February 3, 2023

Now Providing Cochlear Implants

From Dr. Douglas Holmes:

A year or so ago, I envisioned adding cochlear implants to our practice. 

Several factors moved me in that direction:

1) The FDA approved Cochlear Implants (CI) for single sided deafness (SSD).  If you had a hearing loss in one ear only, that was not helped by a hearing aid, the FDA finally recognized what we knew long ago: how debilitating to hear from one ear only.  And conversely, how incredibly beneficial it is to have stereo hearing.  (Try plugging one ear.)  Several insurance companies have decided to cover this procedure for SSD, but unfortunately Medicare is still lagging.

2) Due to the expansion of potential candidates for implants, Cochlear Corporation created a series of workshops and practical temporal bone labs that included inserting electrodes in cadaver cochlea’s to teach implantation to general otolaryngologists.  Heretofore, cochlear implants in the US and Raleigh area were almost always performed by otologists and university programs.  I attended such a workshop in May 2022 for a weekend of lectures and labs, after hours discussion, and relationship building with the instructors, Cochlear staff, and other ENT’s branching out.

3) Patients have related to me that driving to Chapel Hill or Duke, finding a place to park, finding the clinic, etc was painful.  “Why can’t you do this here?”  It was even worse if further testing indicated that they were not an acceptable candidate.  All that for nada.

So, I trained and read and viewed numerous educational videos.  Our audiologists stepped up and trained in the assessment of potential candidates and programming the implants once inserted.  Our audiology assistant worked with Cochlear Corp staff to obtain insurance approval, our schedulers found the OR time, our nurses and assistants taught patients and family members about pre and post op care, etc, etc.  And then on OR day, our highly experienced Cochlear Corp rep was there with the implant and electrode, instructing and assisting OR team members new to the procedure, and confirming precise electrode placement through nerve monitoring.

It was a huge team effort!!  And what a team!!

In a separate blog I will describe the surgical procedure in great detail and with an interesting analogy.  Suffice it to say here, it is so cool and amazing to utilize a microscopic approach through the mastoid and area called the facial recess, sight the round window niche, expose the round window membrane of the cochlea, opening the membrane, carefully feeding in the electrode, and then verifying the electrode function and cochlear nerve response.  

Last Saturday, I did our second.  Patient number one is a 93 year-old woman with bilateral deafness, now returned to the hearing world with the ability to hear her children, grandchildren, and great grandchildren.  What a gift!!  Patient number two is in her 60’s with SSD.  Her implant will be turned on after a two-week healing period.

And this is just scratching the surface.

CI, as amazing as it is, comprises only a small part of what we do as part of our total dedication to improve hearing in each and every hearing impaired patient we encounter. If you want to hear better or if you have family members who need better hearing, we have a solution!

Douglas K. Holmes, MD, FACS ENT & Audiology Associates PLLC 3820 Ed Drive Raleigh, NC 27612