2nd August 2013

Cochlear Implants for

SSD

Emma van Wanrooy, SCIC

SSD

Binaural Hearing Benefits • Head Diffraction Effects

• Binaural Squelch• Localisation

SSD

Binaural Hearing Benefits

Head Diffraction Effects

Dillon, 2012

-SNR +SNR

SSD

Binaural Hearing Benefits • Head Diffraction Effects

• Binaural Squelch

• Localisation

SSD

Binaural Hearing Benefits

Localisation

Dillon, 2012

SSD

A “significant hearing loss in 1 ear”

Advisory group for single sided deafness, 2003

Also known as unilateral hearing loss

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?

• Improvement in speech perception in noise S0N0, SciNhe

• Significantly better SSQ scores at 3 months

• 1-3 hours/day rehab

SSD

Tavora-Vieira et al 2012

• 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

Arndt, et al, 2010

• Definition of ‘SSD’

• Auditory training/ loudness balancing

• Music appreciation

• Candidacy assessment

SSD

Further research needed

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

Right CI

CUNY @ 65dB SPL 100%CUNY in noise (+10dB SNR)

93%

CUNY in noise (+ 5dB SNR)

100%

CUNY in noise (0dB SNR)

86%

CNC words @65dB SPL

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

AUSTRALIA’S LARGEST COCHLEAR IMPLANT

PROGRAMME

SYDNEY | NEWCASTLE | CANBERRA | GOSFORD |

LISMORE | PORT MACQUARIE | PENRITH

emma.vanwanrooy@scic.org.au

www.scic.org.au

Thank You

SCIC