Episode 15

Adult Cochlear Implantation

with Dr. Jacob Hunter

We speak with Dr. Jacob Hunter about Adult Cochlear Implantation, including patient workup and counseling, surgical tips and tricks, and post procedure followup.

A BackTable Production

BackTable, LLC (Producer). (2021, February 2). Ep. 15 – Adult Cochlear Implantation [Audio podcast]. Retrieved from https://www.backtable.com/podcasts

In this Episode

Podcast Participants

Dr. Jacob Hunter is Assistant Professor of Neurotology in the Department of Otolaryngology-Head and Neck Surgery at UT Southwestern Medical Center.

Host Dr. Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.

Co-host Dr. Ashley Agan is a practicing ENT and assistant professor at UT Southwestern Medical Center in Dallas, TX.

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Show Notes

In this episode, Dr. Jacob Hunter joins hosts Dr. Ashley Agan and Dr. Gopi Shah to discuss cochlear implantation in adults.

Dr. Hunter outlines the indications for cochlear implantation and walks us through the evaluation process to assess candidacy in adults. He emphasizes the importance of patient counseling in setting expectations for post-implantation hearing. He also describes routine preoperative imaging weighing the relative strengths of CT vs MRI.

The discussion then delves into the nuances of cochlear implant devices focusing on factors such as electrode length, stiffness, and shape as well as hearing aid compatibility. The major surgical approaches are then reviewed along with potential surgical complications. Lastly, the disparities in access to cochlear implantation and hearing care in adults are highlighted.

Resources Mentioned:

Disparities in Cochlear Implantation:
Dr. Hunter and Colleagues at UT Southwestern:
https://journals.sagepub.com/doi/abs/10.1177/0003489419888232

Dr. Samy and Colleagues at University of Cincinnati:
https://journals.lww.com/co-otolaryngology/Abstract/2017/10000/Closing_the_gap_in_cochlear_implant_access_for.7.aspx

Disparities in Hearing Care:
Dr. Carrie Nieman and Colleagues at Johns Hopkins:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363549/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881797/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826391/

The video version of this Podcast has closed captions on YouTube:
https://youtu.be/3IHUMhH9x0E

Transcript Preview

[Jacob Hunter MD]
A cochlear implant is essentially a little wire that we place in the cochlea that fires directly on the hearing nerve, and so the idea is that when patients can no longer receive any benefit from a hearing aid, and a hearing aid, again, is basically just a microphone that's boosting the sound into the ear, then we start talking about a cochlear implant. At least the way I felt I was trained was that maybe when people are struggling with their hearing aids, they might be a cochlear implant candidate, and that can be the case, but many times hearing aids aren't fitted appropriately. I know the idea is trying to get a hearing aid off the store shelf, and there's some benefit to that, but also some complications. But many people struggle with their hearing aids, so that's not the easiest rule of thumb. Generally, when they're at the limits, then they're a candidate for this surgical procedure to place the wire in the cochlea, so to speak.

[Ashley Agan MD]
I think, for some people, when they think cochlear implant, they think it's going to be something that's just completely implanted and that you don't really see it all. So can you talk about the components, or when we see these patients who have the external process, what all is going on underneath that?

[Jacob Hunter MD]
That is a good point. I actually do have a conversation probably once a week to delineate that key feature. While the wire is in the cochlea and you have essentially a computer under the skin, you're also wearing an external device that allows people to still hear or allows that patient to hear, transmitting the information through the skin into the computer underneath, so you have that external device. Generally, I joke with patients that they can take it off and they won't be able to hear their spouse if they so choose, but their spouse will clearly know that they're not listening to them.

Disclaimer: The Materials available on the BackTable Podcast are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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