Electroacoustic hearing: Using residual acoustic hearing to address the shortcomings of traditional cochlear implants
Ian Power & Heather Power
LING 2P91- Brock University
April 2014
Introduction On March 20, 2014, the US Food and Drug Administration (FDA) approved the first hybrid device to combine a cochlear implant (CI) with traditional amplification (USFDA, 2014). In theory, electroacoustic stimulation (EAS) allows users to take advantage of the strengths of both hearing aids (HAs) and CIs. The EAS-qualifying population currently includes individuals age 18 and older who have bilateral mild-moderate hearing loss (HL) in frequencies below 1000Hz, and bilateral, steeply sloping severe-profound HL in frequencies above 1000Hz
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Furthermore, low-frequency hearing alone is not sufficient to achieve open set speech recognition, since discrimination of most consonants and vowels requires access to higher frequencies (Hornesby & Ricketts, 2006). Even when functional levels of speech perception are achieved, however, devices are often rejected by users because of excessive feedback resulting from high levels of gain, and the requirement of uncomfortable occluding earmolds (Turner, 2006). Furthermore, discrete models of hearing aids such as the open-ear style are not powerful enough to aid severe-profound HL (Johnson, 2012). Studies examining the benefits of bimodal hearing, in which patients with a unilateral CI use a hearing aid in the contralateral ear, have noted improved ability to discriminate differences in pitch (Kang, Nimmons, Drennan, Longnion & Ruffi, 2009; Wright & Uchanski, 2012), perceive speech in noise (Dunn, Tyler & Witt, 2005; Gifford, Dorman, McKarns & Spahr, 2007; Dorman et al., 2008), and localize sound (Dunn Perreau, Gantz, & Tyler, 2010). Though high frequency amplification is not typically effective for people with a sloping severe-profound HL configuration, there is compelling evidence that low-frequency residual hearing should be preserved and amplified.
Limitations of cochlear implants alone
A cochlear implant is an electronic device that restores hearing for people anywhere from hard of hearing to the profoundly deaf. The cochlear implant is surgically implanted under the skin behind the ear. The surgeon puts the electrode array inside the inner ear and than inside the cochlea. The implant works by a device outside the ear, which rests on the skin behind the ear. It is held upright by a magnet and is also connected by a lead to a sound professor.
Most doctors recommend that children with cochlear implant only use spoken language as a method of communication so they can maximize the benefits from the cochlear implant. However, the popular method of communication for children with cochlear implants is total communication which is the integration of oral communication and ASL. Although Heather Artinian was fluent in ASL before she received her cochlear implant, she was able to communicate with hearing and deaf people through both ASL and spoken language after years of intensive speech therapy (Aronson, Sound and Fury: Six Years Later). When cochlear implant users take it off, they cannot hear any sounds so they are technically still deaf. Even though they are able to hear sounds, cochlear implant recipients will not be able to identify themselves as hearing individuals. When they bridge the gap between the deaf and hearing world, they can still be a part of both cultures without defining themselves as a part of only one culture (TedX: The Heather World). Therefore, the cochlear implant can be a great device for deaf people who want to stay in the Deaf community but still be able to take advantage of additional opportunities in the hearing
Since many measures of analysis were found for pre- and post-operatory hearing outcomes (scales and tests), rendering it difficult to compare the results of each author.
There are many things that people in the hearing world take for granted every day, such as verbal communication, using a telephone or something as simple as the feeling you get when your favorite song comes on the radio. To a person that has been completely immersed in the deaf community, it may be easy to view the sense of sound as unnecessary. As a member of the haring community it would seem nearly impossible to live a day without sound. Cochlear implants are devices that help a person who is deaf gain hearing to some degree, and in some cases nearly full hearing. This new technology has become very controversial throughout both the hearing, and the deaf world.
Deafness or hard of hearing, is defined by the medical society as a disability, but those who are diagnosed with the disability think otherwise. They think of themselves as a community, embrace it as an identity, or a culture with their own language, sign language, and they believe their community is being threaten. They label themselves as a minority endangered of being wiped out because of one leading cause, cochlear implants. Those serious about their ideals of their community see cochlear implants as a threat, because cochlear implants are considered as cure. Countless number of controversies over cochlear implants have been brought up, but the Deaf community should see cochlear implants as gift for patients rather than an extreme threat.
