September 9th, 2008 by Elizabeth | Tags: Advanced Bionics, Audiology, Cochlear Implant, Cochlear™, Encouragement, Facts, MED-EL, Misconceptions, Opinion, Research | 10 Comments »
One of the most common concerns expressed by people considering a cochlear implant is, “What about new technology? What about hair cell regeneration or fully implantable CIs? Is now really the best time to take this leap of faith?”
Now, these are prefectly legitimate questions. In fact, I’d be a little bit concerned if someone considering surgery, any surgery, didn’t think long and hard about all the possible ramifications of that choice. But for cochlear implants, the time is NOW… and here’s why:
(I’m going to omit the “number crunching” aspect of this topic from the main body of this post, just to spare readers who couldn’t care less about the tech aspects, but, for my fellow CI historians and technology geeks, anywhere you see an asterisk (*) check at the bottom of the page for more information on that topic!)
Technologies like a fully implantable device or scientific advances like hair cell regeneration may very well be in our future. Who knows? I may live to see them in my lifetime. But though these exciting discoveries are on the horizon, to say they are in the “near future” is simply untrue. Though recent advances have yielded exciting results, the research is extremely preliminary. Even if such technology was 100% ready today (meaning ready to be used in humans), it would still have to undergo the FDA approval process* which is incredibly long and grueling (as it should be!). Drugs as simple as an over-the-counter allergy pill can take years for approval, so imagine how long a drug for cochlear hair cell restoration would take to make it through the process? As for a fully implantable CI, it would have to go through the FDA’s medical device approval process and, because of it’s implantable nature, would be placed under Class III regulations, the strictest the agency provides*. So, there’s a good chance that these technologies may happen one day, but for now, I wouldn’t suggest holding your breath.
Also, who’s to say that current implant recipients couldn’t benefit from this new technology when it becomes available? Cochlear hair restoration is supposed to restore absent and/or damaged hairs in the cochlea — remove the internal electrode array from the cochlea of someone with a CI and — voila! — that’s what you have — damaged and/or absent hair cells! As for a fully implantable device, there’s no reason why your current CI couldn’t be removed and replaced with the newest fully implantable device. CIs are explanted and reimplanted easily in the case of device failure. I don’t see any reason why that couldn’t be just as commonplace to explant and replace with a fully internal device. The current technology is constantly updated*, too — and current users CAN benefit from these upgrades WITHOUT a new surgery!
So yes, new and exciting developments in hearing science very well may be in our future. But is it really worth sacrificing REAL benefit now for POSSIBLE gain at some indeterminate time in the future, especially when partaking of today’s technology does not necessarily preclude benefitting from later advances? I would say no. For children, there is a small and precious window of time to give them access to hearing if you desire listening and speech. For adults, espcially adults who have lost hearing as they’ve aged… haven’t you waiting long enough? There’s a lot of life out there to hear and experience. If you’ve been thinking about a cochlear implant, you owe it to yourself to at least check it out. Whatever decision you make, at least you can know that you learned all that you could to make the very best-informed decision for you.
There are so many beautiful things to hear out there. Why wait?
*Okay, techie-friends… here’s the nitty-gritty:
- See a diagram of the FDA approval process for drugs HERE
- For more information about the FDA’s approval process for medical devices, click HERE
- Since 1985, Cochlear™has had 6 different internal implants (Mini22, Nucleus® 22, Nucleus® 24, Nucleus® 24 Contour, and Nucleus® Freedom) and 7 different external processors (WSP – Wearable Speech Processor, MSP – Mini Speech Processor, Spectra Bodyworn, SPrint Bodyworn, ESPrit BTE, 3G BTE, and Freedom Babyworn/BWP/BTE). The past five upgrades of the “modern era” are all fully compatible for older types of implant arrays (the first 2 were in the ’80s during the trial phases of the technology). So, if you received one of the first N22 internal components, you would be able to benefit from FIVE processor upgrades (which include upgrades in comfort, water-resistence, and, most importantly, microphones and programming strategies) without ever undergoing an additional surgery. The internal/eternal upgrades for the other companies are impressive, too.
- MED-EL has had 2 types of internal implants (PulsarTI100 and SonataTI100) and just released it’s second generation processor, the Opus2.
- Advanced Bionics has had multiple internal implants (Clarion, CII, and HiRes90K) as well as external processor upgrades (Platinum Sound Processor Bodyworn, CII BTE, Auria BTE, and Harmony BTE)