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Selecting a Cochlear Implant Surgeon
June 11, 2015, 85 Comments
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Surgeon
Advanced Bionics, Auditory Neuropathy Spectrum Disorder, Cochlear,
Cochlear Implant, Jace Wolfe PhD, John Niparko, Kickbacks, Kickbacks,
Med-El, Neurotology, Uncategorized 11 Jun 2015
85 Comments
Hiring a cochlear implant surgeon for yourself or your child is just as
important as selecting the right implant manufacturer, as the quality of the
outcome is at stake. Unlike fitting hearing aids where the Best Practices are
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testing and radiographic imaging were edited to clarify terminology. Also,
please see Brief Addenda to Selecting a Cochlear Implant Surgeon for
additional discussion.
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performing this delicate task. It’s one thing to have a resident
performing the “grunt work” of grinding out the pocket for the implant
package and cutting the mastoid opening without nicking any nerves;
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Steroid Use on Low-frequency Hearing Preservation After Cochlear
Implantation ^11 by David Haynes MD & his crew at Vanderbilt; and
Effects of CI Electrode Insertion on Tinnitus ^12 by Thomas J Balkany
MD in The Institute for Cochlear Implant Training blog. Although
Balkany talks about how tinnitus can be generated when the basilar
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brief article breaking out these two articles;
Third, how many implant surgeries per year of each brand does this
urgeon perform? cochlear_duct_cross-section_thumb You want a surgeon
who performs at least 50 implants per year, and at least 25 implants of
your particular brand choice in the last year: Experience pays;
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electrode that was folded between the 3rd & 4th electrodes during
placement. Because neither the implant was booted up and impedance
checked during surgery, nor was there post-surgery radiography
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Click to enlarge in a new window
Fifth, it’s mandatory that the implant be booted up in the OR by the
audiologist with a cleaning cycle and an impedance check performed:
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electrode. What’s more, by not using radiographic imaging the patient
with the improperly placed electrode would need to be reimplanted,
which involves additional trauma to the skin flap, an increased risk of
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better to be safe than sorry, so make sure you get this in writing;
Eighth, how will the implant electronics package be fastened down to
the skull? It takes the surgeon time to carefully cut the pocket in the
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the surgeon used a “slip and go” method to reduce the OR time even
further, which allows for movement of the implant package, and more
harmfully puts unnecessary stress and strain on the delicate electrode
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Tenth, what is guiding the CI brand recommendation by the audiologist
and surgeon? The best ones are comfortable implanting and MAPping all
three major brands, so sometimes financial “considerations” are in
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“halo effect” from their name and “standing in the community;” so
you’ll do much better by going to a CI center that also implants
adults. As best we can tell, based on numerous off-the-record
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concentrate on “administrative tasks.” We just found out he’s
implanting again, confirmed by their PR rep, with 15 implant
procedures in the last two weeks alone. Needless to say, we are
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On choosing a CI brand, The Hearing Blog recommends you focus on the
implant electronics package itself, as that is what will be wired into
your head for the next 20 or so years; and except for the Advanced
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References:
1. Public review draft of AAMI/CDV-2 CI86, Cochlear implant systems –
Safety, performance and reliability: Association for the
Advancement of Medical Instrumentation, May 21^st, 2015
2. Cochlear Implant Programming: A Global Survey on the State of the
Art (31 authors). The Scientific World Journal Volume 2014 (2014),
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3. Role of electrode placement as a contributor to variability in
cochlear implant outcomes (Charles C. Finley and Margaret W.
Skinner). Otol Neurotol. 2008 Oct; 29(7): 920–928.
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8. Wolfe, Jace, and Schafer, Erin C. 2014. Programming Cochlear
Implants 2^nd Edition. San Diego: Plural Publishing. ISBN-13:
978-1-59756-552-3 ISBN-10: 1597565520
9. First Person Report: Cochlear Implant Channel Crossover. The
Hearing Blog, June 1, 2011;
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11. Impact of Perioperative Oral Steroid Use on Low-frequency Hearing
Preservation After Cochlear Implantation. Sweeney, Alex D.;
Carlson, Matthew L.; Zuniga, M. Geraldine; Bennett, Marc L.; Wanna,
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12. Effects of CI Electrode Insertion on Tinnitus, by Thomas J Balkany
MD. Institute for Cochlear Implant Training, October 1, 2015
Bootnotes:
A. We give props to Envoy Medical, maker of the troubled Esteem
implanted hearing aid, for tossing out one surgeon from their program,
as this individual, who is also well known in his region as a butcher
CI surgeon, was taking as long as nine hours to implant the hearing
aid. What’s more, this particular surgeon took almost six hours on a
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minutes), yet still bungled it, rendering her ear completely destroyed
and unimplantable in the process;
B. These gentlemen are also trained electrical engineers, which gives
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ignal processing involved with these magical devices;
C. These gentlemen also implant Auditory Brainstem Implants (ABI),
which truly is “brain surgery;”
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June 11, 2015 at 7:55 pm
I was implanted three days ago. I wish I had this to guide my
questions prior to surgery. Now I just hope for best. Reading this
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your surgeon, specifically on the measured impedance values
after cleaning when the implant was booted up, and the
post-surgical imaging to verify electrode placement.
