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Options Abound in Implantable Hearing Devices

With so much new technology available, it gets hard to keep abreast of all of the options in implantable hearing devices. So, Samuel Gubbles, MD, of the University of Colorado School of Medicine, gathered industry experts to discuss the options in the Panel Presentation, “The Spectrum of Implantable Hearing Devices: Indications and Outcomes.”

Osseointegrated Implants

Jack Wazen, MD, of the Silverstein Institute, said the challenges of unilateral deafness are underestimated, and osseointegrated implants such as BAHA, the oldest ones being used today, are still good tools to use to correct the problem. Surgery has advanced over the years, and implants have evolved and been modified to keep up with the times.

Dr. Wazen described the surgery used for implantation, touching on the standardized surgery with a single-line incision.

Cochlear Implants

One size does not fit all when it comes to cochlear implants, whether you’re dealing with children or adults, said panelist Oliver Adunka, MD, of Ohio State University.

“The outcome variance is dramatic. Some people do extremely well, while others don’t do well at all,” he said. But the earlier you can get a person into one, the better. The main problem is if it will compromise residual hearing.

Dr. Adunka said the criteria for cochlear implantation include moderate to profound sensorineural hearing loss, limited benefit from a hearing aid, no active middle ear pathology, and a normal cochlear nerve and “present” cochlea. He said there is a complex clinical algorithm used to determine if a patient is a good candidate, which includes diagnosis, doing early images (usually an MRI), and an evaluation of the patient’s speech.

Hybrid Implantation

“Cochlear implants are not just for the profoundly deaf anymore,” said Bruce Gantz, MD, of University of Iowa Hospitals and Clinics. “Fifty percent of the patients we’re implanting today have residual hearing.” And it’s important to keep as much of that residual hearing as possible, something that can be accomplished by using a hybrid approach of acoustic hearing with electric hearing.

Dr. Gantz detailed helpful new strategies that are coming along, such as a device developed by a colleague that uses a motor to assist with implantation. He said eight to 15 percent of people will lose their residual hearing over time with cochlear implants, so physicians should always try to preserve residual hearing.

Dr. Gubbles also presented case studies from his own practice and asked the panelists their thoughts on each individual case, leading to informative discussion encompassing best practices and thoughts on devices and implantation.

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