Services

What is a Middle Ear Implant?
The Middle Ear Implant is a New, Direct Drive Hearing Technology, Made up of Two Components:
The internal medical device, which is surgically implanted, consists of a receiver (Vibrating Ossicular Prosthesis) and a Floating Mass Transducer The external component is referred to as the Audio Processor, which is worn behind the ear and is easily covered by the hair. There are no visible cords or wires. The Audio Processor is a digital signal processor that is programmable.How Does it Work?Sound is picked up from the Audio Processor and is transferred across the skin electromagnetically to the implanted receiver. The receiver then transmits the signal to the floating mass transducer which directly vibrates the ossicles (copying the way a "normal" ear moves the ossicular chain) and sends the signal to the cochlea. This ossicular motion moves the fluid in the cochlea that stimulates the hair cells in the cochlea. The hair cell movement stimulates the auditory nerve, which sends the signal to the brain for interpretation. Since the implant bypasses the middle ear, sound goes directly to the cochlea. This avoids the problems of contaminated and dampened sound caused by placement of a traditional hearing aid in the ear canal.

When Choosing a Hearing Aid, the Following Factors Should Be Considered and Discussed With Your Audiologist:
Your physical ability to manipulate a hearing aid (i.e. if you have severe arthritis, you may not want to purchase a very tiny hearing aid which would have a small battery and a small volume control to manipulate)How active you are and the type of lifestyle you lead (i.e. whether you attend a lot of meetings, are very athletic, and amount of time you spent in quiet environments vs. in social settings with background noise)Cosmetic preferencesWhat you want the hearing aid to do for you (type of circuitry and special features to help with background noise or the telephone, for example)Expense and financing options (as a rule, most insurance companies do not cover hearing aids for adults but financing options may be available to meet your needs)Importance of battery lifeAny other medical conditions that may affect your use of the hearing aid

When sound enters the ear and stimulates the cochlea in the inner ear, the cochlea produces an electrical response to the sound along the nerve pathways. This electrical response is the same type of response that is measured in an Electroencephalogram (EEG), a study of brain waves that may be more familiar to you. ABR waveforms (the electrical "waves" of nerve/brain activity in response to sound) can be measured on your skin using measurement electrodes. The responses can be interpreted to yield valuable information about the function of the auditory pathways. In analyzing the ABR, the audiologist and physician look at the presence of the various waveforms, at how long it takes each wave to occur, the distance between certain waves and the shape and height of the waves. The waves or responses of the two ears are compared to each other to further aid diagnosis

Disorders of the balance system are not an uncommon complaint, particularly in the older population. When a subject presents with dizziness, or vertigo, useful information can be obtained from monitoring their eye movement.

Information gathering of eye movement may be as a result of intentional stimuli or tasking or as a result of spontaneous or involuntary events.

Nystagmus is an involuntary back and forth jerking movement of the eyes that occurs when the entire balance system is stimulated. When the vestibular and ocular systems are functioning normally, nystagmus is only rarely seen. For the purpose of testing, nystagmus can be elicited through certain movements or stimulation of the vestibular system (the balance organs of the inner ear). This helps to determine the cause or origin of your dizziness. An ENG evaluates the oculomotor system and the vestibular system. The test takes approximately an hour and a half to complete.

The ENG is Comprised of a Series of Subtests or Tasks. There are Three Main Parts:
Oculomotor Analysis -- patients perform various visual tasks that require eye movementPositional Testing -- patients are placed in various body positions to determine if dizziness develops and to see if nystagmus occursCaloric Stimulation -- small amounts of both warm and cool water are introduced into each ear canal to independently stimulate the inner ear vestibular system Throughout each part of the test, patterns of normal and abnormal eye movements are analyzed. The main purpose is to look for the presence of nystagmus in both the absence and presence of vestibular stimulation, as well as look for symmetry of responses. Analysis allows for determining if the disorder is central, peripheral or systemic.Central problems are caused by disturbances in the brain or central nervous systemPeripheral problems arise from disturbances in the labyrinth (inner ear balance organ)Systemic problems are the result of disturbances in the organs and peripheral nerves (nerves outside of the brain or spinal column)

Personal Listening Systems / Radio Frequency Modulated Systems (FM)
"FM Systems," as they are commonly called, have the ability to increase the volume of a particular sound source (such as a public speaker, entertainer, teacher or a television, radio or stereo) and deliver it directly to an individual without also increasing the amount of background noise, regardless of the amount of distance that exists between speaker and listener or the amount of reverberation present. (Reverberation refers to sound echoes produced as sound travels, bounces or reflects off of various surfaces). FM Systems improve the signal-to-noise ratio, which means that the level of speech or desired sound source is louder than the level of noise in the room or environment. For example, in a typical classroom setting the noise level is often nearly as loud as the voice of the teacher, making it difficult for a hearing impaired child to hear and understand well. The teacher's voice can be heard much better with an ALD because it reduces or controls for factors such as distance, background noise and reverberation.

Personal Listening Systems usually consist of FM Systems (also called Auditory Trainers) or Pocket Talkers. Typically, personal listening devices are used in classroom settings, in small group discussions or meetings and in any other situation where an individual's voice needs to be amplified directly to the listener (nursing homes, automobiles and restaurants). FM Systems work by transmitting or broadcasting a signal on a particular FM radio frequency (comparable to a miniature FM radio station) to a wearable radio receiver. The speaker (often a teacher) wears a lavalier (lapel) clip or headset-type microphone that is connected to a body-worn trasmitter that looks like a little box or large pager.

There are two components of a cochlear implant, the internal implant and the external speech processor. The internal implant is surgically implanted under the skin and consists of a receiver/stimulator, antenna, magnet, internal electrode array and grounding lead. The electrode array is inserted directly into the cochlea. Currently there are two choices for the external speech processor, a body-worn device and an ear-level device which resembles a behind-the-ear style hearing aid. Additionally there are many accessories that enhance the ability to hear music, the television, on the telephone, in background noise, in theaters, in the car, at places of worship and at restaurants.

How Does A Cochlear Implant Work?
The directional microphone in the headset of the processor picks up sound and delivers the sound to the speech processor via a cable/cord. The speech processor then analyzes and filters sound into digital information and a coded signal. The coded signals are then sent to a transmitting coil worn on the back of the patient's head. The coil sends the coded signals to the internal implant. Electrical energy is then delivered to the electrode array. The electrodes stimulate surviving auditory nerve fibers and the electrical sound information is interpreted by the brain.

The speech processor is able to utilize various "speech coding strategies" to help improve or maximize the benefit and understanding received from an implant. A coding strategy describes the way in which the processor interprets loudness, pitch and timing cues to send signals to the cochlea. Having a choice of coding strategies allows for flexibility and individualization for each cochlear implant patient.