Hearing Aids vs. Cochlear Implants

Hearing Loss
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I am in the process of being evaluated for a Cochlear Implant. This is a very big decision and based on my research the best option doesn’t seem obvious. I would like to hear first hand experiences with Cochlear Implants from the deaf/hearing impaired community to help me make a decision.

My Hearing Loss: I have had a 50% hearing loss in my left ear since brith; my right ear is still working at 100%. I tried wearing a hearing aid as a young child, but due to teasing and not liking the way a hearing aid felt I stopped wearing one at a very young age (5-6 years old). As of late the hearing loss is becoming an issue at work and at home. I cannot hear what people are saying during business meetings and I’m constantly asking my 4 year old daughter to repeat her self. In the past month I had my hearing tested and it was determined that the hearing loss in my left ear is now at 60-70% loss and even more concerning I scored a 34% on the word recognition test.

As a result, my health care team is recommending a Cochlear Implant as the best solution. Their recommendation is that a traditional hearing aid will only amplify distorted noise that my brain cannot understand. They are also recommended against the BiCROS aid; their concern is that it will pump sound into my dominate ear and further degrade the word recognition in my bad ear.

My Concerns: Based on my research and talking with a few people who have had Cochlear Implants I’m seeing very mixed reviews. I understand that there is fair bit of training that determines the success of the implant. However it seems like people love it or hate it.

Again, and experiences would be greatly appreciated and helpful in the decision making process!

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You have TOO good audiogram for CI. Try miniRITE hearing aids - Oticon Real may be the best solution. Either way, it will help your other ear and relieve listening fatigue.

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@ScottyT

You have a really good audiogram.

You’re not even in the severe range let alone profound range.

One brand of hearing aid may not work but there are many available. You may have to try a few.

Where I live, you can’t even get a CI evaluation until a certain amount of frequencies are in the profound range. 90 dB +.

You said you tried a hearing aid when you were younger. Have you tired one recently as they are massively improved?

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So I do have a SIEMENS in ear hearing aid that I got about 7-8 years ago. I got it to primarily wear at work events, but I was not very strict about wearing it and have hardly used it. I recently pulled it out and started wearing it again, however I don’t find it very helpful.

Yesterday during another hearing test, the doctors had me wear a loaner hearing aid that was at max volume. In a conversational setting I found it to be extremely helpful. However, during the word recognition test (when white noise was being blasted into my dominant ear) I was struggling to understand words and sentences.

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This comment where I live would be a definite no to a CI if you are not strict to wear a HA and get your brain adjusted. It does take time. It’s not quick.

Are you going to decide very quickly that you don’t like the CI sound?

Max volume? There are a huge amount of hearing aids that are massively more powerful.

Wearing a HA that is at max volume (max gain?) likely means it’s heavily compressed as you don’t have much room in it which means it’ll sound bad.

Honestly not really sure the person you saw yesterday helped you properly

Remember one brand of HA might help someone but another brand of HA might be perfect for another.

Honestly I think you’re making a very quick choice to go the CI route when you haven’t even been a long term HA wearer.

Despite having very good hearing, you may find a CI is best if you can get it done with very good hearing and that is okay but don’t rush having a CI on a very quick try of a new HA.

Where I live, you have to wear HAs for most of the day for 6 months before having CIs.
Data Logging tells how long a HA has been worn.

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Welcome to the forum.

From your initial post my thoughts go along with Zebras.

You may not understand this but your hearing is a learning thing. It doesn’t just come naturally, you have to give your brain time to learn.

Since you have not done this learning with your bad ear you really don’t know if you can hear with that ear.

I would recommend getting another opinion about your hearing. Maybe even a couple more new opinions before even thinking CI.

Where are you located? What country?
This forum may be able to get you going in the right direction to help you hear better.

Good luck

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I’m based in the US specifically the greater Cleveland area.

These recommendations are coming from the Cleveland Clinic. I agree and plan on taking the advice to seek as second opinion.

