ANA Discussion Forum

Treatment Options => Microsurgical Options => Topic started by: Autumnbird on November 03, 2021, 01:41:29 am

Title: Cochlear Implant Vs BAHA in the context of surgery approach
Post by: Autumnbird on November 03, 2021, 01:41:29 am
Hi! Am having translab surgery for 1.5 cm AN soon. I have very poor hearing function in the AN side ear. I have been told that the doctor can not guarantee the possibility of cochlear implant after the surgery (he said it’s possible but he won’t give me false hope). My diagnosis was made recently so I am sorry for posting so many questions! I know very little about hearing implant options but the idea of cochlear implants appeals to me because my assumption is that it provides some hearing function in the AN ear *independent* of the other “good” ear. This is not the case with BAHA (please correct me if I am wrong). If I had other approaches in surgery (retro-sigmoid) or middle fossa, will
I have better chances of preserving the cochlear nerve and therefore getting cochlear implants? Thanks
So much!!
Title: Re: Cochlear Implant Vs BAHA in the context of surgery approach
Post by: anapaul on January 06, 2022, 07:39:17 pm
Hello!

Yes, if you're completely deaf in your AN ear, cochlear implants (CIs) are the only option to achieve any hearing in that ear. BAHA and CROS units capture sound on your AN side and transmit it to your good ear, which can be super helpful, but they can't do certain things (for example, they won't help you localize sound, which requires 2 functioning ears.)

But damage to the auditory nerve by your tumor and/or tumor surgery can impact the success of a CI, and unfortunately there's no good way to determine in advance if you will be helped by one.  There ARE some tests, but they're not very reliable.  I had a CI put in last July (after fighting with my insurance company for 8 months - another story...), and while they were doing the implant surgery they did some testing of my auditory nerve functioning.  My physician said the test results were poor, but my CI is working quite well for me.  He said this is why he doesn't do that kind of testing in advance - it's unreliable and not predictive of success.

If you and your physician decide to give it a go, realize that you'll face an uphill battle with your insurer.  Don't give up, and use all your appeals.  I was finally approved when it progressed to an independent external reviewer, but my insurer denied every single one of the internal appeals.

Good luck.
Title: Re: Cochlear Implant Vs BAHA in the context of surgery approach
Post by: Autumnbird on January 07, 2022, 10:26:29 am
Thanks, Anapaul, for sharing that. Unfortunately, my auditory nerve on the AN side was either damaged or removed (I don’t know) during the translab surgery, and so I am not a candidate for CI. I begged my doctor to save it several times before the surgery, but I was told that, given the size of my tumor, things didn’t look very promising. Frankly, I just don’t know if the outcome would have been different if I had gone to UCSD or House (when I talked to the docs there for phone consultation, they sounded more hopeful about the possibility of saving the nerve for CI than my doctor). Accepting SSD has been very tough emotionally for me. Grieving the loss of hearing on the left side has not been easy.
Title: Re: Cochlear Implant Vs BAHA in the context of surgery approach
Post by: anapaul on January 08, 2022, 01:27:19 pm
Very sorry to hear that. Have you explored BAHA or CROS?
Title: Re: Cochlear Implant Vs BAHA in the context of surgery approach
Post by: Autumnbird on January 08, 2022, 04:04:19 pm
Thanks. I will see my doctor at Uni of Iowa in May. Will discuss both BAHA and CROS then.