Understanding Cochlear Implants and who can benefit

North Western Melbourne Primary Health Network

27 Oct 202197:27

EducationalLearning

32 Likes 10 Comments

TLDRThe transcript discusses the intricacies of cochlear implantation and the importance of addressing hearing loss. It features Professor Stephen O'Leary and Rael Wills, who delve into the latest developments, patient candidacy, and the impact of hearing loss on quality of life. They highlight the Victorian Cochlear Implant Program's expansion, aiming to improve accessibility and offer solutions like bimodal hearing. The discussion also touches on the correlation between sensorineural deafness and dementia, emphasizing the value of early intervention and rehabilitation.

Takeaways

🎓 Professor Stephen O'Leary and Rael Wills provided insights into cochlear implantation and hearing loss, emphasizing the importance of early intervention and rehabilitation.
👥 The Victorian Cochlear Implant Program aims to improve access to cochlear implants throughout Victoria, with local audiologists offering testing, counseling, and rehabilitation.
👂 Cochlear implants are not only for severe hearing loss; they can also benefit those with single-sided deafness or steeply sloping hearing losses, improving speech clarity and sound localization.
👴 Age should not be a barrier to cochlear implantation, as the benefits of improved communication and social engagement are valuable at any stage of life.
📈 Significant hearing improvements are observed after cochlear implantation, with many patients experiencing dramatic increases in speech understanding and sound awareness.
🔊 Bimodal hearing, which combines a cochlear implant with a hearing aid in the opposite ear, can provide a fuller and richer sound experience.
💡 Hearing preservation during cochlear implant surgery is crucial, allowing patients to maintain their natural hearing alongside the electronic hearing provided by the implant.
🦠 Sudden sensorineural hearing loss can be distressing, but timely intervention and potential treatment can help manage the condition and improve outcomes.
🔄 Advancements in bone-anchored hearing aids and technologies like the Ossia system offer more discreet and efficient options for patients with hearing loss.
🌐 Telehealth services have been successfully implemented for cochlear implant programming and rehabilitation, allowing for remote support and follow-up care.
📋 Referrals to the Cochlear Implant Clinic are MBS funded, and it is recommended to use the specific referral form available on their website for a smoother process.

Q & A

What is the primary function of a cochlear implant?
-A cochlear implant is a device that introduces electrodes into the cochlea or inner ear, which are electrically stimulated to send meaningful hearing signals to the brain. The external control takes in sound through a microphone, processes it, and transmits the information to the internal device, which then sends electrical impulses to different parts of the cochlea, allowing the patient to perceive various sounds.
Why is it important to have two ears for hearing?
-Having two ears allows for better sound localization and the ability to attend to specific sounds in a three-dimensional auditory space. It also helps to overcome the head shadow effect, where the head blocks certain sounds from reaching one ear, particularly in noisy environments. Two ears provide a more comprehensive and clear hearing experience, which is crucial for understanding speech and environmental sounds.
What is the significance of age in cochlear implant candidacy?
-Age is not a barrier for cochlear implant treatment. Both very young and elderly individuals can be treated with cochlear implants. The importance lies in the quality of life improvements that come with restored hearing, particularly for those at the extremes of life. Early intervention is crucial for children to develop language skills, while for the elderly, hearing restoration can prevent social isolation and improve overall well-being.
What are the differences between acquired and pre-lingual hearing loss?
-Acquired hearing loss occurs after an individual has learned to speak, while pre-lingual hearing loss occurs before the onset of speech development. Congenital hearing loss refers to hearing loss present at birth, which can lead to either acquired or pre-lingual hearing loss depending on its severity and whether effective rehabilitation was provided early in life.
How do you assess a patient's candidacy for a cochlear implant?
-Assessing a patient's candidacy for a cochlear implant involves a comprehensive evaluation, including a detailed clinical history, speech perception testing, and audiometry. Key questions address the patient's ability to use the telephone and understand TV even with hearing aids, as well as their social isolation levels. These assessments help determine if the patient is likely to benefit from a cochlear implant.
What is the role of speech perception testing in determining the need for a cochlear implant?
-Speech perception testing is a critical component in determining whether someone needs a cochlear implant. It involves having the patient listen and repeat back words or segments of words (phonemes). This test helps assess how well someone can hear and understand speech, especially in different listening conditions, and is used to compare the patient's performance with average cochlear implant performance to make informed decisions about implant candidacy.
How do sudden hearing losses affect individuals and what are the treatment options?
-Sudden hearing losses can be very distressing and significantly impact an individual's ability to localize sound and understand speech, especially in noisy environments. Treatment options include cochlear implants, bone-anchored hearing aids, and other assistive listening devices. It's crucial to address sudden hearing losses promptly to prevent long-term negative impacts on communication and quality of life.
What are the emerging technologies in the field of cochlear implants?
-Emerging technologies in cochlear implants include advancements in the implant devices themselves, such as the osseo system, which is a new type of bone conduction implant. There are also improvements in the rehabilitation process, such as telehealth services for remote programming and adjustments of cochlear implants, making the technology more accessible and convenient for patients.
How does the Victorian Cochlear Implant Program aim to improve access to cochlear implants?
-The Victorian Cochlear Implant Program aims to improve access by decentralizing the service and training audiologists throughout Victoria to offer testing, counseling, and post-operative rehabilitation. This pilot program seeks to reduce the need for patients to travel to Melbourne for these services, thereby increasing the number of people who can benefit from cochlear implants.
What is the significance of preserving residual hearing during cochlear implant surgery?
-Preserving residual hearing during cochlear implant surgery is significant because it allows for electro-acoustic hearing, where the implant can be used in conjunction with a hearing aid. This provides a more natural sound experience and can lead to better overall outcomes for patients. It also serves as an indicator of the minimal damage caused to the inner ear during the implant procedure.

