In order to be fit with a MEI (or a
binaural fitting), one requires a purely sensori-neural hearing loss.
Since MEIs are better at generating mid- and high-frequency gain than
low-frequency gain, the optimal hearing loss should be sloping. Many
MEIs can be digitally programmed or are in fact digital. With the extra
control that these technologies afford, other sensori-neural
configurations can be fit. I would doubt if any new hearing aid users
would be MEI candidates. Although the various
surgeries are not complicated, they can be lengthy (up to 3 hours) and
like any surgery, can be traumatic. A MEI
candidate is therefore one who has tried conventional hearing aids and
was unsuccessful either because (i) they were not able to obtain as much
high-freuency amplification as required, or because (ii) the occlusion
effect (Vagal response) could not be resolved to the satisfaction of the
patient. While the cosmetic issue is important, I am not convinced
that this should be the primary deciding factor, given that CIC hearing aids can be made quite small with newer technology.
Incidentally, there will be a panel session, chaired by myself and Dr. Jon Spindel, at the next AAA
meeting in San Diego (Thrusday AM). In addition, part of the August
2001 issue of Hearing Journal will be dedicated to this topic, with
myself and Jon as co-editors.
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