StromCochlear implants continue to make substantial advances, both in terms of technology and in their candidacy requirements as the devices apply to a wider range of ages and hearing losses. There are now more than 70,000 cochlear implant recipients worldwide, with an estimated 23,000 in the United States (about 10,000 adults and 13,000 children). While this number is low in comparison to hearing aid users, it should be remembered that, in the United States, the FDA did not approve cochlear implants for the treatment of hearing loss in adults until 1985 and in children until 1990. Five years ago, there were only 26,000 users of cochlear implants worldwide, so the percentage of implant users is growing by around 30% per year. The market penetration for these devices is still probably well under 5%, hindered in part by natural fears about the surgical procedure and hearing outcome, as well as the substantial financial barriers to acquiring an implant (as much as $27,000 for adult assessment, implantation, and follow-up in the first year alone). Despite these barriers, few hearing care professionals would disagree that the current success and future promise of this technology (especially for children who have a profound loss and receive an implant early in life) is exciting, and greater numbers of dispensing professionals are now seeing patients who are cochlear implant recipients or who are considering an implant.

This month’s article by Teresa YC Ching, PhD, and her colleagues at the National Acoustics Laboratory (NAL) in Sydney, Australia, is the first in a two-part series that focuses on bimodal hearing (ie, cochlear implant + hearing aid) for cochlear implant recipients. Part 1 presents an excellent tutorial for fitting a hearing aid on the opposite ear of a cochlear implant, including the methods involved for obtaining the appropriate frequency and gain responses of the hearing aid while balancing the loudness of the aid with the implanted ear. In Part 2 of the article (appearing in the August edition of HR), the NAL team shows why binaural processing contributes to benefits in speech, localization, and functional performance of people who use bimodal hearing devices. The researchers conclude that fitting a hearing aid to a recipient of a unilateral cochlear implant can help to improve the quality of life for the recipient and his/her family.

And speaking of cochlear implants… In June, Boston Scientific announced its intention to acquire Advanced Bionics Corp of Sylmar, Calif, the world’s second largest manufacturer of cochlear implants. Advanced Bionics reports that the purchase allows it to continue its research and development of new products—which includes a new ear-level processor for Clarion users—as well as to operate autonomously with the same executive leadership and staff. Boston Scientific is a worldwide developer, manufacturer, and marketer of medical devices with approximately 15,000 employees and revenue of $3.5 billion in 2003. The company specializes in less-invasive medicine with wide-ranging product applications for a number of medical specialties. The reported purchase price of Advanced Bionics was $740 million in cash, plus potentially sizable performance-related payments that will be made during the next several years if Advanced Bionics meets net sales and profitability targets in each of its four technology platforms (cochlear implants, implantable pulse generators, drug pumps, and bion microstimulators).

Karl Strom