What are Cochlear Implants?
Cochlear implants are advanced electronic devices that function as bionic ears and are the first medical technology to replace one of the five major senses. They are designed to provide sound to individuals with significant hearing loss in one or both ears, especially those with poor word recognition ability. Unlike traditional hearing aids, cochlear implants are inserted into the inner ear (cochlea) and directly stimulate the brain electrically through the auditory nerve. Cochlear implants offer a unique solution for patients who are unable to benefit from conventional hearing aid amplification.
Who Can Benefit from Cochlear Implants?
Ideal candidates for cochlear implants include both children, 9 months and older and adults who have moderate-to-profound sensorineural hearing loss in both ears with poor word recognition ability, asymmetric sensorineural hearing loss with poor word recognition, or single-sided deafness with normal hearing in one ear and severe-to-profound hearing loss in the opposite ear. Your doctor will guide you as to whether the type and degree of your hearing loss qualifies you for a cochlear implant.
Medicare patients with hearing loss must meet all of the following criteria:
- Bilateral sensorineural hearing loss with less than 60 percent word recognition in both ears
- Limited benefit from conventional hearing aids
- Intact cognitive ability
- No middle ear or mastoid disease
- A patent inner ear
- No auditory nerve tumors or central nervous system disease
- No contraindication for having an operation under general anesthesia
- Meet current U.S. Food & Drug Administration guidelines for cochlear implantation
Cochlear implants are particularly beneficial for those who gain limited benefit from conventional hearing aids and have a strong commitment to the rehabilitation process post-implantation.
The cochlear implant process begins with a comprehensive hearing test, a consultation and examination by one of our cochlear implant surgeons, and a consultation with one of our cochlear implant audiologists for special hearing testing. Following special testing, a CT scan of the ears (x-ray) is performed to make sure that the inner ears are acceptable for a cochlear implant. If a cochlear implant is scheduled, a pneumococcal vaccination is required if the patient has not already been vaccinated.
Cochlear implantation involves a 2–3–hour surgical procedure performed under general anesthesia. During the operation, one of our cochlear implant surgeons implants the internal component of the cochlear implant into the inner ear. To do this, an incision is made behind the ear, and the mastoid bone is opened. The operation involves careful placement of the implant in the cochlea of the inner ear.
Our implant surgeons at Atrium Health Wake Forest Baptist are the first surgeons in the Southeastern United States to use a new robotic-assisted insertion system that permits a very slow, gentle, continuous, consistent, and controlled insertion of cochlear implant electrodes to minimize insertion forces and micro-trauma of the delicate structures of the inner ear. Our goal is to preserve structure and function in hopes of achieving better long-term hearing outcomes for our patients. More about this new roboticassisted technology may be found below.
After the operation, patients undergo a 3-4-week period of healing followed by activation of the cochlear implant by our audiologists and the fitting of an external Sound Processor. The healing period allows for the resolution of any postoperative swelling over the implant and clearer transmission of sound energy through the skin provided by an externally worn Sound Processor. Cochlear implant activation and programming take place with a highly trained cochlear implant audiologist. The external Sound Processor device is programmed and is adjusted to suit the individual's hearing needs.
Adapting to a cochlear implant is a special journey. Initial hearing with a cochlear implant does not sound natural. It often takes up to one to two years for our brains to learn how to use the sound signals produced by a cochlear implant. Maximum success involves working closely with our audiologists and speech-language pathologists for optimal device functioning and habilitation. Over time, patients often experience significant improvements in hearing and speech understanding. Batteries are contained in the Sound Processor. There are no batteries in the implanted component of a cochlear implant. In addition, the implanted cochlear implant components will always remain retro-compatible with all new Sound Processor technology. All our cochlear implants are now conditionally MRI compatible.
Our multidisciplinary cochlear implant team is very experienced and is genuinely committed to delivering exceptional care to individuals with severe hearing impairment. Our dedicated team encompasses a group of professionals including audiologists, otologists and experienced speech language pathologists. Our surgical specialists have completed rigorous residency programs/fellowships and hold certifications in otology/neurotology, ensuring the highest level of expertise in their field.
In December 2023, we became a leader in cochlear implant surgery by being the first center in the Southeastern United States to adopt and use advanced robotic-assisted cochlear implantation technology. This safe, effective and U.S. Food and Drug Administration authorized robotic-assisted iotaSOFT® Insertion System is designed to provide enhanced control during surgery and maximize patient outcomes by preserving the very delicate structures within your cochlea.
The iotaSOFT® Insertion System is robotic-assisted technology designed for cochlear implant electrode array insertion during cochlear implant surgery. The system allows our highly skilled surgeons to slow down the speed of electrode insertion beyond human capability and to reduce insertion force variation to maximize your outcomes. The use of robotics helps to ensure that the delicate structures within the cochlea are preserved during cochlear implantation.
Benefits of Robotic-Assisted Cochlear Implantation:
- Confidence in Surgery: The iotaSOFT® System is designed to maximize surgical outcomes by preserving the delicate structures within your cochlea.
- Controlled Insertion: iotaSOFT® also gives your surgeon enhanced control during surgery to levels beyond the capability of manual insertion using the human hand. With robotic-assistance, our surgeons can deliver a minimally invasive workflow and tailor the surgical approach to each patient’s unique needs.
- Latest Robotic Technology: We are the first cochlear implant center in the Southeastern United States to provide robotic-assisted cochlear implantation to our patients.
- System Compatibility: The iotaSOFT® is a safe and effective system that is compatible with all three cochlear implant manufacturers.