Cochlear Implants

KECK MEDICINE OF USC PROVIDES CUTTING-EDGE COCHLEAR IMPLANT SURGERY FOR ALL AGES — FROM INFANTS TO THE ELDERLY — GUIDED BY A MULTIDISCIPLINARY TEAM  AT THE USC CARUSO DEPARTMENT OF OTOLARYNGOLOGY – HEAD AND NECK SURGERY.

By Raymond Kung, MD, clinical assistant professor of otolaryngology at the Keck School of Medicine of USC and specialist in cochlear implant surgery

CASE PRESENTATION

The 38-year-old woman sitting before me was certainly an unusual patient. She had simultaneously progressing deafness and blindness. She had become completely deaf 13 years prior, at the age of 25. Typically, cochlear implant surgery takes place within 10 years or even five years of hearing loss or the hearing nerve may have atrophied. The longer the wait, the less benefit the patient may receive.

It’s important to treat adult patients with severe hearing loss rather aggressively because the condition is a risk factor in developing dementia and cognitive decline as they age. At Keck Medicine, we implant patients in their 90s, as long as they are biologically young or biologically healthy and able to tolerate general anesthesia.

The patient was subdued and withdrawn, having lost meaning in life because she could no longer communicate with others. She shared that she had once been a passionate musician, playing guitar and piano. She wanted her life and her music back — she wanted the surgery. With cochlear implants, such patient motivation is key.

MANAGEMENT AND OUTCOME

In January 2020, I led the surgical team in the cochlear implant procedure, placing a receiver-stimulator under the skin behind her right ear and inserting an array of 22 electrodes into the cochlea, carefully opened by microscopic drilling of the mastoid bone. After a month of healing, the patient met with one of the experienced audiologists in the USC Caruso Department of Otolaryngology to activate the device via an external sound processor. The moment it was switched on, the patient was overjoyed.

In July 2020, I implanted a second cochlear implant, this time in the patient’s left ear. Activation a month later marked the first time in over a decade she could hear from both ears. There is no guarantee an implant will work — outcomes vary. Not all patients who benefit do so immediately, as this patient did, partly because of her biology and because she quickly dedicated herself to our individualized rehabilitation program to derive meaning from the new sounds provided by the cochlear implant.

At Keck Medicine of USC, we have an entire team of cochlear implant experts — from surgeons to auditory-verbal therapists. Our audiologists follow each patient post-activation to ensure the cochlear implant is working at its optimum for them and make adjustments in programming when necessary.

This patient continues to improve in her language understanding, and happily reports she has resumed the piano and guitar.

For information or to refer a patient to the USC Caruso Department of Otolaryngology, please call 213-764-2823.