Cochlear Implant Questions

 

Welcome to Cochlear Implant questions and answers. If you would like to submit your own question to be answered click here.

For more information on our Cochlear Implant Services please visit Cochlear Implant Center at GBMC.


I am currently a 2nd Year Speech-Language Pathology student at UNC-Chapel Hill interested in serving infants, toddlers, and children with pediatric hearing loss. I will be graduating in May 2014 and am planning to pursue LSLS certification through AG Bell.

My husband has a current job offer in Washington, DC. I am curious - will the Greater Baltimore Medical Center's cochlear implant team have any availability for a CF student or a clinically-certified SLP pursuing LSLS certification in the near future? I will be in Washington, DC this summer.

Through my graduate program, I have completed two clinical semesters with CCCDP-CASTLE, a cochlear implant program which works with a multidisciplinary team of audiologists, speech-language pathologists and surgeons. I have had the privilege of watching the first FDA-approved ABI candidate through his post-implant progress. I am dedicated to continuing my experience in serving this population.

I would very much appreciate your response.

Thank you for your job inquiry. At this time and in the near future we do not have financial support for a CF. This may certainly change so if you would like to forward your resume and information to us to keep on file please do so. You can send it directly to me.
 
Thank you for your interest and good luck to you,

Kelly
 
Kelly Hume-Johnson, M.S., CCC-SLP
Aural Rehabilitation Therapist
Cochlear Implant Center
Greater Baltimore Medical Center
6535 North Charles Street, Suite 250
Baltimore, MD 21204
Phone: (443) 849-8400
Fax: (443) 849-8464
 
Visit us on Facebook
www.facebook.com/GBMCCochlear


Would like to upgrade to the new processor.  What steps do I need to take, will it require a visit?  Will GBMC work with my insurance company?

The process of upgrading a processor is done directly with the manufacturer of your implant.  Your implanting center can certainly assist you in knowing what to order based on your history and preferences.  If the manufacturer participates with your insurance company, they will submit it on your behalf.  If they do not, it may require that you pay up front and then get reimbursed.  You may also obtain assistance determining if the upgrade will be covered by contacting Otologic Management Services (OMS) (800) 633-4667.  The upgraded processor is typically mailed directly to the cochlear implant recipient and then the recipient should schedule an appointment for mapping.  Please let us know if you need any further assistance.  Thank you.

Regina Presley, Au.D., FAAA, CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
Like us on:
www.facebook.com/GBMCCochlear
443-849-8400 - office
443-849-8464 - fax
Office Hours: 
Monday - Thursday 7:00 a.m. - 3:30 p.m.


Hello, I am possibly interested in looking into a cochlear implant for my mom, who turned 85 on Valentine's Day. She has profound deafness and wears a very old hearing aid that has a cord and a separate box that she hides in her blouse. Her audiologist here in York did say she may be eligible. Is that true? I think it would make a world of difference for her, especially in her social life, to be able to hear better. Thanks.

It is possible that your Mother may be a candidate for cochlear implantation.  This would require a candidacy evaluation which would assess her hearing and her performance with her hearing aid.  If the results qualify her from a hearing standpoint , she would then need to have  CT scan complete and meet with a surgeon to determine if she is a good medical candidate.  If you would like to begin this process with our office, please feel free to contact us at 443-849-8400.  Thank you.

Regina Presley, Au.D., FAAA, CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
Like us on:
www.facebook.com/GBMCCochlear
443-849-8400 - office
443-849-8464 - fax
Office Hours: 
Monday - Thursday 7:00 a.m. - 3:30 p.m.


Are Cochlear Implants covered by Medicare?

Medicare generally covers 80% of the cost of cochlear implantation. If a patient has a secondary insurance, they usually will pick up the remaining 20%. With the many changes in healthcare; however, we always seek authorization/approval. and notify patients in advance of their surgery. Please let us know if you need any additional information. Thank you.

Regina Presley, Au.D., FAAA, CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
Like us on:
www.facebook.com/GBMCCochlear
443-849-8400 - office
443-849-8464 - fax
Office Hours: 
Monday - Thursday 7:00 a.m. - 3:30 p.m.


My daughter is eight years old, born in Washington DC and diagnosed with profound hearing loss at birth. We are currently residing in the UK. Please send me details on how she can undergo cochlear implant in your facility. Thank you.

