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EAS and Hearing Preservation with a Cochlear Implant

I owe a post that discusses EAS (electrical acoustic stimulation) and my CI journey so far.  When I discussed my reasons for visiting UNC Chapel Hill (almost 4 hours from home) with the surgeon there we agreed that since I came that far seeking information about “hearing preservation” that we should go that route.  By that point I wasn’t sure I really cared much about preserving hearing in my worse (right) ear, I just knew I wanted to benefit from a CI.  I was surprised that the fact that I did not qualify for the MedEl hybrid CI trial didn’t mean we couldn’t try for hearing preservation and electric-acoustic stimulation as the end result.

How does that work?  Well aparently MedEl has another electrode that is already FDA approved that allows a chance for hearing to be preserved.  I’d get that electrode with their normal CI implant and normal processor.  Then if a new hearing test showed that I still had usable low-frequency hearing I could wear a hearing aid too.  So if that happens I may be in the market for an in the ear hearing aid.  In the mean time I think I can wear the MedEl ‘sports’ processor that pins to your shoulder along with my current BTE.

This article has a good summary of EAS. http://www.asha.org/about/publications/leader-online/archives/2007/071016/f071016c.htm

So is this other electrode going to prohibit from full use of the CI?  Probably not really.  It just isn’t the extra long electrode that MedEl normally uses.

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.

That article also mentions using a BAHA type hearing aid after a CI. Interesting.  Not sure my better ear is good enough to bother with that.  There’s an article about that here.

Time to get back to work.  Playing catch up on everything after a week out of town.

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3 replies on “EAS and Hearing Preservation with a Cochlear Implant”

  1. Share

    Ace says:

    How was your trip out of town? I emailed you and responded to the comment “Spring” ill add a few more comments for your new blog post. Thanks for reading and responding.

    Howcome you now are unsure if you really care about hearing preservation? If I find hearing preservation the most important thing about a CI, does this mean I have too much residual hearing to risk and thus not a good candidate? Of course I want to benefit, from what I read the average aided CI result is 40db across the frequencies. Is this enough for you? Youll hear high frequencies again but trade away most of the low frequency hearing.

    You did mention in a previous blog post that you were waiting for a cure before you decided on CI. No one knows what effect a CI will have on still being able to get a cure in the CI ear, especially if all hearing in that ear becomes history. Also there is the possibility CI will quickly become obsolete and phased out, what will all those CI wearers do as support diminishes?

    How many channels are you going to get from that shorter electrode? Do you plan to wait for a version with more channels or an internal CI processor? Will you need to cut your long, beautiful hair for the magnet to stick? Will I need to cut my curly hair? Won’t you feel self concious with a CI and magnet on your head/hair?

    I am a guy who’s almost 27, feel free to ask me as many questions as you want. 🙂

    1. Share

      Lauren says:

      This is more of a comment to Ace as well as Sara. Ace, I find it interesting all of the questions that you are asking about the CI. I am 24 and I was recently implanted in one ear. I love my implant to the extent that I am having my other ear implanted in two weeks. The questions you are asking are all great questions. I can answer most of them and would be glad to talk more with you if you want to email me. I would also be happy to talk with Sara. I am a teacher of the Deaf as well as spending my life with a progressive hearing loss.

      Concerning the post about residual hearing. I have the regular Med-El Sonata with the long electrode. I have maintained all of my residual hearing so far since implantation in November. This has been determined because I can still respond to pure tone testing in the implanted ear at 100dB. I am not sure what levels other adults thresholds for their implants are at…however my ranges right now are between 25dB in lower frequencies and 15dB at higher frequencies….this mostly varies on the individual and how much power they want.

      Technology is changing rapidly, however I do not forsee CIs becoming obslete, at least within my lifetime. Will they become completely internal devices….probably.

      In regards to the hair…no you will not have to cut your hair to get the magnet to stick. I have long hair as well and I have not had any problems. As far as being self-conscious….that is an individual response. Personally, I am proud, and thankful that I was able to receive the gift of hearing from my CI. I wear it within visibility of everyone. I will continue to make my CIs visible when I have two as well as the one. Granted, I also do this because I teach Deaf and Hard of Hearing children. I do not want them to feel ashamed of their hearing losses, but to accept it as part of who they are and to live as proud individuals. CIs are easily hidden. Simply slide the magnet under your hair and no one ever knows it is their. This is especially true with the Med-El processors as they are so slim and are less visible than some hearing aids.

      Feel free to contact me with any questions about CIs or the process.

      Lauren

      Lauren’s last blog post: CI Number 2 Pre-op and First CI 3 Month results

  2. Share

    Ace says:

    Lauren,

    I sure ask alot of questions but they are informative. There is still so much I need to know about CIs. What was your audiogram unaided and aided before CI? What were your expectations and the odds given for improvement/benefit? Did you have trouble hearing environmental sounds?

    It sure seems that more and more people are experiencing CI tresholds better than 40db average I read about. I don’t know exactly what determines how well a person can hear with CI and what limits the tresholds at each respective frequency. It’s possible that how the electrode is implanted, how healthy the cochlea, auditory nerve and how responsive the brain is as well as the quality of the mappings contribute to CI aided scores.

    Shouldn’t a person only consider CI if itll be better/louder than HAs at all frequencies? Ive always thought I had way too much residual low frequency hearing and up till now, every CI story, blog or case study I read, they have worse hearing than me, usually 90db to 110db, and NR above 1000Hz to 2000Hz as well. They always talk about their hearing aids not working, everything too quiet and how they struggle to hear sounds.

    I could never relate to those who got CI because I hear the majority of sounds with my HAs as they hear with CI. The only difference appears that they appear to understand speech comphrension better than me. Ive wondered if I just need more auditory training as my audiologist told me in order to improve my speech.
    Ive also wondered how people with normal hearing and those with exceptional CI results understand 90% to 100% of speech.

    I am prelingual, born deaf and have no understanding of what normal hearing is like(well now I do at 500Hz and below with those Phonak Naida V UP HAs) I always thought sounds weren’t loud enough to be heard or understood and that if they can make a hearing aid that amplifies to the point that my aided hearing is equal to a person with normal hearing, id hear as well as normal.

    I am now getting that at 500Hz and below but still need to find out why my gains are so low at mid/high frequencies and why transposition either isn’t working or is set beyond what I can hear. If I can make my new HAs work great for me, they should work that much better for Sara who has drastically better hearing at 1000Hz and below than me.

    Sara says she hears 30-45db aided, I await her most recent unaided/aided audiogram so I can compare. If Sara is getting 45db aided at 2000Hz, this is something I should also get, not the 80db aided I probably am getting now.

    If a cure comes out in 10, even in 25 years who will want a CI?

    That makes sense you aren’t self concious of your CI since you and your students are deaf and proud of yourselves. Ill ask some more questions on your own blog.

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