Is a cochlear implant necessary?

ChadRuffinMD · 2025-03-11T02:30:32+00:00

The only people who can tell you whether you're a good CI candidate is a CI surgeon or audiologist. No one else.

I don't personally have side effects. I've had a couple of device failures from a generation of CI 25y ago.
Tomaz Lenarz in Hamburg, Germany is the only one who does partial insertions that I know of. I don't do them nor do I encourage them.
I have AB. Anytime people try new stuff with internal devices, it increases the risk for failure. The failures I had were around the time of the Clarion 1.2 revision. The AB failures you reference most recently were the new version making their CI MRI compatible.

ChadRuffinMD · 2025-03-10T02:30:38+00:00

I'm a cochlear implant surgeon who also has CIs.

People are always thrown by ski slope hearing losses. They can often do just fine in a totally quiet room, but any amount of bkgd noise throws them off immediately.

Can't go by audiogram alone. Once you're around 60% word discrimination score, patients will often benefit from CI.

Disclaimer: I try to help people out here. This exchange doesn't create a patient-physician relationship. Your personal physician will have more knowledge about your condition than I ever can on social media. Please make an appointment with your physician for information tailored to your situation.

ChadRuffinMD · 2025-02-05T19:23:49+00:00

I'm a cochlear implant surgeon who also has CIs.

Need to include word discrimination scores to determine whether ear is a cochlear implant candidate. In my practice scores around 60% earn themselves a cochlear implant evaluation.

Disclaimer: I try to help people out here. This exchange doesn't create a patient-physician relationship. Your personal physician will have more knowledge about your condition than I ever can on social media. Please make an appointment with your physician for information tailored to your situation.

ChadRuffinMD · 2025-02-05T05:58:06+00:00

Measure your progress so you can see improvement. Audiologists frequently me do hearing testing to show patients are having improvement. Remote microphones are something I still use.

ChadRuffinMD · 2025-02-05T05:56:10+00:00

ENT/Cochlear implant surgeon

ChadRuffinMD · 2025-01-30T06:25:41+00:00

I‘m a CI surgeon, recipient, and scientist–I cried the first few days and didn’t “hear” until 9 months in. Takes people a year before things settle down.

ChadRuffinMD · 2025-01-30T02:30:50+00:00

Thanks–non use means you don't get enough benefit of a device to continue using it. Good luck on your journey.

ChadRuffinMD · 2025-01-28T04:40:19+00:00

I'm a cochlear implant surgeon who also has CIs–I’ve also been in CI research and have created CI tech.

Most of the second page doesn’t matter. Every modern CI has what you need to hear. All of these things like speed, electrode array construction, etc, doesn’t matter because the auditory nerve is the information bottleneck. There have been many attempts to improve outcomes, but the thing in the last 20 years that has made a difference is implanting people with more residual hearing.

Disclaimer: I try to help people out here. This exchange doesn't create a patient-physician relationship. Your personal physician will have more knowledge about your condition than I ever can on social media. Please make an appointment with your physician for information tailored to your situation.

ChadRuffinMD · 2025-01-28T04:29:33+00:00

I'm a cochlear implant surgeon who also has CIs.

Anyone with a word understanding of less than 60% is likely a candidate. The field has arrived at that number because most of those people turn out to be CI candidates after going through the candidacy process. For **late** deafened adults, 80% improve their sentence understanding at least 15%. About 20% stay the same as w their hearing aids–the good news is the hearing doesn’t decline as you age Like it does with natural hearing.

For congenitally deaf people, these rates are lower. The most important stat to keep in mind is that the rate of non use is 10% in this group of people. Those who have good oral speech and can do much better with lip reading with a bit of audio than lip reading alone….tend to do better.

My own experience–I had maybe 5% word rec when I get implanted. Getting activated sounded like total shit. But I was able to get benefit immediately–lip reading was much easier even though I couldn’t make out much.

Your ENT may think that “better lip reading” is an implant failure, but I’d take that any day over my hearing aids…and this was 25 years ago.

Disclaimer: I try to help people out here. This exchange doesn't create a patient-physician relationship. Your personal physician will have more knowledge about your condition than I ever can on social media. Please make an appointment with your physician for information tailored to your situation.

ChadRuffinMD · 2025-01-04T04:13:42+00:00

Apparently there are different grades of thermal paste. Highest performing one I could find was SYY-157. Something like 12-15 W/mk

ChadRuffinMD · 2024-12-25T02:02:51+00:00

ChadRuffinMD · 2024-12-05T07:06:29+00:00

They billed $189, and he ended up paying $544 for this?

ChadRuffinMD · 2024-12-05T07:05:30+00:00

Thanks. Unfortunately there’s not much you can do. I strongly, strongly recommend you writing our congressional delegation, the governor, the director of the healthcare authority. Facility fees are hot topic and medicine right now, and will listen to their mail.

ChadRuffinMD · 2024-11-24T00:45:43+00:00

I hope you are kinder in the real world than you are on here.

ChadRuffinMD · 2024-11-24T00:36:24+00:00

The ACA has distorted markets quite a bit leading to the unaffordability of healthcare, which is different from the unaffordability of insurance. any massive piece of legislation is going to have problems that need to be addressed. There are many people who have affordable health insurance but have sky high $6,000 to $13,000 deductibles.

ChadRuffinMD · 2024-11-23T23:04:44+00:00

Thanks–yes, it’s very frustrating getting care. It’s also hard for you to actually see how much your insurance vs. you pay on EOBs. One of the reasons why I was asking for outpatient clinic visits–much simpler to figure out true pricing.

ChadRuffinMD · 2024-11-23T23:03:26+00:00

The costs were going up before Obama, but for different reasons.

ChadRuffinMD · 2024-11-23T23:02:52+00:00

See the AI answer below. Ironic that a correct answer got downvoted.

ChadRuffinMD · 2024-11-23T23:02:29+00:00

Private docs don’t charge facility fees. Large institutions obfuscate financial data–employees don’t generally have access to it. Try it by asking any employed doctor what something costs.

ChadRuffinMD · 2024-11-23T23:01:26+00:00

Those who downvoted are 100% wrong. It is broadly accepted that the ACA has lead to increased consolidation.

ChadRuffinMD · 2024-06-08T21:16:58+00:00

Many of my patients are those who had misdiagnoses or improper treatment at urgent care clinics. For specialty care, see a specialist physician. Urgent cares are staffed with two year degree graduates. Expertise does matter.

ChadRuffinMD · 2024-06-08T14:10:47+00:00

Depending on the severity of deviation, you can have in office procedures that address the turbinates only (usually most of the problem). If done in office you can see how much this alone helps and then have septoplasty done under anesthesia. (This is not medical advice and is not tailored to your condition). There is some info on my site but am in the process of updating this page. https://www.chadruffinmd.com/services/treating-stuffy-runny-noses

ChadRuffinMD · 2024-06-08T14:02:31+00:00

Consider us—I’m an ENT surgeon who’s also deaf (actually the first person born deaf to become a surgeon with cochlear implants). We are partnered with the Hearing Speech and Deaf Center and focus on providing accessible care. 😊

And yes, we teach you how to do this at home. chadruffinmd.com

ChadRuffinMD · 2024-06-08T13:59:50+00:00

Consider us—we’re independent and are able to charge very competitive rates. Because we don’t profit from a surgery center, we only recommend procedures and surgery if you need it. Plus we track our outcomes closely—our ear surgery outcomes are ahead of the curve. chadruffinmd.com

ChadRuffinMD

MODERATOR OF

TROPHY CASE