Thank you for your interest in cochlear implant technology.  It would be our pleasure to serve you and your daughter; however, I think that it is important that you are aware of the large time commitment and need for follow up that is required for cochlear implant candidacy, treatment and management.  As you look at our website you will see the general guidelines for necessary appointments prior to and following implantation.  Your daughter will need to be seen for rehabilitative services after implantation to help her learn how to hear and understand with the implant.  Although we are more than happy to provide those services, it would be difficult if your family will be living outside of the United States.  You may request an appointment on our website.  Completing this request will give allow us to schedule an appointment and will also result in literature regarding implant technology to be sent directly to your home.  If you would prefer to obtain services in the UK, you may use any of the links to the cochlear implant manufacturers on our website and locate a center nearest you.  Please do not hesitate to contact our office if you have any further questions.  Thank you.

Regina Presley, Au.D., FAAA, CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
Like us on:
www.facebook.com/GBMCCochlear
443-849-8400 - office
443-849-8464 - fax
Office Hours: 
Monday - Thursday 7:00 a.m. - 3:30 p.m.


I lost my hearing 3 years ago and I have been to see a specialist and he determined I am a candidate for the implants. I would like to get more information and see if my insurance will pay or how much they will pay.

Regina Presley, Au.D. responds:

Thank you for your request for information regarding cochlear implant technology. Our website is a great resource for frequently asked questions. The clickable videos will also serve to educate you regarding implant technology, insurance, procedures and expectations. You will also find patient testimonials. Most insurances cover the cost of cochlear implantation if it is deemed medically necessary by the cochlear implant team. I would recommended that you review information on our website as well as the information that you will receive from the manufacturers (at your request via our telephone conversation). If after reviewing this information, you determine that you would like to schedule an appointment for an evaluation, please feel free to contact our office at 443-849-8400 or schedule an appointment on our website.  We also have many cochlear implant advocates who are happy to discuss their cochlear implant experience with you if you would like. We are here to meet your needs. Thank you.

Regina Presley, Au.D., FAAA, CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
Like us on:
www.facebook.com/GBMCCochlear
443-849-8400 - office
443-849-8464 - fax
Office Hours: 
Monday - Thursday 7:00 a.m. - 3:30 p.m.


Do you offer internships?

Kelly Hume, MS, CCC-SLP responds...

We do accept interns for both Speech Pathology and Audiology. We are a part time program, so I am here two and a half days a week. Your school would need to contact our Human Resources department to fill out the necessary paperwork. An interview is required prior to being offered a placement at our facility. I can give you additional information about our program if you email me directly at khume@gbmc.org .

Thank you for your inquiry,
Kelly Hume-Johnson, M.S., CCC-SLP


Kelly Hume-Johnson, M.S., CCC-SLP
Aural Rehabilitation Therapist
Cochlear Implant Center
Greater Baltimore Medical Center
6535 North Charles Street, Suite 250
Baltimore, MD 21204
Phone: (443) 849-8400
Fax: (443) 849-8464

Visit us on Facebook
www.facebook.com/GBMCCochlear


Regina Presley, Au.D., CCC/A responds...

Thanks for all of the great questions you posted to our forum. I am placing my answers below for your convenience.

 -I'm currently in the pipe line to have implant surgery done. As far as I know... one more set of tests to be done before scheduling surgery. Having the perspective of seeing the date coming, a couple questions come to mind:  - How reliable are the sound processors? I have been using aids for many years. I can't function without them. But unfortunately, they break down. This is obviously very inconvenient.

THE SOUND PROCESSORS ARE VERY RELIABLE. WE ARE A TWO PROCESSOR CENTER WHICH MEANS YOU WILL RECEIVE TWO SYSTEMS FOR ONE EAR. THIS WAY, YOU ALWAYS HAVE A BACK UP AND SHOULD NOT BE WITHOUT SOUND.

- Do they come with a warranty? Typical aids do.

YOUR PROCESSORS COME WITH A 3 YEAR WARRANTY.

- If a repair is needed that is not covered by a warranty, what would a ball park figure be for the repairs?

REPAIRS VARY BASED ON WHICH PART IS IN NEED OF REPAIR. A COCHLEAR IMPLANT HAS SEVERAL COMPONENTS SO THE WHOLE SYSTEM DOES NOT USUALLY NEED REPAIR. AS PART OF THE INITIAL KIT, YOU WILL ALSO RECEIVE SOME ADDITIONAL SPARE PARTS. COCHLEAR IMPLANTS ARE CONSIDERED DURABLE MEDICAL EQUIPMENT SO THAT REPAIR REQUESTS CAN BE MADE TO YOUR INSURANCE COMPANY AS WELL.

