Cochlear Implant Program Serves Military Families When Air Force Colonel Ben Sierra first joined the U.S. Air Force in 1975, he described himself as a “baby” audiologist. “I started when eyeglass hearing aids were a big thing and everyone wanted them,” he chuckled. “I was really, really young.” Little did he know he would become part ... Features
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Features  |   November 01, 2009
Cochlear Implant Program Serves Military Families
Author Notes
  • Kellie Rowden-Racette, print and online editor for The ASHA Leader, can be reached at krowden-racette@asha.org.
    Kellie Rowden-Racette, print and online editor for The ASHA Leader, can be reached at krowden-racette@asha.org.×
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Hearing Aids, Cochlear Implants & Assistive Technology / Features
Features   |   November 01, 2009
Cochlear Implant Program Serves Military Families
The ASHA Leader, November 2009, Vol. 14, 32. doi:10.1044/leader.FTR3.14142009.32
The ASHA Leader, November 2009, Vol. 14, 32. doi:10.1044/leader.FTR3.14142009.32
When Air Force Colonel Ben Sierra first joined the U.S. Air Force in 1975, he described himself as a “baby” audiologist.
“I started when eyeglass hearing aids were a big thing and everyone wanted them,” he chuckled. “I was really, really young.”
Little did he know he would become part of a life-changing program for the military community. In the early 1980s, while Sierra was working at Lackland Air Force Base in San Antonio, Texas, the Wilford Hall Medical Center’s fledgling cochlear implant program began. Although there are other military programs today (Walter Reed Medical Center and Portsmouth Naval Base, to name a few), at the time it was the first Department of Defense program of its kind and the hearing health profession was on the brink of exciting growth.
“The services today are dramatically better when compared to our capabilities in the ‘80s,” Sierra said. “The digital revolution, advances in cochlear implant technology, and the development of programming algorithms have improved sound perception and speech recognition. Over the last 20 to 25 years, hearing health professionals have dedicated their lives and work to pushing forward this technology.”
Developments in audiology prompted changes in service provision. In 2001 Sierra, along with Drew Horlbeck, an Air Force major, made significant changes by restructuring the program to include a cochlear implant board. By adding this layer, the board (which comprised audiologists, speech-language pathologists, developmental pediatricians, social workers, psychologists, and educators) ensured that cochlear implants were offered only to candidates with realistic expectations, good prognosis for full function, and high probability of receiving maximum benefit from the implant.
“We needed to make sure they understood this [cochlear implants] isn’t a miracle cure and that there’s a long process of intervention that must be followed,” Sierra explained. “The procedure by which we select our candidates isn’t meant to slow down the process, but to ensure they tailor their expectations and understand that the brain plasticity process needs time to take place.”
This procedure seems to work; the program’s success continues to increase. Today the program runs under the command of Dean Hudson, an Air Force major, and Connie Converse, an Air Force captain who serves as chief of the Air Force Cochlear Implant Program. Sierra, who retired from the military in 2005, works as a civilian audiologist and program director of the Air Force Audiology Externship Program as well as consulting to the program. The exact number of cochlear implant procedures done before 2001 is not clear; since that time, however, an average of 22 patients per year (anywhere from five to 40) have received cochlear implants.
“Our numbers are mostly supply-driven, but the demand seems to follow,” Sierra said. “If we have qualified staff, demand rises.” Given this dynamic, the program could be on the brink of another growth spurt—two neurotologists and one pediatric otologist are performing the surgeries and, as Sierra said, “We’re in hog heaven.”
Most patients are military dependents and retirees; active-duty members are occasional because of the physical demands of most active-duty careers. It’s also notable that although the cochlear implant program is located on a U.S. Air Force base, it’s available to patients from all uniformed and commissioned service branches (Army, Navy, Marine Corps, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration) and also provides services and training for military members from other countries, depending on the particular “status of forces agreement” between the country and the U.S. government.
Most of the cochlear implant recipients, however, are U.S. military dependents or retirees, and the program continues to grow. The procedure and follow-up care is free (for the most part) and, in many cases, a life-changing procedure for patients and their families. Over the years, professionals who have worked in the program have witnessed children hearing their mother’s voices for the first time, children learning to speak, and retirees regaining their independence, and now are even straddling the generations by treating children of the program’s earliest patients.
“One Army patient came in, and I recognized the last name, but didn’t think anything of it,” Sierra recalled. “When I started talking to him, he said, ‘My family owes a debt of gratitude to this hospital.’
“It turns out we had implanted his mother with a single-channel CI in the ‘80s,” Sierra said. “She was our first implant patient and is still doing well. It feels so good to hear that.”
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November 2009
Volume 14, Issue 14