Cochlear Implants for Single Sided Deafness & Asymmetrical Hearing Loss | FDA Approval

By: Dr Cliff Olson
August 14, 2019
Video Transcript

Whether you were born deaf in one ear, experienced a Sudden Sensorineural Hearing Loss, or you developed a tumor in one ear, there are a variety of treatment options at your disposal.  Some of these treatments for an Asymmetrical hearing loss or Single Sided Deafness include the Contralateral Routing of Signal (ie CROS) Technology and Bone Conduction Technology.  Both of which I have discussed in detail in other videos.  While these are effective treatment options for hearing sound from your deaf side, due to overcoming the Head Shadow Effect, there are still some major problems that persist with these treatment options because they do not bring back Binaural Hearing.

Binaural hearing, aka. hearing with two ears, offers some significant benefits over hearing with just one ear such as Improved hearing in Quiet and Noise, Improved Ease of Listening, and Localization ability.  Localization, or the ability to determine which direction sound comes from, requires a timing difference between two ears.  Don't get me wrong, Bone Conduction and CROS are absolutely terrific options for Single Sided Deafness, but they do not give you back the ability to hear with both ears and achieve the true benefits of binaural hearing.  

However, there is another, less common treatment option for Single Sided Deafness that is more commonly thought of for individuals with bilateral deafness, and that is a Cochlear Implant.  A Cochlear Implant can stimulate hearing on the deaf side by stimulating the cochlear nerve directly with electrical impulses.  These impulses are then interpreted as sound by the brain, allowing you to hear.By giving hearing back to the deaf ear, it is possible to somewhat restore the benefits of binaural hearing, including the ability to localize where sound is coming from.  This is something you just can't do with traditional treatments like Bone Conduction and CROS.

A few weeks ago, the FDA approved the Med-El Cochlear Implant System as the first cochlear implant system approved for the treatment of Single Sided Deafness and Asymmetrical hearing loss.  According to their press release "MED-EL Cochlear Implant (CI) Systems, including SYNCHRONY and the recently FDA-approved SYNCHRONY 2, are now indicated for individuals aged 5 years and older with SSD who have profound sensorineural hearing loss in one ear and normal hearing or mild sensorineural hearing loss in the other ear, or individuals aged 5 years and older with AHL who have profound sensorineural hearing loss in one ear and mild to moderately severe sensorineural hearing loss in the other ear, with a difference of at least 15 dB in pure tone averages between ears."Prior to this FDA approval, Cochlear implants have been used as an Off-Label treatment for Single Sided Deafness.  

Basically this means that they weren't specifically approved by the FDA but were used as a treatment anyway.  However, FDA approval does not equal guaranteed treatment with a Cochlear Implant.  There are candidacy requirements that must be met.  For Adults-You must receive limited benefit from unilateral amplification-Score less than 5% words correct in quiet on the CNC word list on the ear to be implanted.

For Children-Aided Speech perception tests using developmentally appropriate monosyllabic word lists-Must score 5% or less in the ear to be implanted.Both Adults and Children must have-At least 1 month of experience wearing a Hearing aid, a CROS, or other relevant device with NO reported Subjective benefit.  The other potential barrier to implantation would be cost.  

While some insurances may cover Cochlear Implantation for individuals with SSD, this won't be the norm for a little while.  With Private Pay costs for Surgery and Technology ranging anywhere between $30,000 to $50,000 or more for a single ear, it is definitely possible to be implanted.  That being said, don't let cost be your main deterrent.  With enough appeals to your insurance or with help from a charitable organization, you may be able to receive at least some coverage for a cochlear implant.

Dr. Cliff's Thoughts
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