- How quickly does manufactured turn around repairs?

TYPICALLY, IF YOUR SYSTEM WAS IN NEED OF REPAIR, I WOULD ELECTRONICALLY SEND YOUR SETTINGS TO THE MANUFACTURER, THEY WOULD PROGRAM A REFURBISHED PROCESSOR AND SEND IT DIRECTLY TO YOU WITHIN 24 - 48 HOURS. IT MAY TAKE A LITTLE LONGER IF INSURANCE AUTHORIZATION OR 3rd PARTY WARRANTIES AUTHORIZATION IS REQUIRED.

- Do the processors come with multiple batteries that can be swapped out while recharging?

YOU WILL RECEIVE NUMEROUS BATTERY OPTIONS (DIFFER FROM MANUFACTURER TO MANUFACTURER) THAT WILL ALLOW YOU TO ALWAYS HAVE BATTERIES AVAILABLE.

- Of the two systems I see mentioned, the Nucleus seems the best for someone who plays sports, and would prefer something from a vanity standpoint. Does that sound realistic.

WHEN YOU ARE IN THE OFFICE FOR DEVICE COUNSELING, I WILL SHOW YOU THE MANY DIFFERENT WEARING OPTIONS AND FEATURES OF EACH DEVICE. THIS WILL HELP YOU DETERMINE WHAT BEST SUITS YOUR LIFESTYLE. I LOOK FORWARD TO SEEING YOU IN THE OFFICE SOON.


I have a 2 month old who has hearing loss, suspected profound hearing loss. However, the doctors are not done with all of their testing. During her first test, they put a round device behind her ear to see if she responded to the sound by bypassing her inner ear and sending it straight to her nerve. She did not respond to that test, does that mean she will not be a CI candidate?

Regina Presley, Au.D. responds...

The round device that was placed behind her ear was to determine if she responded better by stimulating just the inner ear. When we use earphones, the sound travels through all 3 parts of the ear: the outer (ear canal), middle(behind the ear drum) and inner (cochlea). If she had responded better with the box behind her ear, that would suggest that something was blocking sound from getting through the system in the outer or middle ear. When we see that responses are poor through the earphones and with the box behind the ear, it suggests that the loss is within the cochlea. Depending on the amount of loss, a cochlear implant may be an option. Your team will be completing a battery of test for hearing and imaging to take a look at the entire system. This information will help you make the right decision for your daughter and your family. If we can be of any further assistance, please do not hesitate to contact our office.


I am 54 years old & I have been deaf for almost 2 months. It started out in March w/severe tinnitus. I was examined last month. They told me I have nerve damage, but I could hear a little. A month later I went back--I can't hear a thing! When I asked about hearing aids (I am now deaf in both ears) the audiologist told us that I am "off the charts". He says that I will benefit from cochlear implants. I'm afraid that I am too old, that my hearing is too far gone! I have an appt. w/a leading cochlear implant specialist in Cleveland, Ohio. Am I just getting my hopes up for nothing?

Regina Presley, Au.D. responds...

I am sorry to hear that you have experienced this sudden hearing loss but happy to tell you that there are solutions. A cochlear implant is inserted into the inner ear (where your damage has occurred). Previously, there have been little hair cells that bend and send off information to your nerve and up to your brain. From what you have described, those hair cells are not functioning. The cochlear implant will be inserted in the inner ear and provide electrical stimulation that will be sent up your brain via the nerve. The good news is, the shorter period of time you have had hearing loss, the better patient performance generally is. Please know that patients are receiving implants into their 90's, so 54 is young! I do not believe that you are getting your hopes up. I would commend writing down any questions and/or concerns you have and discuss them with your implant team. They will be a terrific resource for you and will be able to share with you realistic expectations. I wish you the best in your pursuit of cochlear implantation.


Hello. I am considering getting a cochlear implant. I have been losing my hearing over the last several years and am nearly deaf now and I never learned sign language or lip reading. I am 83 years old. Hearing aids don't help and my audiologist says an implant is the only thing that will help me. When I wear hearing aids, it just sounds like static and it bothers me especially since I can't make out words. My concern is that with the implant, it will drive me crazy with the sound of static and noise. What do your patients say about that? Will I be able to take it? Also, is my age a problem? What are the chances it will be a success? Thanks very much for your response.

Regina Presley, Au.D. responds...

