Friday, July 17, 2009

Bilateral Progress

Our daughter received her first implant shortly after her first birthday back in 1999. Back then, implanting prior to 18 months of age was not common. She lost her hearing due to meningitis as a baby, and her right cochlea ossified (filled with bone) very quickly. Since we wanted to have her receive the implant, the doctors needed to move very quickly to insure a full insertion of the electrode array before her left cochlea ossified. The surgery was a success. Partly because of her prior hearing history, partly because of the early implantation and partly because of all the speech therapy we did with her, she did very well with the implant. Everyone was thrilled with her progress. But that does not mean she had equal access to sound that hearing people have. We were very aware of that, and did our best to give her better access to the language around her. She has no problem when she is with other D/deaf people who sign, and she has an FM system at school. Where she had the most difficulties was in noisy situations, such as the school hallway and the playground. We knew that the people who had gotten bilateral implants generally reported that the bilateral implants helped immensely in noise situations, and helped them in group discussion settings. But with her ossified right cochlea, bilateral success was a big question mark.

We talked it over, and since she was older, felt that she had to be involved in the decision this time around. She wanted to try, and in December 2008 the surgery was performed. Initially, the doctor said that he had gotten half of the electrodes in place, but subsequently, three of them were not able to be mapped. Out of 22 electrodes, she has 8 active. Between that and not having any stimulation on that side for 10 years, we knew that her progress would be slow. But the question still remained. Would she get any benefit from the right implant? The right side was activated in January, and her map stabilized in March. She had her six month mapping check up in early July.

No surprise that her right ear was still unable to understand any of the words in the booth test. With the ossification, and only having 8 active electrodes, she may never be able to use that ear alone to understand speech. Her left ear has 100% understanding in a quiet environment. The real question was how well would she do in noise. With both implants on, the doctor did the test several ways. With the background babble on the right side and the sentences she was supposed to repeat on her left side she tested 12% below normal hearing. When it was switched, and the babble was on her left (good) side, she tested at 13% below normal. When the babble and main voice were equalized, and both sounds were going to both ears (true bilateral hearing) she tested at only 6% below normal hearing.

The audiologist was thrilled with this outcome. She said that it showed that our daughter’s brain was really able to utilize her hearing in her right ear even though she couldn't understand anything in it alone. It also showed that the bilateral hearing was making a big difference when hearing in noise.

We had three things we wanted our daughter to achieve with bilateral hearing that she didn't have with her single implant. Better distance hearing, localization of sound, and better discrimination in noise. All three of those objectives have been achieved, and she has only had her right implant for 6 months. It would be icing on the cake if she could actually understand speech with her right implant alone, but even if that goal is never realized, she has benefited immensely from getting bilateral hearing, and we are thrilled with her progress.



Anonymous said...

I'm glad you had a positive experience. We are going to have to decide soon about our daughter, who got her right CI one year ago at age 2, if we want to go bilateral. It's really more a question of when, not if. We have heard nothing but positive things about bilateral CIs. I just got one for myself (age 33) three weeks ago and activiating it next week. I don't plan on going bilateral though. :)

kim said...

WOW! I'm so impressed with her progress despite the ossified bone and no use for so long. Amazing!

Sara said...

Oh gosh, I have the EXACT same problem!! I got my second implant when I was 18 (my first was when I was 3 1/2 years old). It's been 5 years and I still cannot hear speech. I can hear sound patterns and maybe my name. But that's just about it. I gave up for the time being. My audiologist said that I really need a good chunk of time to allow that side to develop, which means finding a time to put my life on "pause". I may be able to do it this coming winter when I am writing my thesis and not doing any coursework.

Please do keep up with your updates on your daughter.

Kristal Coral said...

I just found this site. The story is so similar to my daughter's. She is 9 now. Meningitis at 10 months..CI at 12 months..ossification resulted in 7 electrodes out of 22. Age 3 second implant -split array 11 out of 22.

SHe is bi-lateral and bi-lingual.

We are so happy with our choices and being apart of the Deaf and Hearing world.

Now I am studing to be an interpreter.

She blesses our life everyday,
Kristal Molina