Also, now that your bandages are off, you should request a
residual hearing test: You received an AB implant which uses a
reloadable stylet, so there is no reason your surgeon should
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I don’t know how anyone can have knowledge of an each cochlear
implant surgeon’s skill at threading a electrical array into a
cochlea. I wish you would share that with us. You indicate
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June 13, 2015 at 8:40 pm
Please don’t be scared. My daughter was implanted 12 years ago and
has had no issues. It’s been a tremendous miracle :) I wouldn’t
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I find your opinion, which is what it is, on pediatric hospital
implant centers as totally off base. My son was implanted at 4 and
we had the best surgeon (who isn’t even on your list – Thomas
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hocked that I was not personally informed of his retirement.
He implanted my daughter over 19 years ago. I should have been
the first on the list for his retirement party.
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While I feel that this article was intended to help deaf and
hard-of-hearing folks in making a decision about cochlear implants,
I am a bit disappointed when I saw that you made worldly
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When it comes to make a informed decisions regarding choosing
cochlear implants and surgeons. I cannot ask for a better staff and
teams at all children’s! Dr. Peter Orebello is the best surgeon,
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My son is a patient at All Children’s in St. Pete also he is a
Medicaid recipient. He was implanted at 15 months of age. He
receives the best care we could have ever imagined. Our audiologist
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referred our mutual friend Regina from Sarasota to him for
Gianna’s implants.
I’ll also reply to you privately on Facebook messenger.
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June 12, 2015 at 6:46 pm
My daughter had her right side cochlear implant at 26 months of
age, her left side done when she was 7 years old. She is now 16
years old. Thus, we have been around cochlear implants for many
years. We have lived in 4 different states since she was diagnosed.
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go and talk to recipients and parents of recipients in person. AG
Bell, Minutman Implant, Hands and Voices, etc. etc.
Second, I would definitely talk to the different cochlear companies
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furthered my research for what was best for kid for her second
implant.
When our daughter was first implanted, AB had a serious issue with
cases of meningitis. I believe all of the implants slightly
increase the risk of meningitis. Therefore, it is important for
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through its buyout. I also considered financial history of the
company. Having the best equipment at the time of implant, but the
company goes under, is not a situation I would want my child to be
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comfortable going with a Children’s Hospital. Once the child is
implanted, the hard work starts. I believe it is crucial to the
uccess of the child and their implant to have the best pediatric
audiologist possible. The speech and listening therapy is also
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As for the CI manufacturers’ financial stability, in fact this
is a big factor for FDA approval of any implanted device
manufacturer — And has been for decades, such as back in 1985
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Just to clarify, the FDA is extremely strict with the
implanted medical device industry; and when one is sold it
typically takes at least six months for the FDA to perform
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comments, a lot of people who have experienced cochlear
implants themselves do NOT agree with him. Please let me know
if I can answer any questions for you!
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all sorts of problems with her two CI’s; and she had to go to
the above-mentioned Dr Baker in OKC to get reimplanted to get
good results.
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Yes, I am very familiar with the Dallas CI Community. My
cochlear implant was so successful that it transformed my
life. My experience was 12% with a hearing aid to 92% with the
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Foundation, which Dr Peters founded to help people who cannot
afford hearing aids and cochlear implants. I worked with Dr
Peters and his CI team for many years prior to relocating to
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done extensive published research on bilateral cochlear
implantation. He is an excellent, very experienced surgeon.
And he has a heart of gold. I would trust him with my life and
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I have been scheduled with Sam Levine at the University of MN in
Minneapolis. Sam has been doing implants since they were invented.
Should I be excited or nervous to have him as my surgeon?
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Interesting article. We had the opportunity to have our daughter
implanted by Dr. Clough Shelton in Utah. He is an excellent surgeon
and does all the things mentioned in this article.
