Cochlear implants
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.
Candidates for a cochlear implant
Children with severe-to-profound sensorineural hearing loss in both ears are potential candidates. The process to determine cochlear implant candidacy for deaf children identified by newborn hearing screening should begin during early infancy, so that implantation may take place by 12 months of age. In some cases, our center may recommend implantation below a year of age.
Prior to the specialized hearing tests needed to determine cochlear implant candidacy, children should have used appropriate amplification for a minimum of three to six months and have received auditory (hearing) therapy. Aided gain with hearing aids does not exclude implant candidacy. What is important is whether hearing aids enable the child to understand speech at normal conversational levels without lip-reading. If a child's auditory abilities are limited, he or she may be an implant candidate.
Children deafened by meningitis merit special consideration because of the frequent occurrence of cochlear ossification (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 be significantly abbreviated.
Children with auditory neuropathy may also significantly benefit from cochlear implantation. Potential candidates include those with the ability to detect sounds, but who are unable to develop useful speech perception abilities.
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 and 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 are still showing improvement.
Although the primary role of a cochlear implant is to help children to hear and understand speech, an implant can also provide auditory information that enables children to learn to talk. Children implanted early in life who receive intensive auditory and speech therapy are the most likely to develop age appropriate intelligible spoken language.
Several multi-channel cochlear implant systems are available for children. Some have commercial approval and others are offered at our center through FDA clinical trials for children who meet eligibility criteria. Information regarding the different cochlear implant systems will be provided to you at the time of initial consultation.
Making the decision about the implant
At Children's Memorial Hospital, the decision to recommend a cochlear implant is made by a multi-disciplinary team of hearing healthcare professionals. Nancy M. Young, MD, Head of the Section of Otology and Neurotology, is the physician and surgeon in charge of the implant team. Our cochlear implant audiologists have special training and expertise in the field of pediatric implantation.
For further information or to schedule an initial consultation, please contact our administrative coordinator at 773.880.4605.
Pediatric cochlear implant services are available at both the Children's Memorial Hospital in Chicago and at our Westchester facility. For more information about our center, e-mail us at cochlearimplant@childrensmemorial.org.