Hearing Aids vs. Cochlear Implants

Dr. Shopovick talks about the differences between hearing aids and cochlear implants.

Transcription:
Hi everyone, it’s Dr. Shopovick, and I hope you all had a wonderful holiday and a very happy New Year! Today we are going to review the differences between a hearing aid and a cochlear implant.
Now, the majority of you are probably more familiar with a hearing aid just because we talk all about those on our channel, so I’m only going to briefly review that today, and we’ll spend the majority of the time focusing on what an implant is. So, I’m just going to briefly go over the hearing aid portion. So, most of you have probably seen this type of hearing aid before. It’s a receiver in the ear canal, and sound comes in through the back of the hearing aid, goes through those microphones, and then the sound gets transmitted down this wire straight into the ear canal. So, what a hearing aid is doing is providing acoustic stimulation to our ear.
On the other hand, we have cochlear implants! There are two styles for implants. There are the on-the-ear option, so it looks like a hearing aid, but nothing is going into the ear canal. It just kind of sits on the back. Then you have the second piece, that is a magnet, that would go right, similar to this space on the back of your head. The other style is off-the-ear so that nothing would be going behind the ear; this would just stick directly on the back of the head.
Now, with the cochlear implant, what that is doing is providing electrical stimulation to our ears. So, a hearing aid is acoustic, and a cochlear implant is electrical. Another main difference between a hearing aid and a cochlear implant is that an implant does require surgery, so it is a surgical procedure that an Otolaryngologist would perform. And for the procedure it is outpatient, and as long as you are healthy to undergo anesthesia, you would be a good surgical candidate. So, some people are concerned about age. “Oh, am I too old to get an implant?” Really, age is nothing but a number. As long as you are healthy and you have cardiac clearance, you would be a good candidate. Another component, or an important component of an implant, I want to touch on is the internal component. So, unlike a hearing aid, there’s just one piece. This is just sitting behind your ear and sending sound into your ear canal.
With an implant, you have an internal and an external. So, for the internal, this is on the inside, so no one, me, you, or the public, is going to see this part. This is all internal. So, the surgeon would just create a little incision and slip the magnet underneath, and then at the bottom of this, there’s a little spiral at the end that you see there. So, that spiral is going to go into our inner ear organ called the cochlea. It looks like a snail. It just wraps around the cochlea, and this electrode array is what provides the electrical stimulation. So, that is how you are hearing through those little electrode arrays. So, with the cochlea, we are bypassing the inner ear; we are bypassing the middle ear; we are just providing direct electrical stimulation to our inner ear and auditory nerve.
The other option, again, would be the off-the-ear. If someone did not want an in-the-ear or might have some kind of ear abnormality, the off-the-ear may be a better option.
Another difference between the two is the candidacy criteria. Ao, for a hearing aid, a person needs to have mild to profound hearing loss, and their word understanding is usually 50% or greater. For a cochlear implant, it’s for someone that has more of a severe loss. So, that person needs to have moderate to profound sensorineural hearing loss, and their word understanding needs to be 50% or less. So, just as an example to put that percentage into perspective, if I’m testing someone in the booth and they got 10% of word understanding in the right ear, that just tells me they are not going to perform well with a hearing aid. Because with a hearing aid, no matter how much I turn up that volume, it’s still going to be distorted to that person. Words are going to be distorted, there’s not going to be good clarity, and hearing aids are not the best option for them. With someone who has 10% word understanding, we would want to switch gears and look into a cochlear implant for them because, again, we are bypassing that 10%, we’re bypassing that inner ear, and really just providing direct stimulation. So, that would probably be a better option for that individual because they are not going to get the clarity they need with a hearing aid.
Another main difference, again, with a hearing aid and a cochlear implant is that the process for getting a cochlear implant is more extensive, so it requires more visits.