Have a look in the scientific literature. A lot of numbers, either successes and failures are well reported. Although some statistical analysis can be biased somehow and not every data set is really and completely significant, the overall advantage of CI over HA emerges pretty clearly.
I did take a look at case studies and all of those individuals were profoundly deaf, many with even worse hearing than me. The failures ive seen weren't due to that person having too much residual hearing and hearing less with CI than HA. That person simply didn't hear with HAs and had so little residual hearing that any improvement with CI was considered a success. I have yet to see a case study of someone with a decent amount of residual hearing getting CI. Such people would never be CI candidates as the audiologists surely make them try every HA first, including transposition and it works and thats what im seeing in those case studies!
Deafdude, you are right saying that the most of people who shift to CI do not get the maximum from HAs.
Often, less than the maximum may still be too "good" to consider CI. Insurance will probably turn you down, then it's your $50,000 and choice if you want a 5db improvement or a 10% improvement and that's only if you get a good result with CI.
I believe this is extremely difficult and time consuming. One should try different HAs (think about the costs here), several different settings, get used to every single change and only after a long time (many years?) being able to derive a result.
CI comes at a $50,000 tag per ear as well as many risks. HAs are risk free and cost $2500 per HA. You can't compare the two. I stick by my words that CI is a last resort.
My thoughts go to the children: this is so difficult for adults, how the hell can it be possible with babies? You can find that HAs, even at their best, cannot help and you are over the deadline for having the most from CI.
How do you determine "can not help" I had a 100db loss at 1000Hz and above when I was young and I was helped to some degree with HAs. CI didn't become FDA approved for children till 1990 and early CI technology would have been worse than HAs for anyone who had residual hearing. Your speech score had to be 0% back then. Another thing is I don't buy the "deadline" because there are prelingual adults who are 40 who benefit nicely from CI.
It is a matter of fact that young children implanted around 2 years of age usually performs very good. I met some of them, completely or profoundly deaf able to score nearly 100% and anyway able to discuss with me in a real life environment, without any apparent problem (and they are very young, 4.5 to 6.5). Could they reach this results in such a short time with HAs? Better, besides the completely deaf, could they reach similar results at all?
Statistics and these cases I experienced personally seem to tell that CI are much easier to be programmed than HAs over a certain amount of hearing loss.
That is a different story when someone is completely deaf or is profoundly deaf with at least 100db loss in most frequencies with a large cochlear dead region. Those who are less deaf can certainly reach those results with proper fitting HAs. You stand correct that CI is easier to program for good results once the hearing loss gets to 100+ db with a large cochlear dead region.
You deafdude are a clear example of a person with an important HL, very well aided, extremely competent in understanding how a HA can help, performing significantly good, but you can understand 50% of what your dad says without lipreading. What about unknown people in a general environment?
Much less, sometimes even 0% with alot of background noise or if the speaker doesn't talk slow and clearly. I usually just face the speaker(it's only polite anyway) and look at the speaker's lips. Many people are surprised to learn that I am hearing impaired(deaf unaided) as I understand over 80% of what they say by reading their lips. I fail to understand how others struggle so much, are they not good at reading lips?
I agree on the correlation about db and speech comprehension, there is for sure a link. Anyway the function is not linear, definitely. The correlation between audiogram and speech comprehension is extremely complex.
Understood and I am here to learn about this correlation. How does db correlate to speech for those mildly HOH unaided, those moderately HOH with different amounts of amplification, those with CI, those profoundly deaf? I have learned that those with a 20db HL can miss 10% of speech, those with 30db HL can miss 25% speech, at 40db HL you miss 50% speech and above 50db HL you are deaf to speech!
I could understand someone profoundly deaf who scores 0% speech still scoring 0% with maximum amplification because his hearing is so poor and distorted. But if someone was scoring 20% speech aided to 40db, why wouldn't being aided to 30db or even 20db(if possible) further improve speech scores? I know that more amplification does not equal more clarity but it improves the quantity and puts you higher up on the speech banana. You guys are welcome to try this: Have someone talk to you from across the room then turn the volume on your HAs down. You will miss more and more speech!
Getting the most out of a HA is very important and can give good results. Still expectations cannot be even close to that a CI can give. For profound deaf people HAs can be a big help, but it is difficult they can enable listening to the radio or TV (without subtitles), or hearing in difficult environments... CI cannot guarantee it, maybe only a few reach that level, but there are at least those few... It's a matter of expectations, or better of hopes and opportunities.
The radio is one thing I can't listen to. For those driving, they want to focus on the road and not be distracted by the radio anyway. For others, simply turn on the TV and read the CC.
Since it is obvious that audiogram cannot be the explanation (CI hardly can do better than 30db across the board, you are teaching to me), there should be something else. I would like to understand what's that.
I am learning the same thing as well. I do know that two identical audiograms can have very different results if one audiogram is due to cochlear dead zones where the "responses" don't truly exist but are due to off-frequency hearing. The other reason has to do with your auditory processing capabilities and is the same story for CI. You need to train your brain or your speech scores will be low.