Mayo Q&A w/ Dr. Raymond: Cochlear Implant & Hearing July 1

Posted by Dr. Mallory Raymond @flotolaryngology, Jun 24 8:00am

Allow me to introduce you to Dr. Mallory Raymond, an expert ear surgeon at Mayo Clinic in Florida offering advanced treatment for outer, middle and inner ear disorders. She specializes in cochlear implant surgery, cerebrospinal fluid (CSF) leak repair, and the management of otosclerosis, cholesteatoma, and vestibular schwannomas (also known as acoustic neuromas).

On Tuesday, July 1 Dr. Raymond will answer questions in a text-style Q&A about cochlear implants, hearing loss and other ear concerns you may have. Please submit your questions before 1 pm ET on July 1. 

Please note that this text-style Q&A is for informational purposes only, and any concerns you have should be addressed to your treating physician. If you would like to learn about care by Dr. Raymond and her team at Mayo Clinic in Florida, please visit this page for information about their program.

Please submit your written questions in advance by commenting on this thread, and Dr. Raymond will reply to your comment on July 1. You will receive a Mayo Clinic Connect notification when she responds to your question. You can start submitting questions now – so please go ahead and ask away!

Interested in more discussions like this? Go to the Ear, Nose & Throat (ENT) Support Group.

I am interested to learn about the treatment of Tinnitus with acupuncture.
Based on my very positive experience several years ago being treated with acupuncture for severe lower back nerve inflammation, I am ready to give it a try.
I am fully aware that it might not bring relief for everyone.
Thank you.

REPLY
Profile picture for lfserpa1 @lfserpa1

yes, audiologists. Sorry about that.
I did get a hearing test at Mayo clinic in Scottsdale and was told i need to test below something like 10% hearing level. I am not sure that is the number they gave me but it is close.

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About one year ago, the audiologist run a hearing test, made some adjustments to my 5 year old Oticon hearing aids. Furthermore, I had been complaining about everything being too loud, up to painful, with or without hearing aids. I had subsequently more extensive testing that showed that I also had hyperacusis, which no further adjustment would offset or alleviate . In the meantime, I got Covid for the second time and tinnitus went from noticeable to making it difficult to fall asleep and/or waking me up at night. The conclusion was, that none of the newest, most advanced hearing aids would improve the word recognition in noisier places, they would obviously not help to alleviate the hyperacusis and a cochlear implant might be the only viable alternative. I am right now going through a sequence of required medical exams to hopefully obtain clearance for the surgical procedure. By the way, I am 85. You may want to ask the Mayo Clinic in Scottsdale to provide you with a copy of the audiogram and a written explanation with the criteria for disqualifying you from getting a cochlear implant, and discuss with them to run the hearing tests once more to validate their assessment that you did not qualify for an implant.

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Hello, Dr. Raymond.

Thanks you for taking time to answer our questions.

If one were to receive CIs, would any hearing ability, especially < 1kHz, be lost? I have pretty good (relative term) hearing in both ears below 1kHz, so if it is true that this would be lost after an implant, that would certainly sway my decision. Attached are audiogram test results from about 18 months ago. I currently wear Phonak Lumity Life 90s with P receivers and vented domes, and have grown rather attached to them, despite the limited battery life of 12-15 hours for me.

Also, I'm not sure of the criteria to qualify for implants, but I did find some guidelines on: https://www.cochlear.com/us/en/professionals/products-and-candidacy/candidacy/cochlear-implant that show I would be borderline, but fall right into their "hybrid" offering, whatever that is. Do my test results show that I should consider CIs in the future?

Thanks,
JustTodd

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Profile picture for Julie, Volunteer Mentor @julieo4

Many seniors who have cochlear implants and/or hearing instruments are struggling with advanced technology that requires constant use of cell phones to manage their personal devices. The ease of 'button pushing' seems to be a thing of the past. Adding to this is the constant need to charge numerous devices to make things work. Is anything being done to make products easier to use?

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Advancements in technology are meant to improve our experiences, but often make it more complicated, especially when not intuitive. Most companies are focusing on both optimizing the contribution of the advancements to hearing loss but also on the ease of use. I don't have list of specifics, but a nice way to get some additional help is to sign up for a manufacturer-specific account to receive personalized support. Sometimes it takes someone in "the know" to help simplify the tech!

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Profile picture for minischnauzer @minischnauzer

Dr.
I know I have to address this with my surgeon, but I’m interested in your opinion. I was implanted on 3/29/24 and I have a HA in my left ear. I’ve been experiencing very bad neck issues lately, which radiates up to the back of my head and right ear. I’m concerned this may be due to the implant but not sure. I’m also getting some dizziness. I did very well after surgery, no vertigo or dizziness. Is it possible to have these symptoms from the implant over a year ago….thank you

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Neck pain is possible but uncommon after cochlear implant surgery. To perform the surgery safely, your head was likely turned away from your implant ear. This can cause some temporary stiffness. Rarely muscle tension can develop after ear surgery, but before settling on that as the answer, it would be important to rule out other common sources of neck pain, as it’s possible that they are unrelated. Similarly, prolonged dizziness can happen after cochlear implantation, but unrelated as well. Talking to your surgeon about specifics (type of dizziness, time course, degree of severity) would all be important to start to understand the relationship.

