2 nd August 2013 Cochlear Implants for SSD Emma van Wanrooy, SCIC

SSD Binaural Hearing Benefits Head Diffraction Effects Binaural Squelch Localisation

SSD Binaural Hearing Benefits Head Diffraction Effects Dillon, SNR +SNR

SSD Binaural Hearing Benefits Head Diffraction Effects Binaural Squelch Localisation

SSD Binaural Hearing Benefits Localisation Dillon, 2012

SSD A “significant hearing loss in 1 ear” Advisory group for single sided deafness, 2003 Also known as unilateral hearing loss

SSD Features Severe to profound Often sudden onset

SSD Causes Physical damage /Trauma Compression of the hearing nerve Viral or bacterial infections Disorders of the circulatory system Severe Ménière’s disease

SSD Impact Difficulty hearing on impaired side Poor localisation Difficulty hearing in noise Tinnitus

SSD Rehabilitation devices Hearing Aid (if sufficient hearing) Cros Aid Bone conductor Bone anchored device eg/ bonebridge

SSD Treatment Until now………….. What about cochlear implants?

Improvement in speech perception in noise S 0 N 0, S ci N he Significantly better SSQ scores at 3 months 1-3 hours/day rehab SSD Tavora-Vieira et al 2012

S nh N ci speech comprehension better than CROS/BAHA, but not better than unaided. Better than unaided, CROS and BAHA for S ci N nh SSD Arndt, et al, 2010

Localisation significantly better with CI SSQ at 6 months post CI significantly better CI used significantly longer per day Significant decrease in tinnitus loudness SSD Arndt, et al, 2010

Definition of ‘SSD’ Auditory training/ loudness balancing Music appreciation Candidacy assessment SSD Further research needed

SSD Personal experiences 47 year old female Sudden loss in right ear 18 years prior Extreme tinnitus

SSD Personal experiences “The hearing in my left ear was perfect and not affected ….the tinnitus.. seemed to mask what my good ear was trying to hear.…a constant challenge to keep my sanity ”

SSD Personal experiences. “In harms way when walking up streets with traffic I just couldn’t hear or the direction in which it was coming”

SSD Personal experiences Referred for BAHA trial and tinnitus counselling Implanted with Med El Sonata Tinnitus reported gone instantly

SSD Personal experiences “I’m a lot more balanced and my sense of direction has improved so much it is unbelievable……I now look forward to going out and socialising, I’m more relaxed and am enjoying life more.”

SSD Personal experiences “I experiment by turning my processor off. Huge difference. Can’t wait to turn it back on again…. when I turn it back on it is such a relief. It just feels so much better, so balanced.”

SSD Personal experiences Aided Speech Perception 6 months post Right CI 65dB SPL100% CUNY in noise (+10dB SNR) 93% CUNY in noise (+ 5dB SNR) 100% CUNY in noise (0dB SNR) 86% CNC 65dB SPL 86%

SSD Personal experiences Female aged 23 Musician and singer, studying musicology Meningitis and lost hearing in Left ear

SSD Personal experiences Loss of spatial separation of sounds Difficult to identify sounds that were similar. Eg/ tap running, rain, boiling water

SSD Personal experiences Implanted 15 months later– Med El Sonata Implant using FSP

SSD Personal experiences At switch on, focussed on loudness and balancing Did a lot of auditory training

SSD Personal experiences Improved directional hearing Good speech understanding Better able to follow conversation in a group in noise Mobile phone in noise better

SSD Personal experiences Unable to perform well in musical when batteries went flat in Speech Processor

SSD Take into consideration Duration of deafness Goals: Tinnitus relief Localisation Listening in noise

SSD Why CI? Relief from severe tinnitus Improved localisation/ spatial awareness Improved utilisation of head shadow effects in noise

SCIC AUSTRALIA’S LARGEST COCHLEAR IMPLANT PROGRAMME SYDNEY | NEWCASTLE | CANBERRA | GOSFORD | LISMORE | PORT MACQUARIE | PENRITH Thank You SCIC