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For more, please see Role of electrode placement as a
contributor to variability in cochlear implant outcomes
(Charles C. Finley and Margaret W. Skinner). Otol Neurotol.
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Just saw your info on Dr. Niparko who just performed bilateral
implants on my son. We could not be more thrilled. I called his
office and learned that he has been elected President of USC Care,
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June 17, 2015 at 8:13 pm
Dr Niparko is implanting again?! That’s the best news we’ve
heard all week! He implanted my former girlfriend in 2003, as
well as implanting a number of friends here in the Delaware
Valley who drove the 90 miles down to Baltimore. In addition,
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doing the insertion so it is a moot point.
As for the surgeon pulling my leg about the cochlear implant
urgery. I can tell you that this surgeon is highly regarded
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most humble Dr I have ever met. As my hearing has worsened, he said
to me, “Please, let me implant you and resolve your issues.” I
believed him and let me tell you, it was the best decision of my
life. By old implant standard’s, I had to much residual hearing at
40%. But I was missing more then half of everything said. Dr
Niparko told me the sooner we implant, the faster the results. Not
only did I preserve most of my residual hearing, the placement of
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word recognition. Now coming up on my 5th month activated, my
hearing in my implanted ear is so great, I am considering going
bilateral. For the record, I did not choose AB but Cochlear. It
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a bad placement, you will struggle. I feel extremely blessed to
have Dr Niparko for a surgeon and his vast knowledge of implantable
device’s. USC was very smart in hiring him, he has raised the bar
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ReSound & Cochlear systems last year at this link. Whether you
choose to use an Enzo or not for your non-implanted ear, we
recommend purchasing accessories which are compatible with it,
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Choose AB, MedEl or Cochlear… it’s all rubish if you get
implanted for any other reason then to be able to continue to
communicate with the world. Some will hear Music, Some will
truggle with Music, if you got implanted with the thought
that you will hear music again like you did with your regular
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July 27, 2015 at 3:12 pm
I am considering a cochlear implant. What information do you have
about Dr. Rick Friedman at USC-Keck?
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Our 29 year old daughter has profound hearing loss and the ENT
recommended that she receive a cochlear implant.
Do you have a recommendation for someone to see in the Phoenix
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malpractice issue with the kinked electrode array? I’m being
implanted next week in Michigan, and it would be good to know…
My surgeon is Dr. Eleanor Chan at the Michigan Ear Institute – do
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• Impact of Perioperative Oral Steroid Use on Low-frequency
Hearing Preservation After Cochlear Implantation by a group at
Vanderbilt.
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heard good things about them as well.
Our current plan was to implant with Brian Dunham at CHOP and
programming by Melissa Ferrello.
My husband and I are professional musicians and am curious if you
have input on the best implant or programming for musical access,
pecifically pitch perception.
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discussed, he tries for residual hearing preservation
As for brand, we recommend the Advanced Bionics implants, as
there’s a new 1024-channel stim for music being developed
which will run on the HiRes 90k implant. Also, although the
externals are not as important as the implant circuit, we
really like the Phonak processors; and as we recently
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and will be getting much better mid-to-late next year.
The Med-El i100 is a decent implant, but although twice as
fast as the Nucleus CI522 and with the electrodes spaced far
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November 30, 2015 at 6:57 pm
It looks like Jefferson only implants adults currently.
December 1, 2015 at 6:56 pm
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in Atlanta. One of my longtime patients who still had
ignificant high frequency hearing was just implanted a few
weeks ago (I’ll not name the surgeon), and even though the
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My 89 year old mother just had a consult with an audiologist in
Cincinnati about the possibility of a cochlear implant…she’s been
totally deaf in one ear for decades, and is progressively losing
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dwarves don’t tolerate general anesthesia well): He said he’s
implanted under a local for a couple patients in their 90’s,
November 19, 2015 at 11:04 pm
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audiologist do the fine tuning post op, or do I need to return
to the site where the implant was done?
November 29, 2015 at 11:17 pm
Unfortunately, Dr Dana Suskind at UC/Comer Children’s only
implants pediatric patients. If you get implanted in another
city, then Yes, you can be MAPped locally; however switch-on
(1st stim) and the first couple of MAPpings would be where you
were implanted, especially if there are any “issues.”
25.
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This is incredibly helpful! Thank you! Do you have any experience
with Colorado implant surgeons? We have been referred to Dr.
Kelsall and Dr. Feehs in Englewood. I would love an outsiders
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Dan, thank you for your excellent blog post on selecting a cochlear
implant surgeon. I am 53 years old, have worn hearing aids
bilaterally for most of my life, and am considering a CI. There is