THE SOUNDS OF LIFE
Cochlear Corporation; used with permission.
The Hearing Rehabilitation and Cochlear Implant Program offers hope to adults with hearing impairment who want to hear and understand better.
Frequently Asked Questions (FAQs) About Cochlear Implants
Meet the Cochlear Implant Team
HEARING REHABILITATION & COCHLEAR IMPLANT PROGRAM
Department of Otolaryngology - Head and Neck Surgery
Washington University School of Medicine
517 South Euclid Avenue, Campus Box 8115
Saint Louis, Missouri 63110-1007
314.362.7245 (voice or TTY)
314.367.7346 (Fax)
For a free brochure, and more information, contact: Sally
H. McCoomb
Click here to find out more about these support and informational groups:
Self Help for Hard of Hearing People (SHHH)
Cochlear Implant Club International (CICI)
Association of
Late-Deafened Adults (ALDA)
Page last updated 6/22/00.
Please email your comments
and suggestions about this page.
Answer the following questions to determine if you are ready for an initial cochlear implant evaluation.
With hearing aids, how much are you able to understand when someone speaks to you from behind?
Only a few words and phrases
Half of what is said
Most of what is said
How much are you able to understand over the telephone, using whatever assistive devices help?
Only a few words and phrases
Half of what is said
Most of what is said
If you answered "only a few words and phrases" to both questions, it
would be worthwhile to explore whether a cochlear implant could help you
hear and understand better than you presently can.
Click here to schedule an initial Cochlear
Implant Evaluation.
If you can understand more than a few words and phrases without speechreading, the Hearing Rehabilitation Program has services which may interest you.
HEARING REHABILITATION (HR) is an umbrella term for a variety of services that facilitate hearing and understanding of important sounds and speech. HR is necessary if you cannot communicate effectively in situations that are important, even when using hearing aids or a cochlear implant. HR services include: assistive devices, auditory training, communication strategies, speechreading (lipreading), music training, and telephone training.
Assistive devices are designed to make speech clearer and reduce the effects of background noise for TV, at movies, in theaters, at places of worship, etc. Alerting devices inform a person when the doorbell rings, alarm clock sounds, or telephone rings.
Auditory training, also called "physical therapy for the ear," maximizes the ear’s ability to distinguish sounds, words, and sentences.
Communications strategies training teaches individuals with hearing loss how to be comfortable in asking for repetition, and teaches family members how to speak more clearly. Knowing what to do when communication breaks down has been shown to be one of the most useful skills for successful communication.
Speechreading (lipreading) involves learning to recognize sounds, words, and sentences, on the lips to help understand conversation.
Music training brings together quality equipment, assistive devices and musical auditory training to enable appreciation of live and recorded music.
Telephone training brings together quality equipment, assistive devices, and communication strategies to enable effective understanding over the telephone. This training is especially useful for those who need to use the telephone on their job.
A Hearing Rehabilitation Evaluation is a detailed interview about
important activities in which you want to hear and understand better.
Recommendations for assistive devices and therapies are made that will
accomplish your goals. Assistive devices are loaned so you and your family
can try them in those situations you want to improve.
Click here to schedule a Hearing Rehabilitation Evaluation.
What is a Cochlear Implant?
A cochlear implant is a surgically implanted prosthesis (receiver/stimulator
and electrode array) that is activated by external components. These include
a microphone that picks up sound, a speech processor that changes sound
into an electrical signal, and a transmitter that sends the signal to the
implanted electrode array.
In sensorineural or "nerve" hearing loss, the inner ear is damaged and does not function normally. Even in the most severe cases, however, some nerve cells usually remain that can send signals to the brain. When the cochlear implant stimulates the remaining nerve cells, recipients with severe hearing loss regain the ability to hear.
Who Can Benefit From a Cochlear Implant?
