CI Video Library

Cochlear Implant Center - Video Library

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Video Transcripts

Patient Testimonials

Speaker: Adele Millwood

Hearing aids for me just didn't do it anymore and the cochlear implant to me doesn't even compare to a hearing aid. The sound is so totally different and for me it's been very natural. Voices sound the same so I just encourage people if you want to hear again than this is what you should do.

Speaker: Anna Boston

I've always been a person who likes to do things, knows they I'd like to know what's going on.  And with the implant, now, I hear things. Yes!

Speaker: William Stiles

Clocks ticking, the turn signals clicking in the car, the birds chirping, it's just amazing.

Speaker: Barbara Plogman

When I had it implanted, after the wait of the healing process, it can take a month, my audiologist says I'm going to activate your hearing, your implant. She said "Barbara can you hear me?" and I almost fell off the chair. It was like, "Yes I can!" it was as if my hearing was plugged right back in the wall.

Speaker: Adele Millwood

I tell people that I'm going to have my brain upgraded when I have a mapping session because I have these implants wired into the hearing canals and everything in my head. What happens is Regina plugs a connector into my processors and from her computer she can change the way I hear.

Speaker: William Stiles

You just keep practicing and working with it. It's not something you just put on and say it's going to do the job. You'll get as much out of it as what you put into it.

Speaker: Adele Millwood

I have a twenty one-month old grandson and a fourteen month old granddaughter. And they're starting to jabber and talk and I can actually understand them. So that was the thing that kind pushed me to go bilateral was I wanted to be able to hear them and understand them so I'm getting to do that.

Speaker: William Stiles

I almost have to tell everybody I talk to, my friends "Don't talk so loud." Hahahaha. They're used to yelling at me, you know,  for me to hear.

Speaker: Anna Boston

The implant has meant quite a bit to me. I'm very thankful. I feel I have a special blessing.

Get to Know Us

Speaker: Brian Kaplan, MD

The Cochlear Implant Center was set up almost ten years ago and started initially for adults with significant hearing loss at first. And it was really a way to bring to GBMC a newer technology that we could provide hearing to patients who were no longer getting benefits from their hearing aids.

And traditionally this has been something which is really only done at the largest academic medical centers which can certainly provide the expertise to the patients but didn't provide them with the level of service which we thought we could provide here.

There really are six members of the team which a typical patient would likely encounter. Kim who provides our administrative support, Regina Presley who provides the audiology coverage, Kelly Hume who does speech and auditory rehab, and then myself Brian Kaplan, Scott London and Dario Kunar, the three surgeons who all provide the surgical portion of cochlear implantation.

Technology

Speaker: Scott London
The cochlear implant simulates the nerve bypassing the hearing organ and allowing us to get new signals into the brain that a person has lost. The hearing aid is basically a volume switch. It's turning up the stereo or the tv or your iPod so that you can amplify sound and hear better.

Speaker: Regina Presley, AuD, CCC/A

Cochlear implant technology has changed drastically over the years, working at trying to make it smaller and more efficient. So the things that we're seeing that are changing a technology is not only longer battery life, making the systems prettier, but we're looking at easier access through remote controls if the patient chooses, we're looking at more sophisticated microphone technology so that patients, depending on the situation they are in, can modify which microphones are working to let them hear more effectively in noise. And than the actual fitting programs that are more mathematical formulas that we use and trying to enhance those as well to make patients more successful in the quality of sound that they're getting. And, we also have a lot of accessories that patients can use now so patients can connect to if they're in an educational system, a system that's called an fm where the child can connect one piece of the system to their processor and the other component is the teacher wearing a microphone so that they have a more direct signal coming to their implant to improve their hearing in the classroom environment. But they are also cables to be used so that patients can plug into their iPod, to their cell phone. They can plug into their laptop if they want to so that patients can have access to anything that a person with normal hearing would have.

Candidacy

Speaker: Scott London, MD

The criteria for cochlear implant differs for adults and children, little babies. But, essentially it's a person who has either severe or profound hearing loss that cannot be helped with the hearing aid.  The hearing aid trial is important.  Some people lose their hearing all of the sudden and they have obviously not been wearing hearing aids their whole life.  Some people that wear hearing aids that have progressive hearing loss, and again, those people it is sometimes a little harder for them to realize where they've gotten to without the help of family friends.

But, essentially what we're looking at is those people whose hearing loss is severe enough that a traditional hearing aid cannot help them anymore. The first step would be really to contact either our program directly or one of the ear, nose and throat doctors who support the program who can certainly help with the whole process to make a fairly straightforward and easy.

Patient Expectations

Speaker: Regina Presley, AuD, CCC/A

Expectations vary from patient to patient so we work very closely with the patients to make sure that those expectations are realistic for each individual. The things that impact what our expectations should be would include the age that their hearing loss occurred,  how long they've been without hearing, has the hearing loss been progressive and profound all of their life, if they've continued to use hearing aids. And the reason that we look at these things is that the cochlea is where we're putting the implant, but the information from the implant actually travels up a nerve to our brain. And it's that nerve that's sending that information up. If it has not been used over a longer period of time, it's kind of like a muscle, use it or lose it. And so we have to train that information to be able to get to the brain and have that system working well. So, the longer it's been, the longer the rehabilitation process tends to be.