Outlines

00:00

🌏 Acknowledgement and Introduction of the Event

The speaker begins by acknowledging the traditional custodians of the land, the Kulin Nation, and pays respects to Aboriginal people attending the event. The introduction continues with gratitude towards the event's speakers, Professor Stephen O'Leary and Rao, for their contribution and expertise. Thanks are also extended to the North Melbourne Primary Health Care Network for their partnership and financial contributors to the GP education program. Technical difficulties briefly interrupt the presentation, leading to a quick shift in the agenda to directly introduce the speakers and skip over additional housekeeping details. The audience is reminded that the event is video recorded, and they're encouraged to participate via the Q&A box due to disabled cameras and microphones.

05:01

🔊 Importance of Cochlear Implantation and Hearing Loss Understanding

The significance of cochlear implantation and a broader understanding of hearing loss is emphasized. The discussion pivots towards identifying candidates for cochlear implants, emphasizing the need for two ears for optimal hearing and addressing common misconceptions about age as a barrier to treatment. Urgent referral cases, including those with sudden hearing loss, are highlighted as critical for immediate attention. The benefits of cochlear implants over traditional hearing aids, particularly in restoring clarity rather than loudness, are discussed. The presentation underscores the distinction between acquired hearing loss and pre-lingual hearing loss, stressing the importance of early detection and intervention.

10:01

📈 Assessing Candidacy for Cochlear Implants

The speaker outlines the process for assessing candidacy for cochlear implants, focusing on the limitations of audiograms in predicting speech perception outcomes. Emphasis is placed on speech perception testing as the gold standard for assessing the need for cochlear implants, with detailed explanation on how the testing is conducted. The discussion further explores the significance of two ears for hearing in noise, introducing concepts like head shadow effect and localization challenges. The presentation concludes with an introduction to the concept of listening in noise and the benefits of bimodal hearing, which utilizes both a cochlear implant and a hearing aid.

15:02

👂 The Cochlear Implant Procedure and Patient Outcomes

The process and outcomes of cochlear implantation are discussed, highlighting the transformative impact of the procedure on patients across various ages. The narrative includes a case study of Dulce, a 98-year-old recipient, showcasing the procedure's feasibility and benefits regardless of age. The importance of early intervention, particularly for children with pre-lingual hearing loss, is emphasized, alongside the necessity for ongoing support and rehabilitation. The speaker addresses the technological advancements in cochlear implants, including intraoperative monitoring to preserve residual hearing, and concludes by addressing urgent referrals, particularly for patients with meningitis or sudden hearing loss.

20:03

📚 Expanding Access and Understanding of Cochlear Implants

The presentation transitions to discussing efforts to expand access to cochlear implants through the Victorian Cochlear Implant Program, aimed at decentralizing services to provide more localized care. The significance of GP referrals and addressing barriers to cochlear implant consideration, such as misconceptions about age and fear of surgery, is highlighted. The narrative includes insights into rehabilitation practices, the importance of dual hearing (using both a cochlear implant and a hearing aid), and addressing single-sided deafness with advanced solutions. The talk concludes with an overview of telehealth services and a discussion on hearing preservation, reiterating the commitment to improving patient outcomes through technological advancements and community outreach.

