The Cochlear Implant Journey

Includes interviews with Dr. William J.D. Turner, patients and staff as they describe the journey to better hearing with cochlear implants.


COCHLEAR IMPLANTS

Worldwide, approximately one person in a thousand is born with a hearing loss. Almost an equal number of people born with hearing will develop deafness during their lifetime.

The cochlear implant is an electronic device that restores partial hearing to the severe or profoundly hearing impaired. Part of the cochlear implant is surgically implanted in the ear and part of it is worn externally like a hearing aid. A cochlear implant is not a hearing aid. It is a medical device which bypasses the damaged part of the inner ear and electronically stimulates the nerve of hearing in those patients who get little benefit from hearing aids. Our implant center is currently using the latest Cochlear Americas and Advanced Bionics systems.


Cochlear Americas Nucleus 5


How Cochlear Implants Work

Cochlear implants are electronic devices that bypass the damaged hair cells and stimulate the hearing nerve directly. The cochlear implant system consists of internal and external parts. The microphone and speech processor are worn outside the body, like a hearing aid. A surgically implanted receiver provides a direct connection between the speech processor and electrodes. The electrical signal stimulates the auditory nerve fibers, and the signal is then sent to the brain.


Who is a Cochlear Implant Candidate

The cochlear implant is designed for individuals who have sensorineural hearing loss and receive no significant benefit from hearing aids. Candidates are usually one year of age or older. The criteria for cochlear implant candidacy are as follows:

Children Ages: 12 months to 24 months

  • Profound sensorineural hearing loss in both ears
  • Lack of progress in the development of auditory skills
  • No medical contraindications
  • High motivation and appropriate expectations from family

Ages: 25 months to 17 years, 11 months

  • Severe-to-profound sensorineural hearing loss in both ears
  • Lack of progress in the development of auditory skills
  • No medical contraindications
  • High motivation and appropriate expectations (both child when appropriate and family)

Adults Age: 18 years of age or older

  • Severe-to-profound sensorineural hearing loss in both ears with poor speech discrimination
  • Pre linguistic or post linguistic onset of severe-to-profound hearing loss
  • No medical contraindications
  • A desire to be part of the hearing world


Becoming a Cochlear Implant Patient

Becoming a cochlear implant patient involves a series of evaluations including otologic, audiologic, radiographic and psychological tests to determine candidacy. An examination must be performed to assure that there is no active infection or other problem with the middle or inner ear that would preclude the surgical placement of the implant. An audiologist performs extensive hearing tests to determine the degree of hearing with and without a hearing aid. Special tests are also performed to evaluate the benefits from hearing aids. Special x-rays, usually computerized tomography (CT) scans or Magnetic Resonance Imaging (MRI), are taken to evaluate the condition of the inner ear bone.


Cochlear Implant Surgery

Cochlear implant surgery is performed under general anesthesia. An incision is made behind the ear. The mastoid bone is opened, leading to the middle ear. The operation takes about 2 to 3 hours and the patient usually goes home the same day.


Postoperative Care and Follow Up

About a month after surgery when the incision is healed, the recipient returns for the first fitting of the external components. The audiologist uses a computer and special software to program the speech processor to the best listening strategy for the recipient. The audiologist along with the recipient's assistance will determine the appropriate levels of stimulation for each electrode and these levels will be used to make "maps" for the recipient to hear with their implant. The audiologist and recipient together will develop a schedule of follow up visits for fine-tuning of the speech processor. As the recipient becomes more experienced with their cochlear implant, the follow-up visits will become less frequent and the recipient will only need to be seen once or twice a year for adjustments.

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