Advanced Bionics - Hearing Loss Indications?

Obviously everyone has to make their own decisions on what is best. I can only tell you that when my hearing was at your levels none of my audi’s even brought up CI in the conversation. That was not mentioned until I had gotten to -90 across and lower. Even then until it dropped further my HA helped a lot.

But when I was at your levels, my hearing aid was significant help. In an Oticon family for example, you may need the higher 1 powers (more expensive) but there is no reason - in my opinion - that you couldn’t get a good set of aids fitted for your loss. Key is finding the audi that listens to what you share about what circumstances you struggle and can make the adjustments.

If it was me, I would trials hearing aids. If you have a Costco near you their trial period is like 6 months which gives you plenty of time for adjustments and experiencing in “real life” if they are helpful.

Good luck.

thanks for the response, nic. when i first posted this thread, i had already completed the CI evaluation with properly-fit hearing aids. if you scroll up a little you can see my scores without aids and with the aids.

i’m grateful i have a great HA audiologist who listens and takes note of what i feel i need and will tune the aids until i’m satisfied. there are some things unique to my situation that cannot be fixed or fine-tuned, but that is mitigated by temporary removal of the hearing aids or me moving to a different area if possible.

unfortunately it is the WRS, not my PTA, that was the reason for referral for evaluation.

update:

as of today i’ve been activated for 3 months. tested at 1mo in w/ 52% wrs. today, i’m at 78%. hit 99% of sentences in the booth as well (missed one word) but of course, in real life it’s not that perfect. compared to 22% wrs in this ear with aids prior to implantation, i am happy.

i do not regret my decision at all. i have retained enough residual hearing in that ear to still wake up to my phone alarm or hear a fire alarm, which is all i really need. if i need quiet, i have it. i can sleep better at night, though the insomnia is still there. my partner and my father, who were the most critical of this decision initially— due to their fears of me undergoing surgery and of the possibility of CI not providing any benefit— have come around and are happy that i ended up going through with it. i’m not planning on implanting my other ear any time soon! thank you all for the priceless advice, as you’d all given me a lot to think about prior to my decision.

@celadon said:

i’m not planning on implanting my other ear any time soon!

You will do as you want, but keep in mind that when you’ll rehabilitate your already implanted ear, rehabilitation of second ear (after obtaining CI after a long break)may be probably harder.

It’s like implanting CI in SSD cases. The brain is lazy and will want to use the easiest way to hear. For me, I had to isolate my CI ear for rehabilitation due to quite good hearing in second ear.

i did ask about possibly having auditory processing issues both when initially buying the hearing aids and during my CI evaluation, since i felt that i should have had better speech recognition with the residual hearing i had.

i was told they don’t do ABRs/OAEs for adults and that often those processing issues go hand-in-hand with hearing loss. unfortunately i have gotten no clearer answer than this, so it hasn’t been completely ruled out nor confirmed.

if i do have ANSD and the CI is providing synchronous stimulation, would that not mean that the processing issues should be mostly resolved with the CI, if not completely? there is still somewhat of a latency between someone speaking to me and my brain processing what it’s hearing. i would imagine this is due to my brain still forming neural pathways or perhaps the asynchronicity you were describing, but while it has improved some, it hasn’t gone away. the discrepancy between the HA and CI when it comes to quality/timing of sound are not too noticeable, but directionality is still difficult. i’m sure being bilateral would help, it’s just hard to justify implanting the other ear currently while i can still hear, especially since i can’t actually get an answer as to whether ANSD or other processing issues are part of my loss.

I’m afraid a neurodiagnostic click-ABR is the only way to rule out ANSD. If they have the equipment to perform infant diagnostic ABRs then it is the same equipment for adults. The tests are also comparatively easy to perform, though it may be tricker with an implant on one side as it may interfere with the surface-based recordings. In my country they likely would’ve required a diagnosis prior to implantation, even for adults.

I cannot say for certain whether the CI will overcome all the consequences of ANSD as it is a spectrum and not all causes of ANSD can be remediated through electrical stimulation. The delay you’re experiencing between someone talking and you hearing it could partly be the internal delay of the CI processing chain, but it could also be related to ANSD if that is the cause of your hearing loss.

If I were in your position I’d be seeking out an audiologist who does neurodiagnostic ABRs, or applying pressure for your current audiologist to do one. We have to rule out ANSD in infants with hearing loss. It is a very similar procedure for adults. If your audiologist is willing to give it a go but wants external support and guidance then I could provide a contact in my own country who might be willing to assist. She is the expert in her area and I would turn to her for guidance myself on what adjustments to make to the test and interpretation with a CI present. DM me if this the case.

ah, i didn’t know that’s what the infant ABRs could also account for. in that case, since i’ve had ABRs and OAEs completed multiple times as an infant and as a child, then they’ve already ruled out ANSD and PHL when i was initially evaluated for hearing loss and diagnosed. my health insurance limits the clinics i can use unfortunately, given that those clinics are the ones providing my insurance.

i appreciate your input, i’ll talk to my speech therapist to see if we can at least narrow down how to work on the processing issues.