CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING

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CSD 5400REHABILITATION PROCEDURES FOR THE HARD
OF HEARING

• Amplification
• Implantable Hearing Aids

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What Are Implantable Hearing Aids?

• These are hearing aids that involve some degree
  of surgery to internally place the device
  somewhere in the auditory system
• They were developed to address specific needs of
  special populations of deaf and hard of hearing
  listeners not able to obtain benefit from more
  conventional amplification

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Types of Implantable Hearing Aids

• There are four major types of implantable hearing
  aids
• Bone anchored hearing aids
• Conductive/mixed hearing loss
• Middle ear implants
• Moderate/severe SNHL and mixed HLs
• Cochlear implants
• Profound SNHL
• Brain stem implants
• VIII N. loss

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Bone Anchored Hearing Aids

• This hearing aid provides stimulation of the
  cochlea by causing the mastoid bone to vibrate
• Here the vibrator is surgically affixed into the
  temporal bone

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Bone Anchored Hearing Aids

• These hearing aids are used for patients that
  have malformation or atresia of the outer ear or
  patients who have unresolvable chronic otitis
  media
• Currently has market approval in the US
• Cleared for market use by the FDA

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Middle Ear Implants

• Directly stimulates the ossicular chain by way of
  a magnet attached to the TM, ossicular chain or
  round window and a magnetic coil

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Middle Ear Implants

• Targeted primarily for patients with
  moderate/severe degree of SNHL dissatisfied with
  conventional air conduction hearing aids
• Feedback
• Distortion
• Occlusion effects
• Currently undergoing FDA clinical trials
• Not marketed yet

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Cochlear Implants

• Available for about 20 years and the treatment of
  choice for profoundly deaf adults and kids who
  obtain little or no benefit from traditional
  amplification
• Over 3000 patients have been implanted worldwide
  as of 1991
• More information on cochlear implants
  specifically will come later

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Brain Stem Implants

• Consists of an electrode array that provides
  electrical stimulation of the cochlear nucleus
• These devices are used for patients who have lost
  auditory nerve function
• Currently undergoing FDA clinical trials
• First recipients were implanted last year

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Advantages toImplantable Hearing Aids

• Nothing is worn in the earcanal
• Discomfort of wearing earmold, or hearing aid
  shell is avoided (BAHA, MI implants)
• Elimination of occlusion effect (BAHA)
• Middle and outer ear problems are decreased
  (BAHA)
• Better impedance matching with the middle ear (MI
  implants)
• More efficient energy transmission to the cochlea
• Improved fidelity and reduced distortion
• Elimination of feedback
• Only option for any kind of amplification benefit
  (cochlear and BS implants)

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Disadvantages to Implantable Hearing Aids

• Surgery is required
• Risk of infection
• Risks of anesthesia
• More so when close to the cranial nerves
• Fatigue from constant skull vibration (BAHA)
• Device failure (MI, cochlear, BS(?) implants)
• additional surgeries
• Electrical stimulation of the cochlear or
  cochlear nucleus doesnt provide normal auditory
  sensation
• Electrical stimulation (longterm) of the auditory
  system isnt well understood

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