The Cochlear Implant (CI) Program at OHSU has been in operation since 1983. Since that time over 400 patients have received cochlear implants at OHSU. Our program has continued to grow to where we are now one of the largest centers on the west coast, implanting approximately 80 patients in the last year. At the present time the CI Program is staffed by two Otologists (surgeons) and three audiologists. We offer our patients the choice of three excellent devices: The Nucleus 24, by Cochlear Corporation; the 90K HiRes implant with the Auria speech processor by Advanced Bionics, and the Tempo+, by Med El. They are all FDA approved.

CRITERIA AND ELIGIBILITY

The criteria for a cochlear implant in adults is a severe to profound sensorineural hearing loss with limited benefit from hearing aids. To determine candidacy, patients are required to participate in a comprehensive audiological evaluation consisting of speech perception testing in a variety of aided conditions. In addition, there is a medical examination and consultation consisting of physical exam and an MRI and CT scan. Once eligibility is determined our authorization specialist contacts insurance providers to determine if the implant is a covered service. The total cost of the implant, including the device, hospital fees, surgical fees, and programming for the first year is approximately $40,000. At this time the procedure is covered by most insurances, including Medicare and Medicaid. However, we urge all interested candidates to contact their insurance provider to determine if Cochlear Implants are a covered item in their policy. When authorization has been obtained a surgery date is scheduled.

BENEFITS

The benefit a patient can expect varies considerably depending on a number of factors including: how long the hearing loss has been present, the person's hearing aid use, and the degree of the hearing loss. At a minimum, all patients will be able to detect the presence of sound, will hear speech and environmental sounds, and see an improvement in lipreading skills. Many patients will see improvement beyond the minimum, including some understanding of speech without visual cues and even use of the phone. It is impossible to determine the level of benefit a patients will obtain prior to implantation.

In recent years there have been significant improvements in cochlear implants. We now have choices in terms of manufacturer, device and speech coding strategy. One of the changes has been the introduction of the Behind-the-Ear (BTE) Processor. While convenient and cosmetically appealing, many of the BTE processors are not full functioning processors, that is they do not offer all the options of the traditional body worn processor. It is the policy of OHSU to offer all patients one processor with their implant system. That processor must be a full functioning processor. For those companies that offer a BTE processor that does offer all the options of the body worn processor, the body worn processor will be the one included in the system. All patients will have the option to purchase the second processor (BTE) at the same price the manufacturer offers to the center.

We understand that the process of getting a cochlear implant is very complicated. The purpose of this web site is to give you preliminary information on the process at OHSU. We encourage you to contact the implant company web sites to get more information on the devices and to help you to formulate questions before you come to the clinic. The initial evaluation takes between 2 and 3 hours.