Mindmap

Keywords

💡Cochlear Implant

A cochlear implant is a medical device that helps provide a sense of sound to a person with severe hearing loss or deafness. It works by bypassing damaged structures in the inner ear and directly stimulating the auditory nerve. In the video, Professor Stephen O'Leary discusses the intricacies of cochlear implantation, including the process and its impact on patients' quality of life.

💡Hearing Loss

Hearing loss is a decrease in the ability to hear sounds at different frequencies. It can be conductive, sensorineural, or a combination of both. In the context of the video, hearing loss is the primary condition that leads individuals to seek cochlear implantation. The speakers discuss the different types of hearing loss and how they affect patients' lives.

💡Speech Perception Testing

Speech perception testing is a method used to evaluate a person's ability to understand spoken language, which is crucial in determining the need for a cochlear implant. It often involves listening and repeating back words or segments of words, known as phonemes, to assess auditory comprehension.

💡Residual Hearing

Residual hearing refers to any remaining hearing ability a person has after experiencing hearing loss. Preserving residual hearing is important in cochlear implant surgery because it allows patients to use a combination of their natural hearing and the electronic hearing provided by the implant.

💡Audiogram

An audiogram is a graph that shows the quietest sounds a person can hear at different frequencies. It is used to determine the type and degree of hearing loss. However, the video emphasizes that audiograms alone are not sufficient to determine the need for a cochlear implant; speech perception testing is also necessary.

💡Rehabilitation

In the context of hearing loss and cochlear implants, rehabilitation refers to the process of helping patients adjust to and make the most of their new hearing abilities. This can involve training and support to understand and interpret the sounds they hear through the implant.

💡Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss is a rapid decrease in hearing that occurs without an identifiable cause. It is typically limited to one ear and can be a medical emergency, often requiring immediate medical attention to potentially reverse or stabilize the hearing loss.

💡Bone Anchored Hearing Aids (BAHA)

Bone anchored hearing aids are devices that use bone conduction to transmit sound from the processor to the inner ear, bypassing the outer and middle ear. They are typically used for individuals with certain types of hearing loss who cannot use traditional air conduction hearing aids.

💡Telehealth Services

Telehealth services refer to the delivery of healthcare services over distance using telecommunications technology. In the context of the video, it involves providing remote support and adjustments for cochlear implant patients, which can be particularly beneficial for those living far from medical facilities.

💡Health Pathways

Health pathways are structured programs or guidelines that assist healthcare providers in managing patients with specific conditions. They outline the steps and services required for effective patient care, from diagnosis to treatment and follow-up.

Highlights

Acknowledgment of the traditional custodians of the land and respect for aboriginal people.

Introduction of Professor Stephen O'Leary, Chair of Otolaryngology at the University of Melbourne, and his contributions to ear disease and cochlear implantation.

Discussion on the importance of two ears for hearing and how age is not a barrier for treatment.

Explanation of the cochlear implant as a device that introduces electrodes into the inner ear to send meaningful hearing signals to the brain.

Clarification on the difference between congenital hearing loss and pre-lingual hearing loss.

Importance of speech perception testing over audiometry for determining the need for a cochlear implant.

The concept of synaptopathy and its impact on hearing in noisy situations.

Challenges faced by people with single-sided deafness and the impact of head shadow effect.

Relevance of speech perception testing scores in deciding upon cochlear implant suitability.

Options available for single-sided deafness, including hearing aids, bone-anchored hearing aids, and cochlear implants.

The Victorian Cochlear Implant Program and its aim to improve access to cochlear implants throughout Victoria.

Advances in bone-anchored hearing aids and the introduction of smaller, more manageable devices.

The use of telehealth services for remote programming and adjustments of cochlear implants.

Discussion on the correlation between sensorineural deafness and dementia, and the potential benefits of hearing rehabilitation.

Information on the referral process to the Cochlear Implant Clinic and the importance of using the specific referral form.

Waiting times for cochlear implant assessments and surgeries at the clinic.

Transcripts

Browse More Related Video

Life with a Cochlear Implant - Interview with Jill Rivoli and Lauren Deckard

The Dr. Cliff Show Episode 21 | Cochlear Implant Brands & Surgery

What you don't know about hearing aids | Juliëtte Sterkens | TEDxOshkosh

Kids Meet A Deaf Person | Kids Meet | HiHo Kids

Why we all need subtitles now

ENT Doctors Debunk 11 Ear And Nose Myths | Debunked

Related Tags

HearingLoss CochlearImplants MedicalInnovation HealthcareWebinar ProfessionalDevelopment Audiology Otolaryngology HealthcareTechnology PatientRehabilitation