Speaker: Dario Kunar, MD

First thing that everyone has to realize is that the cochlear implant device, as wonderful as it is, it's trying to reproduce a truly complex organ of the body and nothing's ever as good as mother nature is. And so yes, people can hear clearly and fairly well, but it's not quite what you and I may be used to hearing in everyday situations. But, some people liken it to learning a new language. If you hear from the cochlear implant does require some training and a great deal of work with our audiologist after surgery after activation of the device. And, we call it rehabilitation and essentially through working with our audiologists you go through an extensive period of aural rehabilitation for, it could be up to months before the device user is able to fully take advantage of or interpret everything  they're hearing.

Services and Therapy

Speaker: Kelly Hume, MS, CCC/SLP
Because the technology that we use for cochlear implants is different than what you have for natural hearing, we need to help the brain be able to process the information and understand and use the information that we get from speech. It's not something that most patients can do automatically. It does require a little bit of extra help and that's why we do the rehab therapy to facilitate that.

Speaker: Kelly Hume, MS, CCC/SLP

"What does the cochlear implant do?"

Speaker: Isaac Johnson

"Cochlear implant makes you hear."

Speaker: Kelly Hume, MS, CCC/SLP

"It makes you hear? What do you hear?"

Speaker: Isaac Johsnon

"I hear people talking to me"

Speaker: Kelly Hume, MS, CCC/SLP

"What do they say?"

Speaker: Isaac Johnson

"They say: Hello!"

Speaker: Kelly Hume, MS, CCC/SLP

Sessions are generally an hour. We try to do the therapy that best meets the patient schedule so if they're working we try to do before or after work hours . If the children are in school we try to modify for that. And, the length of therapy time as far as whether it's six months or a year will really depend on the progress of the patient. Some of our patients are able to do the therapy for a couple months, they're fine, they're ready to go. And other patients may need a little bit more time.

Surgery

Speaker: Dario Kunar, MD, FACS

The surgery is an outpatient procedure. It generally takes anywhere between two and a half to three and a half hours and it's done under general anesthesia. The patient is fast asleep and unaware anything is going on while we're doing it and they're under the care of an anesthesiologist while we operate. We typically make an incision in the ear that we're going to implant behind the ear. We may have to shave a little hair in the process. We then drill on the mastoid bone which is the bone behind the ear. We make our way down under the microscope to the cochlea, which is a small structure in the middle of the inner ear. We then, under the microscope, drill a small hole into the cochlea itself. And then, we can advance a cochlear implant electrode directly into the cochlea, under the microscope. The bulk of the device is seated in a small well that we drill in the skull and once that's in place and everything's secured we put back the skin and put on the dressing. The patient is allowed to wake up and they spend perhaps 2 to 3 hours in the recovery room after anesthesia and then they're allowed to go home as long as they're doing well.

Speaker: Brian Kaplan, MD

People often get very focused on the surgical aspect of the cochlear implant. When you describe the surgery and potential complications, people get very worried, understandably so. And, they really focus on that aspect of the process which just about any center that does a lot of these will tell you is probably the least important of the entire process. Really any competent ear surgeon can do your cochlear implant for you, but what you need to find is that team which is really a cohesive group of people who communicate well with each other, who've shown the ability to problem solve, who are accessible to you if you have an issue that's there so that if you're having a programming issue and if you're having a speech and rehab issue, if it's a schooling issue that the team can go to bat for you and provide you the guidance that you need. And I think that's really where we excel here.

Insurance Options

Speaker: Kim Andrulonis

We work with most major commercial insurances. We also work with Medicare, Medical Assistance, for example. Just some basic big guys out there: Blue Cross Blue Chield, Aetna, Bravo we work with, you know, just to name a few.  We work with a patient financial specialist here in the hospital. Also, it's important to know that the surgeons portion of the surgery is separately billed and separately authorized by the insurance company then when the actual implant device in the hospital is authorized. So once we have all of the testing done, we find that you are a candidate, then go ahead, get you scheduled for surgery and from there all the information would be submitted to our patient financial specialist here in the hospital and we would go forward with the authorization. But again, we would have to have a surgery date before any of that is able to happen.

Mapping and Programming

Speaker: Regina Presley, AuD, CCC/A

You hear the term mapping and it's really more of setting all of the components of the processor. So patients come in and they're an active part of this listening process. And I work with them to determine loud sounds and soft sounds on a range of the electrodes that are in their cochlea. And the electrodes really, the easiest way to think about it is like an equalizer on a stereo or piano keys that each electrode is a range of different frequencies or pitches. And so when we set soft and loud levels to what the patient prefers to make sure that this sound is comfortable and that we're getting them access to speech information and then in addition to that within the programming session there are multiple memories within the cochlear implant processor and so we will create different programs for each individual's personal needs. So some patients may want a music program, a telephone program, listening in a noisy environment. We will establish those programs through good communication with one another so that we make sure that they have access to what they need for their daily living.

Greater Baltimore Medical Center | 6701 North Charles Street | Baltimore, MD 21204 | (443) 849-2000 | TTY (800) 735-2258
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