To benefit from cochlear implantation surgery, an individual must have
enough remaining nerve fibers to receive sound from the implant. Individuals
who are severely or profoundly deaf, who receive little benefit from hearing
aids, who communicate through hearing and/or speechreading, and who want
to be part of the hearing world, are the best candidates for cochlear implantation.
What Are the Benefits of a Cochlear Implant?
There are no tests to predict the level a benefit a particular individual
will receive from cochlear implantation. The level of benefit a cochlear
implant provide varies among individuals. Most recipients report that their
lives are enriched following implant surgery. Some of the benefits include
the ability to:
What Happens During and After Surgery?
The receiver/stimulator and electrode array are implanted underneath
the skin behind the ear. The surgery usually takes several hours
and the hospital stay ranges from 23 to 48 hours. General anesthesia
is used.
During surgery, an incision is made behind the ear. The surgeon places the receiver/stimulator into a small depression in the mastoid bone. The electrode array is inserted through an opening in the cochlea. Once the skin heals, the only visible evidence is a slight bump behind the ear.
After the healing process is complete (usually four weeks), each patient is fitted with the external portion of the device. The audiologist programs the speech processor over several sessions, setting appropriate levels of stimulation for each electrode from soft to comfortably loud.
As the user adjusts to the sounds, s/he undergoes an intensive listening
program (physical therapy for the ear) to maximize the benefit from the
implant. The flexibility of the cochlear implant system allows the user
and the audiologists to work together to achieve the best possible performance
with the device.
Click here to schedule an initial Cochlear Implant Evaluation.
Frequently Asked Questions (FAQs) About Cochlear Implants
Are cochlear implants covered by insurance?
Cochlear implantation is covered by private insurance, HMOs, PPOs,
Medicare, and Medicaid. Prior to the surgery, our insurance specialist
will determine how your insurance benefits will cover the procedure. Calling
the insurance company yourself can often yield incorrect information.
I’ve been told nothing can help me. Why should I look into
cochlear implantation?
Many people with sensorineural or "nerve" hearing loss have been told
that nothing can help. However, the great majority of these people
have a hearing nerve that functions sufficiently well to use a cochlear
implant. Testing can determine if the hearing nerve will function with
an implant. Also, because implant technology is constantly improving,
it is difficult for professionals to keep up with the most current information.
I’m afraid of surgery. What can you tell me to ease my mind?
Like any surgery, cochlear implant surgery has its risks. However,
the procedure is not considered dangerous or even particularly painful.
It has no more risk than a simple tonsillectomy. You should speak
with your implant surgeon about risks that may be specific to your case.
Aren’t implants experimental?
Cochlear implant technology has been available since the late 70’s.
This is considered to be a "new" technology by some despite over 25 years
of research and results proving its effectiveness. Research continues
on all fronts to improve the performance, durability, and looks of cochlear
implants. Cochlear implantation is endorsed by the American Medical
Association and the American Academy of Otolaryngology-Head and Neck Surgery,
as an effective treatment for severe hearing loss. The FDA has approved
several cochlear implants and continues to monitor their performance for
consumer protection.
I’ve heard that cochlear implants would only allow me to hear sound,
but not understand words.
The single channel cochlear implants used in the 70’s and early 80’s
were only able to provide awareness of sounds in the environment, such
as doorbells, traffic noise, dog barks, and speech. These recipients
needed to face the speaker in order to converse more accurately.
Consequently, telephone understanding was not possible. The current
generation of implants allows for much greater opportunity to understand
without having to speechread constantly. If an implant candidate
has had normal hearing at one time and has worn hearing aids, their chances
of understanding speech without speechreading are very good. Your audiologist
will counsel you more specifically about your expected benefits.
I have heard of some people who have gotten an implant but don’t
wear it. They must not always be successful.
These are most likely people who lost nearly all their hearing at birth
or when very young and were implanted as adults. Frequently these
individuals use sign language instead of hearing and speechreading.
Sign language is very effective form of communication. Those who
use sign language and are satisfied with that method of communication are
not candidates for cochlear implantation. For individuals who had
normal or near normal hearing at one time, cochlear implantation is very
successful.
