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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
