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Cochlear
Implants for
SSD
Emma van Wanrooy,
SCIC
2nd August
2013
SSD
Binaural
Hearing
Benefits
• Head Diffraction Effects
• Binaural Squelch
• Localisation
SSD
Head Diffraction Effects
Binaural
Hearing
Benefits
-SNR
Dillon, 2012
+SNR
SSD
Binaural
Hearing
Benefits
• Head Diffraction Effects
• Binaural Squelch
• Localisation
SSD
Binaural
Hearing
Benefits
Dillon, 2012
Localisation
SSD
Also known
as unilateral
hearing loss
A “significant hearing
loss in 1 ear”
Advisory group for single sided
deafness, 2003
SSD
Features
• Severe to profound
• Often sudden onset
SSD
Causes
•Physical damage /Trauma
•Compression of the hearing
nerve
•Viral or bacterial infections
•Disorders of the circulatory
system
•Severe Ménière’s disease
SSD
Impact
• Difficulty hearing on
impaired side
• Poor localisation
• Difficulty hearing in noise
• Tinnitus
SSD
Rehabilitation
devices
• Hearing Aid (if sufficient
hearing)
• Cros Aid
• Bone conductor
• Bone anchored device
• eg/ bonebridge
SSD
Treatment
Until now…………..
What about cochlear
implants?
SSD
Tavora-Vieira
et al 2012
•
Improvement in speech
perception in noise
S0N0, SciNhe
•
Significantly better SSQ
scores at 3 months
•
1-3 hours/day rehab
SSD
Arndt, et al,
2010
• SnhNci speech
comprehension better
than CROS/BAHA, but
not better than unaided.
• Better than unaided,
CROS and BAHA for
SciNnh
SSD
Arndt, et al,
2010
• Localisation significantly
better with CI
• SSQ at 6 months post CI
significantly better
• CI used significantly
longer per day
• Significant decrease in
tinnitus loudness
SSD
Further
research
needed
• Definition of ‘SSD’
• Auditory training/
loudness balancing
• Music appreciation
• Candidacy
assessment
SSD
Personal
experiences
• 47 year old female
• Sudden loss in right
ear 18 years prior
• Extreme tinnitus
SSD
Personal
experiences
“The hearing in my left
ear was perfect and not
affected ….the tinnitus ..
seemed to mask what
my good ear was trying
to hear .…a constant
challenge to keep my
sanity”
SSD
Personal
experiences
.
“In harms way when
walking up streets
with traffic I just
couldn’t hear or the
direction in which it
was coming”
SSD
Personal
experiences
• Referred for BAHA
trial and tinnitus
counselling
• Implanted with
Med El Sonata
• Tinnitus reported
gone instantly
SSD
Personal
experiences
“I’m a lot more balanced
and my sense of direction
has improved so much it is
unbelievable……I now
look forward to going out
and socialising, I’m more
relaxed and am enjoying
life more.”
SSD
Personal
experiences
“I experiment by turning
my processor off. Huge
difference. Can’t wait to
turn it back on again….
when I turn it back on it
is such a relief. It just
feels so much better, so
balanced.”
SSD
Personal
experiences
Aided Speech
Perception 6 months
post
CUNY @ 65dB SPL
CUNY in noise
(+10dB SNR)
CUNY in noise
(+ 5dB SNR)
CUNY in noise
(0dB SNR)
CNC words @
65dB SPL
Right
CI
100%
93%
100%
86%
86%
SSD
Personal
experiences
• Female aged 23
• Musician and singer,
studying musicology
• Meningitis and lost
hearing in Left ear
SSD
Personal
experiences
• Loss of spatial
separation of sounds
• Difficult to identify
sounds that were similar.
Eg/ tap running, rain,
boiling water
SSD
Personal
experiences
Implanted 15 months later–
Med El Sonata Implant
using FSP
SSD
Personal
experiences
• At switch on, focussed
on loudness and
balancing
• Did a lot of auditory
training
SSD
Personal
experiences
• Improved directional
hearing
• Good speech
understanding
• Better able to follow
conversation in a group
in noise
• Mobile phone in noise
better
SSD
Personal
experiences
Unable to perform well in
musical when batteries
went flat in Speech
Processor
SSD
Take into
consideration
• Duration of deafness
• Goals:
• Tinnitus relief
• Localisation
• Listening in noise
SSD
Why CI?
• Relief from severe
tinnitus
• Improved localisation/
spatial awareness
• Improved utilisation of
head shadow effects in
noise
SCIC
Thank You
SCIC
AUSTRALIA’S LARGEST
COCHLEAR IMPLANT
PROGRAMME
SYDNEY | NEWCASTLE |
CANBERRA | GOSFORD | LISMORE
| PORT MACQUARIE | PENRITH
[email protected]
www.scic.org.au