Interview with Jack J. Wazen MD, Neurotologist
AO/Beck: Hi Dr. Wazen. Thanks for your time this morning.
Wazen: Hi Dr. Beck. It's a pleasure to meet you.
AO/Beck: Dr. Wazen, if you wouldn't mind, could you please spend a few moments reviewing your education and professional career?
Wazen: I graduated from Medical School at the American University of Beirut (AUB) in 1978. Finished my residency in Otolaryngology-Head & Neck Surgery at the Columbia-Presbyterian Medical Center in New York in 1983, and completed a fellowship in Otology-Neurotology in 1984 at the Ear Research Foundation in Sarasota, Florida. I have been on the academic faculty since in the Department of Otolaryngology-Head & Neck Surgery at Columbia University College of Physicians and Surgeons. I am presently Chief of Otology/Neurotology at the Lenox Hill/Manhattan Eye &Ear Hospital in New York
AO/Beck: Please tell me where you practice?
Wazen: I see patients at 2 locations:
-364 East 69th street New York NY 10021 Tel (212) 249-3232
-180 Ft. Washington Ave. Suite 209-210
Columbia -Presbyterian Medical Center
New York NY 10032 Tel (212) 305-1618
AO/Beck: Very good. I'd like to focus our discussion on the Baha System and the surgery related to it. Would you please tell me about the device?
Wazen: Very good. The Baha System is a bone anchored cochlear stimulator. Although it was originally designed to be used in cases of conductive and mixed hearing loss, such as bilateral atresia, chronic mastoiditis and similar disorders, it has recently been approved by the FDA for Single Sided Deafness.
AO/Beck: For example, patients with normal hearing on the left ear, but status post-op acoustic neuroma removal on the right?
Wazen: Yes, that's a perfect application. However, people with unilateral sudden sensorineural hearing loss, temporal bone trauma and other etiologies may also be candidates.
AO/Beck: Very good. Dr. Wazen, do you implant these as outpatient procedures under general anesthesia?
Wazen: Generally, these are out-patient procedures that can easily be performed under local or general anesthesia according to patient preference. They could be done in the office too, but outpatient in an operating room or surgi-center is generally preferred. As you know, there is a tiny titanium implant that is inserted into the lateral table of the mastoid and then connected to an abutment through the skin. We place a dressing on it and the patient goes home. We see them back in the office a week later to make sure everything is healing well. After it heals, and after osseo-integration has occurred, which takes about 90 days, the abutment is ready, and the Baha System can be snapped on and off as desired by the patient.
AO/Beck: Please explain a little more about the abutment?
Wazen: The abutment is the connection between the titanium implant and the processor. It is not magnetic or electrical. It is simply the place where the sound processor attaches, and it transmits through bone conduction to the cochlea.
AO/Beck: What sort of control does the patient have after the whole thing is setup and functioning?
Wazen: They have a volume control, and that's really all they need. All processors are delivered with a directional microphone. There are some limited adjustments usually set by the audiologist. But all the patient needs to do is to snap it on and turn it on when needed. Patients also need to maintain appropriate local hygiene at the implant/abutment site.
AO/Beck: Is the sound processor analog or digital?
Wazen: At this time, they are analog, and that works well with a bone conducted signal.
AO/Beck: What do patients report to you after they've been wearing the Baha System?
Wazen: They are very pleased. Some 85 or 90 percent of them report that they use it every day through all of their waking hours. Of course, there is no occlusion effect and the patients that notice that are the ones who have previously worn traditional hearing aids. There's also no feedback, and they report doing well in background noise too.
AO/Beck: What can you tell me about insurance coverage?
Wazen: It varies tremendously from plan to plan. There are some plans that cover the whole package, and others cover the surgical implantation only. So it needs to be verified and pre-approved before the patient has surgery. Routinely, we pre-certify everyone for their implantation, and that's the safest way to do it from the financial perspective. Generally, we can say that the surgery is covered, but the external device itself varies from plan to plan.
AO/Beck: Any contraindications to the Baha System?
Wazen: The Baha System is FDA cleared in the US from ages five and older. Once the patient satisfies the audiological and medical indications they generally do well with the device. I would say one contraindication would be either physical or mental inability to care for the device and the implant site with no personal help or support.
AO/Beck: Thanks Dr. Wazen. I appreciate your time and energy this morning.
Wazen: Thank you too Dr. Beck. It has been my pleasure.
For more information about the Baha System, Click here.