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Profile picture for ger4 @ger4

How does one judge when the right time is to get a hearing aid?

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Having a hearing test and evaluation by an audiologist is a good first step. This will help determine the degree and type of hearing loss and allow you the opportunity to understand how your hearing loss is affecting your quality of life, what you might be missing and what you have to gain.

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Profile picture for lmayo @lmayo

Question number 1
I am 73. I have an Osia II implant for my completely deaf right ear. Hearing in my left ear is diminishing fast even with a hearing aid. Should I consider a Cochlear implant in the future for my left ear, and how well would that work with my existing Osia in the right?

Question number 2
If I sleep on my left side for several days, I wake up with vertigo, but digestive issues would dictate sleeping on my left side. I can get rid of the vertigo with the Epley, but my question is this. Can crystals be trained to enable me to sleep on my left side without the vertigo? I sleep like a baby on my side, but I cannot go to sleep on my back. I always take forever to fall asleep that way, then wake up after a couple of hours wide awake. It is a dilemma. So, to address my issue, can crystals be trained to remain in place for certain positions or am I just stuck forever avoiding the left tilt of my body. I know this sounds like a dumb question, and it may not even make sense, but I was hoping someone would be able to explain since it affects my quality of life.

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An Osia works by sending sound energy to the inner ear through vibrations of the skull. If your right ear has no hearing, then the Osia is sending sound from your right ear to your left ear.

As your left hearing diminishes it will have less of an ability to benefit from the vibrations being sent by the Osia. One could consider a cochlear implant instead of the Osia for the right ear (depending on the reason for the right sided hearing loss) now, or for the left ear when the hearing diminishes beyond getting benefit from the hearing aid.

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Profile picture for lfserpa1 @lfserpa1

I do not hear very much with my existing (and expensive) hearing aids but my ophthalmologists assure me I do not qualify for cochlear implants and won't for many years. That said many of my friends have cochlear implants and they indicate they were not as deaf as I am when they got them. Is there some recent change that affects when you qualify for implants or are my doctors just trying to keep me spending a small fortune (~$7000) on new hearing aids? I am getting very frustrated at not being able to go to places with a group of people or engage in conversations with more than one person at a time.

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There have been some recent changes that do allow more patients to qualify for cochlear implants. To understand if you could be a cochlear implant candidate, you would first want to understand if going through the evaluation is worthwhile. I generally say that if your pure tone average (PTA) in your better ear is worse than 60 dB and your word recognition score (WRS) is worse than 60%, then going through the cochlear implant evaluation is worth it. In this evaluation, your hearing would be tested with your hearing aids to 1) ensure that you meet FDA and insurance criteria and 2) help your audiology/ENT team talk through expectations for improvement

REPLY
Profile picture for justtodd @justtodd

Hello, Dr. Raymond.

Thanks you for taking time to answer our questions.

If one were to receive CIs, would any hearing ability, especially < 1kHz, be lost? I have pretty good (relative term) hearing in both ears below 1kHz, so if it is true that this would be lost after an implant, that would certainly sway my decision. Attached are audiogram test results from about 18 months ago. I currently wear Phonak Lumity Life 90s with P receivers and vented domes, and have grown rather attached to them, despite the limited battery life of 12-15 hours for me.

Also, I'm not sure of the criteria to qualify for implants, but I did find some guidelines on: https://www.cochlear.com/us/en/professionals/products-and-candidacy/candidacy/cochlear-implant that show I would be borderline, but fall right into their "hybrid" offering, whatever that is. Do my test results show that I should consider CIs in the future?

Thanks,
JustTodd

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Great question that comes up all the time. Hearing loss in the low frequencies is common after cochlear implant but not guaranteed. In fact, commonly now, through techniques that we generally refer to as hearing preservation, patients often maintain their low frequencies immediately after surgery. We do tend to see some decline or complete loss with time. For some, this loss does not outweigh the benefit of improvements in clarity that the implant gives them. Unfortunately, I cannot see the test results but would recommend in general considering a cochlear implant evaluation if you are still struggling with your hearing aids and your pure tone average is worse than 60dB in your better ear and word recognition score is worse than 60%.

REPLY
Profile picture for deberh @deberh

I am interested to learn about the treatment of Tinnitus with acupuncture.
Based on my very positive experience several years ago being treated with acupuncture for severe lower back nerve inflammation, I am ready to give it a try.
I am fully aware that it might not bring relief for everyone.
Thank you.

Jump to this post

Go for it!

REPLY
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