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Thanks for sharing with us. I have recently gone from RICs to BTE slim tube HAs and it has made a big difference.

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There is also a type of hearing aid that does something called CROS, which takes sound from the side of the bad ear and sends it to an aid on the good ear. This is to reduce the hearing issues associated with single-sided deafness. At least by audiogram, your good ear looks really really good.

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One big thing to remember: You can get a hearing aid on a trial basis, you can not get a CI on a trial basis - it is permanent.

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I have a different take on this. Yes, your hearing level seems to those on the platform to be too good for a CI. CI criteria has changed significantly in just the last 5- 10 years, so many people who have had CIs for a while had to wait until they were in the profound range before qualifying. I had my CI activated in December of '22 and am now 10 months into the journey and have never looked back. I was considered “borderline” to qualify because my low frequencies (see audiogram) were in normal range and then I tanked to profound. My speech understanding was about 40% in my left ear. With CI surgery there is a risk of losing what hearing you have left and I did lose mine. Some will say it is based on the surgeon, but it’s just a matter of your inner ear structure and luck. I went to Vanderbilt which is a leading CI research university and my surgeon said it’s 50-50 whether you retain residual. Research also shows that getting it sooner than later, while you still have residual hearing, can have faster brain adaptation because the brain is used to the stimulation. I had what they call “rock star” activation results - activation is when they actually turn your CI on a couple week after surgery - and could understand words right away. All sounds were like Darth Vadar in a tunnel for a month or so and gradually got more natural sounding. I am still noticing improvements as time goes by and those improvements can happen for a couple years after activation. I chose the Advanced Bionic brand over Cochlear and Med El due to what I considered advanced tech. Medicare and other insurances have raised the threshold very recently to allow coverage for those who still have a some hearing but have low speech understanding scores. Certainly you can get a second opinion - always good to do research and other inputs. I am not saying you should or should not, just that the criteria are changing rapidly. See this link for the new Medicare approval criteria for US: NCA - Cochlear Implantation (CAG-00107R) - Decision Memo

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I do not have cochlear implants, but on two occasions I was just about pushed into getting them and I refused.

I have read and studied and had extensive conversations with my doctors about this.

It is very surprising to me that you would receive a recommendation for a cochlear implant without trying hearing aids first. The advances in the technology have been substantial over the years.

To qualify for a Cochlear Implant through medicare (I am 67), your audiogram has to be pretty bad. To me it sounds like your condition is bad but going straight to C.I.? I would get a second opinion.

There are many things said about recovery and I have had direct conversations with one of my audiologists (at UCLA), who has a C.I.

The surgery is outpatient. 2-3 hours and you go home.
The most common complication is called “Octave displacia.” I am a composer. I asked, an octave? Or a major third? In one ear? Both? No one can say.

Recovery times are generally shorter for older patients because their brain already knows how to speak and relearning is easier. For someone born with severely compromised hearing the recovery time is longer because they do not know how to speak.

Finding a good audiologist and getting a good audiogram is very important. I have had so many done I can’t even say how many. And by many different audiologists in two countries.

I can tell you the qualitative difference in them is vast and the importance of a good one is key to successfull programming of HA’s.

It is unfortunate that until recently HA’s have been expensive and controlled and hardly ever covered by insurance.

My ears are in the profound hearing loss zone and my last word recognition scores taken 6/16/23 show my word recognition in my right ear at 16% and my left ear 64%.

Finances. The good ones to help with clarity for severe word recognition problems are expensive. Well, you couldn’t buy the OTC hearing aids when my loss first declared itself. They are so much less expensive and I bet they are good.

Main issue: You want to communicate easily with your daughter. Your daughter will love you no matter what.

Costco has a well-regarded hearing aid center and has many brands. You can get an audiogram done there.

Try one of the higher end over-the-counter hearing aids and get them programmed. Explain clarity is the main struggle for you.

