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However, it’s still in draft form, it’s complex; and one of the experts who reviewed this document just made us aware of this as the draft was published only days ago.

Here are pertinent questions for which you need to get answers from the surgeons and audiologists, preferably in writing on the consent forms, and other things to watch out for: First, just exactly is threading the electrode into your or your loved ones’ cochleas, anyway?

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Photo courtesy of Adrien Eshraghi MD, University of Miami Miller School of Medicine, Miami FL Advanced Bionics received the CE marque by TÜV for their Naída CI Q90 EAS combination hearing aid/CI speech processor, which unlike the Med-El and Cochlear systems uses a full length electrode insertion.

We’ll have much more on this in an upcoming article, as we already know one person participating in the FDA clinical trials.] by Thomas J Balkany MD in The Institute for Cochlear Implant Training blog.

While it’s vitally important to train the next generation of CI surgeons, in fact at many programs in teaching hospitals it’s the resident, not the surgeon you believed you hired 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; however drilling the cochleostomy and threading the electrode is what separates the top surgeons from the rest, (and more on this later).

Unfortunately, especially here in the United States, there are factors that conspire against making an informed choice, not the least of which is the CI manufacturers quietly keeping reams of information on each of the approximately 700 or so US CI surgeons’ outcomes.

The problem is that the manufacturer’s patient reps and support personnel maintain , lest they offend the delicate feelings of the audiologists or bruise the fragile egos of the surgeons, both of whom guide the brand selection.second “revision” surgery if the surgeon makes an error; and second, that fibrous tissue starts growing around the electrode almost immediately, making revision surgery for a folded or kinked electrode more difficult, if not impossible after a few days — And this applies to a decade or two when the CI needs replacing, as well.At university hospitals there is tremendous pressure from the Ivory Tower to cut costs, and often this step is either postponed until the switch-on, or even skipped altogether, with the surgeon & audiologist crossing their fingers that all will turn out OK.Almost everything else, such as bedside manner, number of papers published, or standing in the community, is no more than mere window dressing.With CI’s, there is no 30 Day Return privilege, so choosing wisely at every step of the process is vitally important for the best outcome.Because neither the implant was booted up and impedance checked during surgery, nor was there post-surgery radiography performed to detect the problem in a timely fashion, fibrous tissue started to grow by the time this x-ray image was taken a month post-op during switch-on, making revision surgery impossible.

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