Often times, when the hearing loss gets to be severe, hearing aids just distort sound, resulting in poor quality sound and noise. The cochlear implant works very differently as it is not making sound louder. The implant actually provides electrical stimulation, instead of the acoustic sound from the hearing aid. This results is a different quality of sound and access to many pitches that were not obtainable through the hearing aid. It does take time to adjust as it does not sound natural immediately, but it is something patients can handle. Age is not an issue as long as you are healthy and your primary care physician feels that the use of anesthesia is okay. If you are interested in pursuing additional information or would like to schedule an appointment, please contact our office. Following a thorough case history and examination, we will be able to share our thoughts regarding expectations for your personal cochlear implant use.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist


My son has been diagnosed with auditory neuropathy. We have had a hearing aid trial, services from MSD and infants and toddlers. We feel as if his current provider is moving extremely slowly, and we want ot be able to get him on the road to CI so he may be able to speak to his twin brother as well as the world. We are also working with KKI to get him used to wearing equipment on his ears/head. What can we do to be in your program? I feel we are losing precious time. THANK YOU.

Regina Presley, Au.D. responds...

It sounds like you and your family are doing everything you need to do to determine if a cochlear implant is a good choice for your son. In order to move forward, we would need to review the previous test results and learn more about his services through Maryland School for the Deaf and the Infants and Toddlers Program. The need for additional evaluations would be determined following a review of this information. Once your needs are determined, our staff would work with you to schedule any necessary appointments. If you wish to move forward, please feel free to contact our office at 443-849-8400. You may fax previous findings to 443-849-8464. We look forward to serving you and your family. Thank you.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist


I am looking into the implant for myself. To see if it's an option.

Regina Presley, Au.D. responds...

If you look at our webpage, you will see the list of candidacy criteria. If you are unsure of what that all means, please email or call us to schedule an appointment. By assessing how you are hearing currently, with and without your hearing aids, we will be able to help you determine if a cochlear implant is the right option for you. If you have a current audiologic evaluation, you may also fax it to us for review. Thank you.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office
443-849-8464 - fax
Office Hours:
Monday - Thursday 7 - 3:30


I am attempting to locate a doctor in the Baltimore area with experience doing Cochlear implants for my wife.

Regina Presley, Au.D. responds...

Thank you for your interest in cochlear implant technology.  We would be more than happy to assist you and your wife in locating an otolaryngologist.  We have three skilled physicians on our staff who are available to meet your needs.  Please see our staff web page to learn more about each team member.  You may contact our office at 443-849-8400 and we can assist you in located a physician closest to you.  (They have several office locations.)  If you would prefer email, please contact kandrulonis@gbmc.org for assistance with scheduling.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office


I am interested in possible Baha Technology.  I have total deafness in one ear and partial deafness in the other ear.  I have not been successful with hearing aids.

Regina Presley, Au.D. responds...

Thank you for your interest in Baha technology.  The Baha instrument is designed for patients with deafness in one ear and minimal hearing loss in the other ear or for patients who have a conductive hearing loss (sound not traveling through the ear effectively).  It would be in your best interest to have a thorough evaluation completed to determine the type and degree of your hearing loss in order to know if the Baha is the right technology for you.  Please feel free to phone our office at 443-849-8400 to schedule an evaluation.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office


I hope you can help. I am from the UK! My Aunt had a cochlear implant many years ago and is now rather old and confused. She is now convinced that she cannot have surgery for a nasty varicose vein and a problem skin graft because of the hearing implant. Does this sound correct to you?

Regina Presley, Au.D. responds...

The presence of the cochlear implant does not restrict a patient from receiving surgery.  Special procedures would be necessary for the completion of a MRI if necessary and certain surgical tools may be utilized due to the presence of the implant.  It is recommended that your aunt inform her surgeon of the cochlear implant.  The surgeon should contact the manufacturer of her device or the surgeon who implanted your aunt for further instruction.  Please let us know if you need any additional information. 

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office


I am 77 year old female. I have had an implant for about 15 years, which is now obsolete. I used it very little because I have tinnitus. Right from the start the noise from the implant was greatly amplified. My niece is a patient there and she told me with her first implant she heard noises, but with her second implant the noises just about disappeared. I would like to consider looking into replacing my old implant and having a second one implanted. Do you think this a sensible thing to do considering my age? I was in an auto accident five years ago which left me with both knees broken and I am only able to walk with a walker. Thank you for you attention and I am hoping to hear from you.

