What is a cochlear implant?
A cochlear implant is a device designed to provide hearing to children and adults who have severe-to-profound sensorineural hearing loss. The internal components are implanted into the inner ear and mastoid. The external components include a microphone and a speech processor. The cochlear implant provides useful information about spoken language and environmental sounds by directly stimulating auditory nerve fibers in the inner ear. The cochlear implant is recognized as a standard treatment for profound deafness by the American Medical Association and the American Academy of Otolaryngology — Head and Neck Surgery.
Who is a candidate for a cochlear implant?
Children of all ages with severe-to-profound sensorineural hearing loss in both ears are potential candidates. Our program has special expertise in evaluating deaf infants and toddlers. We recommend newly identified infants and children be referred to our implant program soon after the diagnosis is confirmed. A trial period of amplification with hearing aids combined with aural habilitation (hearing therapy) is an essential part of the evaluation process. For newly diagnosed deaf children, hearing aids may be loaned to the family for the trial period.
During the evaluation process, the cochlear implant audiologist will determine the child's ability to hear and to distinguish the range of sounds most important to understanding spoken language. If the child's ability is limited, he may be an implant candidate.
Children recently deafened by meningitis merit special consideration because of the frequent occurrence of cochlear ossification (scar tissue and new bone formation within the inner ear). Because of the potential need for urgent surgery, the hearing aid trial for children deafened by meningitis may not be required.
Children with auditory neuropathy spectrum disorder (ANSD) may also significantly benefit from cochlear implantation. Potential candidates include those with the ability to detect sounds, but who are unable to develop and maintain age appropriate understanding of spoken language.
What are the benefits of cochlear implantation?
Benefits range from the detection of sounds to understanding speech without lip reading. Research has also demonstrated that after implantation, children in oral and total communication programs often significantly increase the rate at which they develop language (spoken language or signed English, depending on the child's primary mode of communication).
In general, children who benefit the most from cochlear implantation are those who receive the implant after a shorter duration of deafness, are in programs that provide intensive auditory and speech training and have families firmly committed to the training process. Another important factor is the length of time the child uses the implant. Children who have used their device for more than three years often continue to improve ability to communicate.
Although the primary role of a cochlear implant is to help children to hear and understand speech, an implant can enable deaf children to learn to talk and to further their development of literacy (the ability to read, spell and communicate through written language). Children implanted early in life who receive intensive auditory and speech therapy are the most likely to develop age appropriate, easily understoon, spoken language and literacy.
Will my child be implanted in one or both ears?
In the past, a cochlear implant was placed in only one ear. Implanting in both ears is now more common. Benefits of bilateral implantation may include improved hearing in background noise and the ability to localize sound. More than 200 children have received a "second side" implant in order to experience the benefits of hearing from two ears. We take great care in determining whether two implants or the use of an implant combined with a hearing aid would be best for each child. The recommendation to implant the second ear depends on multiple factors. Each child's case is considered individually.
Is there more than one cochlear implant device?
This hospital's cochlear implant center has the capability to implant and program all commercially available devices. We work with all major cochlear implant manufacturers in order to provide families with the latest technology. Information regarding the different cochlear implant systems will be provided to you at the time of initial consultation.
Why does my child need certain vaccinations?
Having a cochlear implant has been found to increase the risk of bacterial meningitis, a very serious infection. The risk is very small and can be reduced by making sure that your child receives vaccinations that help to prevent the specific types of bacterial meningitis that have occurred in implanted children. We ask you to provide us with your child's vaccination records at time of initial consultation. After review of these records, we will let you know if and when any additional vaccinations will be necessary. Our cochlear implant team nurse will provide you with additional information about vaccinations.
How long will my child be in the hospital after surgery?
Most children return home on the same day as surgery. Children may return to school the following week.
When will my child begin to hear through his implant?
After two to four weeks, your child will return for programming of the device. The number of visits required will depend of the age of your child and his ability to cooperate. Several times each year, your child will be scheduled to return for hearing evaluations and programming rechecks.
Does my child need special training with the implant?
Weekly individual therapy that focuses on development of listening skills is of great importance. For preschool age children, a parent-centered approach that enables carryover into the home environment is extremely beneficial. Once your child has acquired the ability to hear and comprehend complex sounds that are essential to understanding spoken language, the focus of therapy often changes to articulation and further development of receptive and expressive language.
The quality of the services your child receives in his school program is of great importance. Children with cochlear implants experience success in a variety of educational settings with differing educational philosophies. Some children use oral communication, while others use total communication. The most important factor is that your child's teachers have expertise in incorporating tasks to develop listening and spoken language skills throughout the day, as well as a general working knowledge of the cochlear implant. It is also beneficial for your child's school to have a positive attitude towards working with children who have received implants, as well as a willingness to communicate with our program and your child's private therapist(s).
How experienced is the hospital's Cochlear Implant Program?
Our program began in 1991 and has grown to be one of the largest pediatric implant programs in the world. The founder and medical director is Nancy M. Young, MD, whose training includes a fellowship in neurotology (advanced ear surgery). Our cochlear implant team consists of an experienced multi-disciplinary team of hearing healthcare professionals from the following disciplines: audiology, speech pathology, nursing, psychology, social work, music therapy and deaf education. Our pediatric implant audiologists have a wealth of experience as well as special training in all aspects of pediatric implantation. Our support staff provide expert assistance in obtaining insurance approval for cochlear implants and related services. More here about our Cochlear Implant Program »
Where are pediatric cochlear implant services available?
How can I learn more?