2 nd August 2013

1. Cochlear Implants for SSD Emma van Wanrooy, SCIC 2nd August 2013

2. SSD Binaural Hearing Benefits • Head Diffraction Effects • Binaural Squelch • Localisation

3. SSD • Head Diffraction Effects Binaural Hearing Benefits -SNR +SNR Dillon, 2012

4. SSD Binaural Hearing Benefits • Head Diffraction Effects • Binaural Squelch • Localisation

5. SSD • Localisation Binaural Hearing Benefits Dillon, 2012

6. SSD Also known as unilateral hearing loss A “significant hearing loss in 1 ear” Advisory group for single sided deafness, 2003

7. SSD Features • Severe to profound • Often sudden onset

8. SSD • Physical damage /Trauma • Compression of the hearing nerve • Viral or bacterial infections • Disorders of the circulatory system • Severe Ménière’s disease Causes

9. SSD • Difficulty hearing on impaired side • Poor localisation • Difficulty hearing in noise • Tinnitus Impact

10. SSD • Hearing Aid (if sufficient hearing) • Cros Aid • Bone conductor • Bone anchored device • eg/ bonebridge Rehabilitation devices

11. SSD Treatment Until now………….. What about cochlear implants?

12. 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

13. SSD • SnhNci speech comprehension better than CROS/BAHA, but not better than unaided. • Better than unaided, CROS and BAHA for SciNnh Arndt, et al, 2010

14. SSD • Localisation significantly better with CI • SSQ at 6 months post CI significantly better • CI used significantly longer per day • Significant decrease in tinnitus loudness Arndt, et al, 2010

15. SSD • Definition of ‘SSD’ • Auditory training/ loudness balancing • Music appreciation • Candidacy assessment Further research needed

16. SSD Personal experiences • 47 year old female • Sudden loss in right ear 18 years prior • Extreme tinnitus

17. SSD “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” Personal experiences

18. 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”

19. SSD Personal experiences • Referred for BAHA trial and tinnitus counselling • Implanted with Med El Sonata • Tinnitus reported gone instantly

20. SSD “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.” Personal experiences

21. SSD “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.” Personal experiences

22. SSD Personal experiences

23. SSD • Female aged 23 • Musician and singer, studying musicology • Meningitis and lost hearing in Left ear Personal experiences

24. SSD Personal experiences • Loss of spatial separation of sounds • Difficult to identify sounds that were similar. Eg/ tap running, rain, boiling water

25. SSD Personal experiences Implanted 15 months later– Med El Sonata Implant using FSP

26. SSD Personal experiences • At switch on, focussed on loudness and balancing • Did a lot of auditory training

27. SSD • Improved directional hearing • Good speech understanding • Better able to follow conversation in a group in noise • Mobile phone in noise better Personal experiences

28. SSD Personal experiences Unable to perform well in musical when batteries went flat in Speech Processor

29. SSD Take into consideration • Duration of deafness • Goals: • Tinnitus relief • Localisation • Listening in noise

30. SSD • Relief from severe tinnitus • Improved localisation/ spatial awareness • Improved utilisation of head shadow effects in noise Why CI?

31. SCIC Thank You SCIC AUSTRALIA’S LARGEST COCHLEAR IMPLANT PROGRAMME SYDNEY | NEWCASTLE | CANBERRA | GOSFORD | LISMORE | PORT MACQUARIE | PENRITH emma.vanwanrooy@scic.org.au www.scic.org.au