Meet the Cochlear Implant Team
The Cochlear Implant Team is headed by Margaret W. Skinner, Ph.D., whose research in fitting of hearing aids and cochlear implants has received international recognition. The team surgeons, audiologists, and researchers are dedicated to helping each individual attain the most benefit from their cochlear implant. Washington University School of Medicine is one of only a few centers that offer cochlear implantation combined with individual follow-up training to help each patient learn to interpret the sounds that are now heard. This combination of individual training and research gives implant recipients every chance of getting the most from their implant.
J. Gail Neely, M.D., F.A.C.S., Surgeon
Joel A. Goebel, M.D., F.A.C.S., Surgeon
Gitry Heydebrand, Ph.D., Neuropsychologist
Susan M. Binzer, M.A., F.A.A.A., CCC-A, Coordinator & Rehabilitative Audiologist
Laura K. Holden, M.A., CCC-A, Research Audiologist
Timothy A. Holden, B.S.E., Biomedical Engineer
Sally H. McCoomb, Medical Secretary
Margaret (Margo) W. Skinner, Ph.D., CCC-A
Professor of Audiology
Director, Adult Cochlear Implant Program
Responsibilities:
Provide leadership and coordination of clinical and research efforts
of the Adult Cochlear Implant Team. Represent the Cochlear Implant Program
within the administrative decision-making and problem-solving processes
of the Department.
Design National Institutes of Health (NIH) supported research studies, supervise their implementation, test research subjects, analyze results with our team and research consultants, present research results at local, national, and international scientific meetings.
Provide clinical services for cochlear implant patients as needed.
Participate in the Otology/Audiology educational program for the Department’s residents, and supervise research studies for selected students in the Master’s Degree program in Audiology from Central Institute for the Deaf.
Review papers on cochlear implants and hearing aids for several scientific journals.
Member of the National Institute On Deafness and Other Communication Disorders Review Committee (CDRD) and of the Executive Board of the American Auditory Society.
Education:
A.B. 1956 Chemistry; Wellesley College, Wellesley, MA.
M.A.1960 Audiology; Case-Western Reserve University, Cleveland, OH.
Ph.D. 1976 Audiology; Washington University, St. Louis, MO.
To contact Margo:
314.362.7125 (voice)
314.362.7245 (voice or TTY)
314.367.7346 (fax)
skinnerm@msnotes.wustl.edu
Susan M. Binzer, M.A., CCC-A
Coordinator and Rehabilitative Audiologist
Hearing Rehabilitation & Cochlear Implant Program
Responsibilities:
Instruct those with hearing loss and their family members in the use
of assistive devices
Provide therapy in auditory training, communication strategies, speechreading, music, and the telephone to adults with hearing loss
Prepare cochlear implant candidates and their families for the implant procedure and provide communication training program after implant surgery
Conduct research on the long-term benefit from cochlear implantation
Serve as administrative head of the Hearing Rehabilitation & Cochlear
Implant Program
Education:
B.S. 1981 Speech Pathology/Audiology; University of Cincinnati
M.A.1984 Audiology; University of Cincinnati
To contact Susan:
314.362.7245 (voice or TTY)
314.367.7346 (fax)
binzers@msnotes.wustl.edu
Sally Henley McCoomb
Medical Secretary
Responsibilities:
Accept hearing rehabilitation and cochlear implant inquiries in writing
and by telephone (including TTY and Relay calls).
Schedule patients for all necessary appointments related to hearing rehabilitation and cochlear implantation.
Process fee tickets for insurance billing and coordinate collection tracking; assist patients with understanding of bills.
Education:
University of Missouri-Columbia, 1970-72
Princess Anne Business College, Virginia Beach, VA, 1976-77.
To contact Sally:
314.362.7245 (voice or TTY)
314.367.7346 (fax)
mccoombs@msnotes.wustl.edu
