Cochlear Implant Technology

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Pauline Pitts
5 years ago
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1 Cochlear Implant Technology BAA student conference Leicester July 2015 Suzanne Harrigan; Specialist Speech & Language Therapist

2 The Ear Foundation business: Family programme Education programme Sound Advice Research

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4 The Ear Foundation began the first paediatric cochlear implant programme in the UK.1989 Michael Batt s operation

5 The Ear Foundation 2009 How does a cochlear implant work? How is it different from a hearing aid?

6 How do cochlear implants work? 6

7 One of the first Cochlear implants Speech Processor Receiver CI implant

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9 Latest Technologies from Cochlear The new CI512 cochlear implants The new Custom Sound Suite 3.0 The new CP810 sound processor The new CR110 remote assistant

10 Latest Technologies from Advanced Bionics The Ear Foundation 2009 Neptune Available 10 Autumn 2011

11 Latest Technologies from Medel 11 The Ear Foundation 2009

12 Latest Implant on the market- from Oticon Medical Not available as yet in the UK 12

15 Simulation: listening with a cochlear implant 1-channel 2-channel 4-channel Start with 1-channel and then increase the number of channels 8-channel 16-channel This demonstration uses the noise-band vocoder technique of Robert Shannon. Original

Links to other CI simulations: http://soundingboard.earfoundation.org.

16 Links to other CI simulations: 0&search_term=ci+simulations 16 The Ear Foundation 2010

17 The Ear Foundation 2009 Cochlear implants aim to provide access to spoken language via audition which was not possible for that child with hearing aids. What aided levels of hearing are we talking about? What are the implications?

18 60 db So what levels of hearing does a cochlear implant provide? 10 db 30db 0 db

19 Thresholds with a cochlear implant

20 NICE recommends... The National Institute for Health and Clinical Excellence recommends cochlear implants for children and adults with severe to profound deafness. Unilateral cochlear implantation of those with severe to profound deafness. Simultaneous bilateral cochlear implantation for children. Simultaneous bilateral cochlear implantation for adults who are blind or have other disabilities that increase their reliance on auditory stimuli. A sequential bilateral implant for those who had a unilateral implant before the publication of the guidance and who are either still a child or an adult who is blind or has another disability which increases reliance on auditory stimuli. 20

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Criteria for cochlear implantation http://www.bcig.org.

22 Criteria for cochlear implantation uk/assessed/getone/ For further information about referrals 22

23 Does a cochlear implant provide normal hearing?

24 The issues that they have are subtle... 3 M s Mishear Misunderstand Misinterpret 24

25 Impetus BCIG 2014: Incidence of Severe to Profound v Surgery (Chris Raine) Incidence Surgery

26 Hearing loss a growing issue World Health Organisation predicts that by 2030 adult onset hearing loss will be in the top 10 disease burdens in high and middle income countries Affects over ten million in the UK. By 2031 predicted to be 14.5 million people with hearing loss in UK We have increasing ageing population working for longer 41% over 50 have a hearing loss.. Communication more important than ever before

27 Interviewing adults: spontaneous comments on the cost savings after cochlear implantation I was seeing a doctor for years, who was treating me for depression, and I don t have that problem anymore, and I was dangerously depressed. Not a little bit down, or a little bit SAD...DANGEROUSLY depressed. The cost of that, the benefits I was claiming that are no longer necessary- it s cheap at half the price! I was out of work for 3 years and then within one month of being switched on I had a job... [L; adult CI user]

28 What would you say to Commissioners of Health Care? You have a middle-aged person,(who has lost their hearing) you have someone who has years of experience, has skills that could contribute to society, you have someone who can contribute tax and in so many other ways, and the single cost of a cochlear implant bears no relation to the dramatic quality of life and improvement that the individual will have, and the ability to contribute again as a worthwhile citizen in society. I have paid for my implant within two years, I like to think that I have given the NHS back what they gave me, but I know that ultimately the alternative was that I would have been a burden to the NHS if the worst scenarios had happened to me, and I would never have contributed again in fact in terms of paying taxes. To look at it as a single monetary measure is incredibly short sighted... [adult CI user]

29 Can we change the narrative... What is the cost of NOT implanting... What is the Real Cost of Adult Hearing Loss...

30 O Neill... British Household Panel Survey, taking model used for obesity studies... Lost income; people with hearing loss earn less than those without, controlling for other factors.. Additional GP and social work costs associated with hearing loss Burden of reduced quality of life... Confident that economic burden to UK is 30 billion

31 Our recommendations... A National hearing screening programme for adults Funders of health care should consider the costs of NOT providing hearing management A review by NICE of the current guidelines for adult cochlear implantation A single commissioning process Increased education of the public, particularly GPs Urgent publication of Action Plan on Hearing loss...

EXECUTIVE SUMMARY Academic in Confidence data removed

EXECUTIVE SUMMARY Academic in Confidence data removed Cochlear Europe Limited supports this appraisal into the provision of cochlear implants (CIs) in England and Wales. Inequity of access to CIs is a