Cochlear Implant An Introduction

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Cochlear Implant An Introduction
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Cochlear Implant

• A cochlear implant is a hearing prosthesis
  designed to restore or provide a level of
  auditory sensation to adults and children who
  have a severe to profound bilateral
  sensori-neural hearing impairment and who get
  limited benefit from hearing aids

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The Component of a Cochlear Implant System

• Wearable part
• Directional microphone
• Cable (long/ short)
• Transmitting coil
• Speech processor
• Implant
• Transmitting coil
• Receiver/ stimulator
• Extra-cochlear electrodes
• Intra-cochlear electrode array

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Candidate Selection Surgery
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Selection Criteria forCochlear Implants
Recipients

• Degree of Hearing Loss
• Benefit from Hearing Aids
• Duration of Deafness (Age at Implant)
• Radiological and Medical considerations
• Family Expectations and Support

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1. Level of Hearing Loss
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2. No benefit from powerful hearing aids for
speech understanding

• Determining a childs functional benefit from
  hearing aids is best done through a Hearing Aid
  Trial. Performance is evaluated with the most
  optimally fitted hearing aids, using diagnostic
  therapy to provide maximum stimulation of the
  auditory system.

• Only then can we decide a childs individual
  potential for developing speech and language
  with regular hearing aids.

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3. Age at Implantation

• FDA approval for children since 1990
• In 2000 FDA approval was extended for children
  from 12 months of age
• Children now routinely implanted before 2 years
  of age

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Duration of Deafness
Critical Period for Language Acquisition
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4. No radiological contraindications
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5. No medical or neurological contraindications
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Appropriate family expectationsand support
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Selection Criteria for Adults

• Bilateral severe-profound sensorineural hearing
  loss
• Post-linguistic onset of severe-profound deafness
  in the ear to be implanted
• Receive little or no benefit for speech
  understanding from hearing aids (50 or less open
  set)
• No medical or radiological contraindications
• Appropriate expectations and motivation

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Selection Criteria for Children

• Bilateral severe-profound sensorineural hearing
  loss
• Little or no benefit for speech understanding
  from conventional hearing aids (HAT)
• Age 18 months to 17 years (FDA approval)
• No medical or radiological contraindications
• Suitable educational support
• Appropriate expectations and commitment from the
  family

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The process of implantation involves..

• Assessment, decision, and preparation
• Surgery
• Fitting and programming
• Rehabilitation, training and further
  re-programming

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Cochlear Implant Evaluation

• Initial Medical Evaluation by team surgeon
• Hearing Aid Trial (2-6 months)
• weekly lessons with intensive listening training
  and parent training
• Audiological Assessment
• X-rays other medical procedures
• Final Team Meeting Decision

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Cochlear Implant Team

• Family
• Team Co-ordinator
• Surgeon
• Audiologist / Acoustician
• Speech and Language Pathologist
• Teacher of the Deaf
• Family Counsellor / Psychologist
• Consultant Professionals Paediatrician,
  Neuropsychologist, Radiologist, Psychologist,
  Occupational Therapist etc.

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Factors that may influence outcomes with an
implant

• Length of profound deafness
• Age at implant
• Aetiology
• Use of hearing aids prior to implantation
• Amount and quality of re/habilitation before and
  after implant
• Family support and commitment
• Educational methods and communication mode