While there are many risks involved with cochlear implants, there could also be many benefits. The question that remains is, “Do the benefits of receiving a cochlear implant outweigh the risks?” Although many advances have been made scientifically to improve the effectiveness of cochlear implants, it is also important to examine the opinions of the deaf society, how a deaf person’s communication skills may develop with or without a cochlear implant, and the economic factors
Infants and children who suffer from hearing loss are at an increased risk for developing delayed speech, language, social, and emotional skills 1. Many children who suffer from mild to moderate hearing loss have great success with hearing aids, however those who are born profoundly deaf cannot benefit from hearing aids alone. If a profoundly deaf individual chooses to hear their only option is to have cochlear implants. Cochlear implants are a two-part system consisting of external and internal parts 2. The external part is much like a hearing aid that has a transmitter, speech processor, and microphone 2. The internal parts consist of the receiver and electrodes. The speech processor process sounds, sends the code to the transmitter 2. The
Cochlear implants are made up of four different parts: microphone, speech processor, transmitter & receiver/stimulator, and the electrode array. The microphone picks up sounds from the environment. The speech processor selects and arranges sounds from the microphone. The transmitter & receiver/stimulator receives signals from the speech processor and converts them into electrode impulses. The electrode array is a group of electrodes that collect the impulses from the stimulator and sends them to different regions of the auditory
According to the National Institute on Deafness and Other Communication Disorders, “About 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears.” Cochlear Implants are mechanical devices that are highly promoted by the hearing society to “cure” deafness. Despite the fact Cochlear Implants can be effective, the risk of serious physical and emotional harm to a patient outweighs the chances of its success.
Cochlear Implantation is not as new of an idea as society may think. Interest in stimulating hearing in deaf individuals can be traced back as far as the 18th century. Since then many scientists, doctors and even audiologists from all areas of the world have worked to develop sophisticated high-tech implant systems. Which has resulted in varying viewpoints between the Deaf and Hearing Communities.
“More than 28 million Americans are deaf or hearing impaired. This statistic may reach 40 million by the year 2020” (“Cochlear Implant Surgery”, n.d.). Individuals who are deaf face many challenges and worry about living their lives and coping with their disabilities, whether they were born without their hearing or whether it was developed later in life. The medical field is constantly changing, and accommodations for people who have hearing problems are advancing every day. As a result of this fast-growing medical field, some people who have never been able to experience sound now can. Also, hearing loss can be corrected for people who may develop this disability later on in life. Some are born with hearing deficiencies where, due to the
While sensorineural deafness can be the result of tiny hair cells being damaged, this can also occur when the auditory nerve is damaged (Better Hearing Institute, n.d.). Sensorineural deafness changes the ability of hearing faint sound and reduce the intensity of sound, creating difficulties for the person suffers from it to understand others (hearcom, n.d.). The causes of sensorineural deafness may vary, the exposure to loud noises, aging, medicines, illnesses, head trauma, or malformation in the structure of the inner ear are all potential causes (Better Hearing Institute, n.d.). Genetic also play as a role in the cause of sensorineural deafness. While sensorineural hearing loss is irreversible, researchers have found a way to help the patients to be able to hear better. Through a cochlear implant, an electronic device that replaces the function of the damaged inner ear and provide sound signal to the brain, people who suffer from sensorineural hearing loss would be able to hear (cochlear,
The Bionic Ear has revolutionised the lives of deaf individuals all over the world, it is not only a great scientific achievement, but also a great progression in a socio-cultural context within the lives and communities of the deaf and hearing-impaired individuals. The Bionic Ear with the aid of IT has provided new capabilities and in turn gives individuals new choices of
David Stein is a 30-year-old male that is diagnosed with a long term mixed sensorineural and conductive hearing loss. David’s work-related barriers include: having difficulty with hearing and understanding customers and co-working in person or over the phone (needs people to speak louder and repeat themselves), difficulty hearing with a lot of background noise (while working on machines, which can be a safety issue), issues hearing during staff meetings, and trouble communicating on conference calls.
Children with hearing loss vary in the degree they can hear, and the learning environment they have. As technology becomes more and more advanced, hearing aids and cochlear implants are more common. With these new changes, the deaf community might face a challenge that is new to them.