Residual hearing after Cochlear Implant

Cochlear Implants
#1

I am well on in the process of having a Cochlear Implant from the NAIP (Nottingham Auditory Implant Programme) in UK. Next appointment is with surgeon.

I have only recently understood that there may be residual hearing in the implanted ear and that CI devices have provision to incorporate a conventional hearing aid in the implanted ear to amplify this. The result being (in my case) that low frequencies will still use conventional HA and high frequencies will be via cochlear.

It seems to be the situation that it is difficult to predict how much residual hearing will remain until after the operation.

Do any CI users here have residual hearing and a conventional HA in the implanted ear?

Any comment welcome.

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#2

@boreham your residual hearing is never guaranteed. Some surgeons do preserve your residual, but the longevity of your residual is hit and miss.

I’ve not personally heard of anyone having a HA in their CI ear. But a hybrid EAS yes I had one.

My residual was preserved at time of surgery. I had a Cochlear hybrid attachment (EAS) for 15 months. I used to be able to understand conversations without my processor. At 15 months my residual tanked on me. I can now only hear noise from my CI ear. Why some tank and others don’t no one can explain the reason why, it just happens.

Good luck with your forth coming CI journey.

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#3

Thanks very much. I wonder if a “hybrid EAS attachment” is the same as what I called a “conventional HA”. I said that because it looked like a conventional HA, but was part the Cochlear Nucleus 8 equipment not a separate thing.

#4

Boreham it’s similar to a RIC receiver attached to the processor that goes into your aural canal. You can see it in the picture here.

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#5

Yes that is exactly what I saw. Thanks for confirming.

#6

I had read up a lot on this. I ended having zero. But even if you have some it may come and go. I have a buddy who ended up with quite a bit and has dual Advanced Bionics HA and Processor.

#7

Like deafpiper, I had residual low frequency hearing after CI implantation. With the hybrid attachment, this allowed me to have some pitch discrimination sufficient to discern a couple of tones apart. For an unknown reason, the residual hearing disappeared about 4 months after implantation so we removed the hybrid component. I can now only discriminate pitch when the notes are about an octave apart.

I was in two minds about the hybrid attachment. On the one hand, it was great that music was clearer. On the other hand, it was a pain in the neck to maintain.

I have still one good ear with which to play musical instruments.

#8

A question to the responders, did you have a post CI CT scan to determine whether there was any translocation of the electrode. If insertion deviates from the Scala Tympani I believe it is a certainty that you lose your residual hearing. Translocation can only be determined with a CT scan afterwards. The literature states that this occurs in <10% of the cases.

I am scheduled for my CI in 2 weeks.

#9

No post CI CT scan done.

Seems results at activation would justify another CT scan if needed.

Good luck with your implant. Looking forward to your updates.

#10

I assume the argument against a CT scan is that the team should know where the electrodes are positioned based only on the depth of insertion matched up with the measurement of the cochlea. Otherwise, how would you know if electrode 3 is located by the region with that frequency?

#11

I would assume this information would be very clear at activation.

#12

Yes I had a post implantation CT. This was to

  1. To check the internal magnet and receiver position on the scull.
  2. To check the electrode was still in a good position.
#13

I wonder if this was due to yours being a hybrid or maybe it’s an Australia thing??

#14

@Raudrive I have a CI 522 array not a hybrid L24. The standard length arrays can sometime bend back on themselves. I’ve read about so many recipients the tip bends back and needs replacing.
Therefore by doing a post op CT it picks this up and it can be rectified sooner rather than later.
I think it’s just good practice from the surgeons.

#15

I remember this subject coming up now. Your point makes great sense.

I wonder if scans are taken during the surgery? Like using a monitor to see the array placement.

#16

Rick they certainly could do this.

@Raudrive when I had my CI my surgeon used some new piece of equipment to guide the electrode into the right spot.

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#17

Thanks, this makes perfect sense. How quickly the surgery is done with such high results.

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#18

The CI 522 is a straight array at 19 mm for full insertion to the apex and the potential for uniform stimulation of all frequencies. These are lateral wall arrays vs perimodiolar (pre-curved) arrays like 532. The PM arrays have a much greater potential to tip fold or worse - translocation. A CT scan after implantation helps confirm placement.

There is now new equipment for insertion that has improved correct insertion. IotaMotion has developed a small devise that can insert the array at speeds much lower than is capable by human touch. When pared with the software used by the CI companies, a near real time picture of placement can be made.

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