There usually is a return period. Take advantage of it. Use the HA’s in clubs, auditoriums, loud family gatherings, really test drive them and if they do not work return them.

I did not do this my first time around but I do now.

As a composer, there are two things that have made me wait. One of the most common side-effect is that you will never be able to play or hear music again. This is because of the octave displacia that happens with the surgery.

Try a high-end model of Oticons or Widex and return them if they do not work for you. Know we are talking about 6 grand.

If that is out of reach, get a high-end OTC brand (I have seen the top end OTC aids run about a grand and do the same thing.

Go to Costco. Get a second opinion. Try HA’s first.

They are better now. I wear behind the ear Widex Moments and no one ever sees them.

Take control.

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Welcome to the forum.
I’m sitting on the fence with this one because today the theory is the sooner the better. You do need to wear your aid every day for at least 6 months. The CI evaluation Auds will tell you this also. They may even tell you to go home and wear it for 6 months then come back for testing. That’s how critical wearing your aid is to your hearing, as well as your brain. Why your brain? Simply with a CI your brain does all the work of what your ear used to do.

Generally speaking those people who don’t wear an aid in the opposite ear to the CI (bimodal) need to do hours upon hours of rehab. Or they don’t get the desired result. It’s a tough gig being a single sided CI. For some reason bilateral or bimodal CI recipients seem to do better than those with a single CI.

Good luck to you which ever way you decide to go.

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Not cool. It takes awhile for the brain to adjust to hearing aid information. Word recognition is not (only) about volume.
You need to wear them regularly to have them work right. And as I mentioned in my previous missive, you gotta have an excellent audiologist perform the tests and understand your need - word recognition, and then have them programed, use them, go back for tune up. Put some work into it. You can make this happen. I think you have to seek out a new ENT/Audiologist team for a second opinion after doing a deep dive in your area, reading reviews. Find someone great. Put in the work. And love your daughter.
:slight_smile:

I am not a doctor but this whole approach you just described sounds completely off. Just my humble opinion.

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Lostdeaf is right. Just looked at your audiogram. Lost deaf’s recommendation for Oticons is good too - they have a reputation for word recognition. Goodness gracious I would die for an audiogram like that.

The key frequencies for vocal/word/peech are between 500khz and 1500 to 2000. That big dip at 4K doesn’t matter. 500khz to 2K is the zone. Roll off everything under 200 - you do not want lows making things muddy. Too much compression will make the spoon dropping in the kitchen 12 feet away louder than you talking to your daughter. Ahh - just riffing. You can make this work.

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Hi, for the case in future you decide an implantation, please narrow the focus onto the best aftercare in your region. It will be necassary to adjust the Speechprocessor and perhaps to attent to special therapy.

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I have replied before and agree with the general consensus.

The surgery is outpatient, 2 1/2 hours and well-tolerated in group studies. I will have to get bilateral cochlear implants soon and am spending time doing my own deep dives and conferring with my audiologist, ENT and surgeon.

And again, I cannot believe the recommendation for CI’s based on your audio gram. I simply do not understand how your audiogram would merit implant.

I am on medicare. Medicare will not approve CI’s unless your audiograms are SIGNIFICANTLY worse than yours.

Aftercare is important. Recovery can vary. Usually better with older people. 1 month, three months, a year. Believe me, when you need them this will not matter to you.

The reason for this new rmissive is to make you aware of a new Oticon product, shortly to be available in the US.

I am quite interested.

W

Addendum: the manufacturers of CI’s have no sense of style. Skins are available to make them not so butt ugly than the 6 or 7 colors usually offered.

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Oticon has already sold its cochlear implant division to the Australian Cochlear. So I wouldn’t recommend Oticon cochlear implant. Choose Medel, Cochlear or any other company.

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I read about that. Am seeing audiologist to discuss. I am looking at many companies. Neuron 8 looks good for my situation.

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my first thought too :smiley: