Interview with Donna Cody Audiologist & Co-Director of the Audiology Department, House Ear Institute, Los Angeles, California
Share:
Topic: Baha® System Bone Conduction Implant
AO/Beck: Hi Donna. It's nice to speak with you. Would you please tell me a little about your education?
Cody: Hi Doug. I went to the University of Arizona where I received a Bachelor of Science in Rehabilitation with a Specialty in Interpreting for the Deaf, then I went to Utah State University where I received a Master of Science in Audiology in 1987.
AO/Beck: And I understand you're working on your doctorate?
Cody: Yes, I started June, 2003, at Central Michigan University.
AO/Beck: Oh how wonderful! Are you enjoying it?
Cody: I am really enjoying it. It's been 17 years since my last class, and lots of things have changed! I wish I would have done it a few years earlier but I'm glad to be doing it now.
AO/Beck: How long have you been at the House Ear Clinic?
Cody: 14 years
AO/Beck: How long have you been involved with the Baha System?
Cody: Probably since about 1999.
AO/Beck: What can you tell me about your experience with the Baha System?
Cody: I became involved about five years ago. I had a patient who had a conductive loss on one side and was also blind. Localization of sound was extremely important for him. It worked very well. He was extremely pleased and I was really impressed with the Baha from that point on. More recently I've worked with patients with Single Sided Deafness.
AO/Beck: Are the Single Sided Deafness people essentially post-operative acoustic neuroma patients?
Cody: Yes, they are typically post-op acoustic neuroma patients, but we also have sudden sensorineural hearing loss patients.
AO/Beck: And in general, they have normal or mild loss on the other side, is that correct?
Cody: Yes. Typically the hearing on the other side is normal. The three main categories of candidates for the Baha System are those with chronic ear infections, congenital deafness, and Single Sided Deafness. So those three categories can encompass dozens of etiologies.
AO/Beck: Have you seen patients who were fit with CROS hearing aids, or perhaps Bi-CROS systems, and were frustrated with those systems so they switched over to the Baha System?
Cody: Sure. When a patient wears two devices, as is standard with a CROS system, they're occluding the good ear. It's just too much for a lot of people. The last patient I fit with the Baha had tried the CROS and just didn't like it - it was too cumbersome. Then he tried the Baha test band in the office and just loved it. His immediate response was I want it. It was that definite for him. Other times patients say, Well I can't really tell. So we loan them the Baha head band for a couple of weeks and let them try it in their own environments, then they make the decision if it's something they want to pursue.
AO/Beck: Yes, that's a wonderful option, trying it before you have the surgery!
Cody: Absolutely. The last thing you want to do is have a patient go through surgery and then say, "This doesn't help me!" So what we do before they have surgery is make absolutely certain this is something the patient is going to benefit from.
AO/Beck: Have any of the patients compared the in the office sound from the demonstrations to the post-op, real device?
Cody: Yes, some have mentioned that the real device sounds even better than their demonstration. That makes sense because the real unit has a direct connection to the temporal bone, there's no impedance from skin or tissue, and you get better sound quality and better clarity. I like when patients tell me the real device is even better than the demonstration device, but I never tell them to expect that, as I don't want to set their expectations too high.
AO/Beck: I've really been surprised by some of the folks I've interviewed, and the impact this device has had on them. Why do you think this works so well for Single Sided Deafness patients?
Cody: When you talk to patients with Single Sided Deafness, and they've had this device implanted, it becomes a positive force in their lives, being able to hear from the deaf side. It's not perfect. It's not like having a normal hearing ear, but it certainly allows them to localize within a small perimeter around them and to hear sounds from the affected side. In some cases they can actually localize within a small radius and they're able to function better in restaurants and in meetings; it becomes less stressful, and they can relax a little more.
AO/Beck: What do your patients tell you regarding sound quality?
Cody: They all say pretty much the same thing -- the sound quality is very good, very natural.
AO/Beck: Tell me about the timing issues. How long does it take between the surgery and the tune-up/first fitting?
Cody: It takes about three months for the unit to osseointegrate, and then we fit them with the Baha processor.
AO/Beck: Please explain what that's like?
Cody: It's actually very straightforward, very simple. At that point, three months post-op, you just snap the processor onto the abutment. I review the care and maintenance issues and make sure they're adequately cleaning the abutment area. I work with them to make sure they can place it and remove it, and that they know how to adjust the volume. That's about it really.
AO/Beck: What are the patient controls and what do you tell them about how to adjust the processor?
Cody: It's very simple. All they really adjust is the volume control. There is a tone potentiometer on the back and recently the Baha System has offered a directional microphone to help individuals in noise. The HINT in Diffuse Soundfield testing has shown improvement in noise using the directional mode in comparison, as compared to the omnidirectional mode.
AO/Beck: Overall, what is your clinical opinion regarding the Baha System?
Cody: I've really been impressed with the results and with the patient satisfaction issues. It's an impressive product and it makes a big difference in the lives of the patients.
AO/Beck: Thank you so much for your time Donna. It's been a real pleasure working with you.
Cody: Thank you too, Doug.
--------------------------
For more information about the BAHA system, please click here.
Cody: Hi Doug. I went to the University of Arizona where I received a Bachelor of Science in Rehabilitation with a Specialty in Interpreting for the Deaf, then I went to Utah State University where I received a Master of Science in Audiology in 1987.
AO/Beck: And I understand you're working on your doctorate?
Cody: Yes, I started June, 2003, at Central Michigan University.
AO/Beck: Oh how wonderful! Are you enjoying it?
Cody: I am really enjoying it. It's been 17 years since my last class, and lots of things have changed! I wish I would have done it a few years earlier but I'm glad to be doing it now.
AO/Beck: How long have you been at the House Ear Clinic?
Cody: 14 years
AO/Beck: How long have you been involved with the Baha System?
Cody: Probably since about 1999.
AO/Beck: What can you tell me about your experience with the Baha System?
Cody: I became involved about five years ago. I had a patient who had a conductive loss on one side and was also blind. Localization of sound was extremely important for him. It worked very well. He was extremely pleased and I was really impressed with the Baha from that point on. More recently I've worked with patients with Single Sided Deafness.
AO/Beck: Are the Single Sided Deafness people essentially post-operative acoustic neuroma patients?
Cody: Yes, they are typically post-op acoustic neuroma patients, but we also have sudden sensorineural hearing loss patients.
AO/Beck: And in general, they have normal or mild loss on the other side, is that correct?
Cody: Yes. Typically the hearing on the other side is normal. The three main categories of candidates for the Baha System are those with chronic ear infections, congenital deafness, and Single Sided Deafness. So those three categories can encompass dozens of etiologies.
AO/Beck: Have you seen patients who were fit with CROS hearing aids, or perhaps Bi-CROS systems, and were frustrated with those systems so they switched over to the Baha System?
Cody: Sure. When a patient wears two devices, as is standard with a CROS system, they're occluding the good ear. It's just too much for a lot of people. The last patient I fit with the Baha had tried the CROS and just didn't like it - it was too cumbersome. Then he tried the Baha test band in the office and just loved it. His immediate response was I want it. It was that definite for him. Other times patients say, Well I can't really tell. So we loan them the Baha head band for a couple of weeks and let them try it in their own environments, then they make the decision if it's something they want to pursue.
AO/Beck: Yes, that's a wonderful option, trying it before you have the surgery!
Cody: Absolutely. The last thing you want to do is have a patient go through surgery and then say, "This doesn't help me!" So what we do before they have surgery is make absolutely certain this is something the patient is going to benefit from.
AO/Beck: Have any of the patients compared the in the office sound from the demonstrations to the post-op, real device?
Cody: Yes, some have mentioned that the real device sounds even better than their demonstration. That makes sense because the real unit has a direct connection to the temporal bone, there's no impedance from skin or tissue, and you get better sound quality and better clarity. I like when patients tell me the real device is even better than the demonstration device, but I never tell them to expect that, as I don't want to set their expectations too high.
AO/Beck: I've really been surprised by some of the folks I've interviewed, and the impact this device has had on them. Why do you think this works so well for Single Sided Deafness patients?
Cody: When you talk to patients with Single Sided Deafness, and they've had this device implanted, it becomes a positive force in their lives, being able to hear from the deaf side. It's not perfect. It's not like having a normal hearing ear, but it certainly allows them to localize within a small perimeter around them and to hear sounds from the affected side. In some cases they can actually localize within a small radius and they're able to function better in restaurants and in meetings; it becomes less stressful, and they can relax a little more.
AO/Beck: What do your patients tell you regarding sound quality?
Cody: They all say pretty much the same thing -- the sound quality is very good, very natural.
AO/Beck: Tell me about the timing issues. How long does it take between the surgery and the tune-up/first fitting?
Cody: It takes about three months for the unit to osseointegrate, and then we fit them with the Baha processor.
AO/Beck: Please explain what that's like?
Cody: It's actually very straightforward, very simple. At that point, three months post-op, you just snap the processor onto the abutment. I review the care and maintenance issues and make sure they're adequately cleaning the abutment area. I work with them to make sure they can place it and remove it, and that they know how to adjust the volume. That's about it really.
AO/Beck: What are the patient controls and what do you tell them about how to adjust the processor?
Cody: It's very simple. All they really adjust is the volume control. There is a tone potentiometer on the back and recently the Baha System has offered a directional microphone to help individuals in noise. The HINT in Diffuse Soundfield testing has shown improvement in noise using the directional mode in comparison, as compared to the omnidirectional mode.
AO/Beck: Overall, what is your clinical opinion regarding the Baha System?
Cody: I've really been impressed with the results and with the patient satisfaction issues. It's an impressive product and it makes a big difference in the lives of the patients.
AO/Beck: Thank you so much for your time Donna. It's been a real pleasure working with you.
Cody: Thank you too, Doug.
--------------------------
For more information about the BAHA system, please click here.