Regina Presley, Au.D. responds...

I am sorry to hear that you have not been successful with your original implant.  It would be my pleasure to see you in our office.  The best course of action would to test both ears and look at your performance with your current implant and/or hearing aid.  We will need all of this information to ensure that we are making the best recommendations for you.  At that visit, we will talk more about options and benefits of the recommendations.  You may call or email our office at 443-849-8400 or kandrulonis@gbmc.org to schedule the appointment.  I look forward to serving you.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office


I have a three month old granddaughter who I feel does not hear.  What do I do?

Regina Presley, Au.D. responds...

We would be more than happy to address your concerns regarding your granddaughter's hearing.  Please contact our office  (443-849-8400) and we can assist you in scheduling an appointment.  There are many ways to obtain good reliable results about how young children are hearing.  She will receive a thorough evaluation and you will receive detailed information regarding results and recommendations.  I commend you for seeking out questions to your concerns.  We look forward to serving you.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office


Can you kindly give detailed information about the cost of procefdure, implant and rehabilitation of cochlear implantation. I have a patient that can benefit from it.

Regina Presley, Au.D. responds...

Most insurance companies cover cochlear implantation if it is deemed medical necessary.  This would be determined by the completion of a cochlear implant candidacy evaluation which would include audiology, speech, radiology and a medical evaluation.  The cost of the cochlear implant process, begin with the candidacy evaluation through surgery and rehabilitation, is approximately $45 - 50,000.  This expense includes all services, surgery and a 2 processor cochlear implant system.  Following the candidacy evaluation, findings would be forwarded to the insurance company for review and final authorization.  At that time, patients would learn if there is any financial responsibility based on their individual insurance policy.


Insurance Coverage Question
 
Hello,
I'm a student at Towson University and I have a patient who has no measurable pure-tone thresholds in one ear and profound pure-tone thresholds in their other ear.  Currently, they have Medical Assistance.  I was wondering if your facility accepts this insurance for a cochlear implant evaluation/surgery or if you have any resources known to help with coverage?  Thank you and hope to hear back from you shortly.

Regina Presley, Au.D. responds...

We are able to provide services to patients with Medical Assistance for audiologic, medical and rehabilitative needs. Patients would be followed through both the Cochlear Implant Center and the Department of Otolaryngology which are both located in the Physicians Pavilion North - Suite 250. Proper authorization would be required for each visit. Please feel free to contact us for additional information, literature or to schedule an appointment. Thank you.


Do I need a Cochlear Implant Question

Lost hearing in left ear 15 years ago due to Acoustic Neuroma removal resulting in nerve damage. Right ear transmission level dropped until hearing aid was needed and acquired about 4 years ago. While not having great hearing, I could communicate effectively and learned by accident to read lips.

One week ago suffered Sudden Deafness in right (good) ear. No sound. Taking oral Prednisone treatment. Not very good outlook according to my physician. No tumors. However, when conducting hearing tests I found I could hear speech at about 35% in left ear. Hearing aid will be switched to left ear and reprogrammed. Optimistic that a good conversational level of hearing can be attained.

Doctor strongly suggests I receive a Cochlear Implant in my right ear. I am 69 years old. I have been living well with hearing in 1 ear for many years. My question is... Will the benefit of an implant be of great enough value to proceed? I am not very committed to the implant idea.

Regina Presley, Au.D. responds...

Pursuing a cochlear implant is a very personal decision and it is important that you gather all of the information possible to help you in your decision. It is exciting to hear that you are receiving some information from the left ear; however, 35% word recognition still will require a great deal of lipreading on your part. Receiving auditory input from both ears would increase your sound awareness, speech understanding and ability for localization. It may be helpful for you to assess how well you do with the left hearing aid and steroid treatment before deciding to move forward with cochlear implant technology. 


Confused About Implant Question

Hi..I have a "special" daughter who is 3 years old. She has bronchotracheomalacia since birth and improving each year. She used glasses and also hearing aid. Her right side is profound and left side is moderate. About 1 year already, she used the hearing aid. Now,she start babbling and quite good to the sound if she wear the hearing aid. Until now she still has middle ear fluid for both side. Last year, she undergone an operation which insert the tubes to both ears,but the fluid still remain in her ears. Our ENT said this because she has phlegm according to her lung problem. Recently our therapy suggest us to do cochlear implant for the right side. My question is "Is my daughter really really need it?? "What if she just using hearing aid for both side??"..I'm just afraid thinking about the risk of the surgery. I don't want her condition become worse as right now going very well under all therapy and seem a lot of improvement. Help me please..what is good and bad if I do and don't? I really don't know what to do. I'm afraid I will make a wrong choice for my daughter. Thank you very much

Regina Presley, Au.D. responds...

