss you have problems with both 'outer and/or middle' and 'inner'. The BAHA allows you to bypass the outer and middle ears, meaning that it can target the sensorineural (inner) loss, unimpeded by the conductive loss.

Thus, to read your audiogram - the [ and ] show your sensorineural loss and o and x show your conductive loss.

This might seem opposite to other places online but that's for conductive loss alone, i.e., if o and x are better than [ and ].
 
A stapedectomy could give you back some of your conductive hearing.

I HAD to have a stapedectomy before we tried a CI because it's a less invasive surgery that insurance would want to try first. The hope being that it would get my hearing up to a level that hearing aids would help again. We only tried it in my left ear. It gave me back between 10 and 15 decibels. For you that might be sufficient that hearing aids would work well. But in my case I'm no response. It didn't get me out of profound range where hearing aids could be useful. While it that ear was no response now it's between 90 and 120. Sooooo once it was established that my sensorineural loss is too profound we went ahead and implanted my left ear.
 
BAHA is for Conduction losses, CI is for sensioneural losses. If you have both issues, I would grill the Dr on realistic gains from the stapes surgery
 
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