by Neil Bauman, Ph.D.
A concerned mother wrote:
My 14 year old son has been hearing impaired in both ears since birth. His hearing has remained pretty stable until now. He has been able to use hearing aids effectively. His recent hearing test showed that his hearing dropped significantly in his left ear, especially in his high frequencies. It was mentioned to me at his last appointment that if his hearing doesn’t come back up, or if his hearing has not changed, they may start screening for a cochlear implant.
My questions for you are:
Does a cochlear implant always kill all residential hearing? Currently he has moderate-severe to profound loss.
Would you recommend a CI if the rest of the ear is not profound?
Is there any advice that you could give us to help us if we are faced with making the decision about our son receiving a CI?
I hear you. You are agonizing whether to get a cochlear implant (CI) now and risk your son’s residual hearing, or wait until some unknown time in the future. But how will you know when the right time comes? That is your real question.
Let me give you a basic rule of thumb that will help make this decision a lot easier for you. It is simply this. When hearing aids no longer provide significant help for your son, then it is time to consider a CI. However, if his hearing aids are giving him significant help, then you probably will want to hold off on the CI.
The reason for this is that, yes, the operation to insert the electrodes into the inner ear often does “kill” any residual hearing, although I know some people that still hear very low frequency sounds even with their cochlear implants off.
Thus, if you wait until he gets no significant help from his hearing aids, even if he loses all his residual hearing with the CI (and it doesn’t work for some reason–although the success rate is over 98%), he is no worse off than before. In other words, he has nothing to lose.
When considering getting a cochlear implant, the basic consideration isn’t how much hearing loss he has (typically severe or worse), or how bad his discrimination is (typically about 40% or worse), but whether hearing aids still significantly help him. If they do, stay with them. It is cheaper (and safer since CI operations have risks, however slight).
However, when his hearing aids no longer give him significant help, then you won’t have to agonize over this issue any more. You’ll know that getting a cochlear implant is the only option available if he wants to hear again. Thus, you will feel comfortable making the decision because now you know that the time is right.