There are a few things to consider prior to thinking about an implant. First and most importantly, we need to know if medically this is a good choice for her. You should discuss the type of hearing loss and the impact of the ear infections on her hearing status. Also, the health of her ears plays an important role in determining if she is a good medical and surgical candidate for a cochlear implant procedure. You should discuss the surgical risk of cochlear implantation for all patients as well as any special medical concerns regarding anesthesia for your daughter. Lastly, it may be helpful for you to talk to other families who have struggled with the decision of how to proceed. If you contact Advanced Bionics or Cochlear (links on this website), they will be able to help you establish contact with other families who have chosen to pursue cochlear implantation.


Cardiology Question

I have been approved for a cochlear implant through the Veteran's Administration. While the ENT who saw me recently says that I am a good candidate and strongly encouraged me to have the procedure, a cardiologist whom I also see tells me that I am NOT a good risk because of a history of strokes (had a series in 1997) which involved temporary partial loss of my field of vision. I have been taking coumadin ever since. On November 13, 2007, I successfully underwent knee replacement surgery without any complications and am planning to have the other knee replaced this spring. There is a difference of opinion between various cardiologists whether or not I might also have had a mild heart attack in the past. In addition, a couple of years ago, it was discovered that my aorta seemed to be slightly enlarged, a condition which is being monitored for further change or enlargement. Last night I lost my hearing almost entirely. The stapes surgery which I had done twice in the late 1970's, and which has been gradually deteriorating, let go. I am frankly terrified of the possibility that the cochlear implant surgery will put me at great risk for a stroke. The cardiologist, if I heard him correctly, said that the risk of stroke is much greater than the knee surgery because, being in the head, is much closer to the brain and therefore more dangerous. I would appreciate your input and advice. I would hate to forego a procedure that would restore my hearing because of one doctor's opinion.

Regina Presley, Au.D. responds...

Additional cardiology recommendations would certainly be the first step. Otologic surgery is very low risk for either stroke specific to the operation or chance of clot formation. The cardiologist is incorrect stating that there is an increased risk because we are operating closer to the brain.


Bi-lateral cleft pallet Question

My 5 year old son was born with bi-lateral cleft pallet, mid-line issues and hearing loss in both ears. His hearing is tested on a bi yearly basis. He just had another hearing test and his hearing in the right ear is just about gone and the left ear is at about 50%. He continues to struggle with speech. Who is the best pediatric otolaryngologist and how would we proceed to go forward?

Regina Presley, Au.D. responds...

Thank you for your inquiry on our "Ask an Expert". The type of hearing loss your son has is going to determine the course of treatment that he will require. Your Otolaryngologist and Audiologist will serve to educate you regarding those options as well as connect you with other educational and medical providers necessary for optimal care. The physicians and/or other medical professionals you can see will be directed by your insurance carrier. Please contact our office if you would like to obtain some direction regarding the list of providers within your plan. It would also be our pleasure to discuss your child's hearing status and make recommendations to help him move forward to better hearing. We look forward to hearing from you.

Regina Presley, Au.D., CCC/A
Senior Cochlear Implant Audiologist
Cochlear Implant Center @ GBMC
6535 N. Charles Street
Suite 250
Baltimore, Maryland 21204
443-849-8400 - office
443-849-8464 - fax


Eligibility Question

Hi. My brother is deaf and I'd like to know if he is a candidate for the cochlear implant. If he is, I would not be using medicare insurance for the operation. I would pay it myself, so money should not be a problem for eligibility.

The thing is, my brother wasn't born deaf. He caught an infection when he was 1 month old and was about to die. Due to the large amount of antibiotics the doctors gave him to save his life, his inner ear was destroyed.

He is 27 years old. Is he eligible for the implant? If not, is there anything else that can help him?

Thank you for reading this.

Regina Presley, Au.D. responds...

Your brother may very well be a cochlear implant candidate. What needs to be done at this time, would be for you to schedule a cochlear implant candidacy evaluation at a center near by. The audiologist will be able to let you know if the hearing test results suggest that he would benefit from a cochlear implant. If this occurs, your brother would need to have a CT scan and an evaluation by an otolaryngologist (ENT doctor) to determine final candidacy.

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