Speaker: Audra Shestak, AuD, Senior Territory Manager at Cochlear Americas. Responsibilities include clinical educaton and support, surgical education and support, hospital contracting. BS in Speech, Language, and Hearing Science at Purdue Unviersity. MS in Audiology and Doctorate in Audiology from Indiana University.
Modern day cochlear implants help both kids and adults with hearing loss. Let's explore the science of how it works and what we've learned from the astounding evolution of this amazing technology over the last 40 years.
Sponsored by Greg Harker
Today’s Presentation
Program: Live and Zoom: Cochlear Implants
Speaker: Audra Shestak, AuD, Senior Territory Manager, Cochlear Americas
Introduced By: Greg Harker
Attendance: NESC: 103, Zoom: 25
Guest(s): Richard Miyamoto and others not signed in.
Scribe: Benny Ko
Editor: Carl Warner
View a recording of today’s Zoom presentation at:
Today's program 081224
Cochlear Implant in Age-related Hearing Loss
About the speaker: Audra Shestak, AuD, Senior Territory Manager at Cochlear Americas. Responsibilities include clinical education and support, surgical education and support, and hospital contracting. BS in Speech, Language, and Hearing Science at Purdue University. MS in Audiology and Doctorate in Audiology from Indiana University. She was introduced by our member Greg Harker, the speaker's father.
Modern-day cochlear implants help both children and adults with hearing loss. Today's talk was predominantly confined to this intervention for individuals with age-related hearing loss.
Indiana University is one of the 7 original medical centers that pioneered and tested this procedure under the leadership of Dr. Richard Miyamoto, former chairman of the ENT department. Today there are three manufacturers of cochlear implants.
It is estimated that 1 in 3 persons over 65 has some degree of hearing loss but only 1 in 20 hearing-impaired individuals eligible for a cochlear implant receive it. The barrier to access is attributed to low identification, misconception of its high cost, and the fear of surgery. The cost for the operation, as determined by audiological criteria, is generally covered by medical insurance as well as Medicare and Medicaid.
Hearing is important to healthy aging and sharp minds. Hearing is considered normal when sound between 0-20 dB is perceptible. Between 20-70 dB, hearing is considered progressively impaired. Between 71-90 dB, hearing loss is severe to profound. Early intervention is important; the outcome of a cochlear implant is better when the duration of hearing loss is shorter. Bimodal hearing is beneficial to functional recovery, i.e., a cochlear implant + hearing aid for the non-implanted ear.
There are two components to the Cochlear Nucleus Implant System (a proprietary name), an external sound processor and the internalized implant. The sound processor picks up sounds and converts them into a digital signal. That signal is transferred to the implant and onto the electrode array
docked within the two-and-a-half turns of the cochlea. The hearing nerve in the cochlea then detects and sends the signal to the brain where it is processed as sound.
Benefits of improved hearing include reduced isolation, improved overall health, and improved verbal and memory function. Subjective satisfaction with cochlear implants includes how well speech is understood by the patient, and how well sounds are perceived in a quiet environment versus a noisy one. Post-operatively, most patients admitted to a drastic improvement in hearing satisfaction compared to their pre-op state. Maximum improvement occurs at about 6 months post-op and requires training.
A cochlear implant should be considered for a patient when audibility is greater or equal to 60 dB and speech understanding is less than 60% in the better ear. The technology of the implant is evolving, the newer slim perimodiolar electrode allows more precise and effective stimulation of the hearing nerve resulting in better functional outcomes. A cochlear implant can be serviced by remote access, the same as a patient's post-op training.
*A special note of gratitude to Dr. David Bash for sharing his personal experience as a cochlear implant patient.
Greg Harker (Dad) Audra Shestak (Daughter)
