Frequently asked questions:

What is an implant?

• Processor (external device and microphone) captures sounds   found in the environment.
• Converts the sound into an electrical energy
• Sent through the magnet into the internal implant device
• The information is converted into signals that are carried to the hearing nerve by electrodes placed along the implant.
• The hearing nerve takes the information to the brain
• It is then processed as sound and speech.
  

Candidacy process?

Initial consult (1 appointment)
Introduction   to cochlear implant technology, candidacy, process
Completion of intake forms
Expectations

Audiological evaluation  (2-4 appointments)
Otoacoustic emissions test 
Acoustic reflexes
Impedance
Audiogram without hearing aids
Audiogram with hearing aids
Speech perception testing

Rehabilitation/auditory skills evaluation  (1 appointment)
Intervention history
Auditory skills evaluation
Language development consult

Medical evaluation (1-2 appointments)
Initial medical/otological evaluation
CT scan
Follow-up medical consult to review candidacy, CT scan etc.

Psychological Evaluation (1 appointment: as necessary)
Expectations
Non-verbal cognitive evaluation

Speech-Language Evaluation (1 appointment: as necessary)
Receptive language
Expressive language
Speech

Surgery  (Outpatient, same day surgery and release)

Initial Stimulation     (4 appointments)
Initial activation (3 hours)
First follow-up programming, 1 day after initial activation (1-3 hours)
Second follow-up programming, 1 week after initial activation (1-3 hours)
Third follow-up programming, 1 month after initial activation (1-3 hours)

Follow-up Programming and Assessment (Every 3-6 months)
Follow-up programming (1-3 hours) More therapy may be recommended depending upon patient performance.

Rehabilitation  
Rehabilitation therapy sessions will be schedule as needed up to 2 times per week.
Typical therapy sessions are 60 minutes in length.

 How does an implant work?

• Processor (external device and microphone) captures sounds found in the environment.
• Converts the sound into an electrical energy
• Sent through the magnet into the internal implant device
• The information is converted into signals that are carried to the hearing nerve by electrodes placed along the implant.
• The hearing nerve takes the information to the brain
• It is then processed as sound and speech

Who is a cochlear implant candidate?

Children:

Ages 12-24 months:

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

Ages 25 months-17years, 11 months:

• Severe to profound sensorineural hearing loss bilaterally
• Lack of progress in the development of auditory skills
• No medical contraindications
• High motivation and appropriate expectations of child and family members

Adult:

Ages 18 years or older:

• Severe to profound sensorineural hearing loss bilaterally
• Prelinguistic or postlinguistic onset of severe to profound hearing loss
• No medical contraindications
• Appropriate expectations and a desire to be a part of the hearing world

What are the potential benefits?

Our team will work with you and/or your child to determine if more benefit would be received from use of the cochlear implant than from hearing aid use.  No one can predict the amount of benefit that a cochlear implant recipient can receive.  There are several factors that influence patient performance: auditory memory, age of implantation, status of the inner ear, motivation and rehabilitation.  Cochlear implant recipients should expect to make continual progress over time although final outcomes will differ based on the factors listed above. 

Does insurance cover?

Most insurance companies often cover cochlear implantation either fully or partially.  Following the candidacy evaluation, your cochlear implant team will submit documentation to indicate medical necessity for cochlear implantation to your insurance company.  Preauthorization will be obtained to ensure coverage prior to surgery.  In the case of partial coverage, the remaining charges would be billed to any secondary insurance or considered to be the patient’s responsibility. 

 Surgery

• Outpatient basis-usually takes 3-4 hours
• General anesthesia
• Incision behind the ear
• Electrodes inserted through inner ear
• Small depression in mastoid bone to secure device
• Incision closed, head bandaged
• 3-6 weeks for healing to occur

Activation and follow-up

Activation:

• Issuance of personal processors, user manuals and accessories
• Counseling regarding care and maintenance
• Mapping – testing to set stimulation levels to processor

Activation Week:

• Appointments scheduled two days in a row
• First appointment lasts 2-3 hours
• Second appointment 1-2 hours
• Sound quality differs for each patient
• Initial responses vary for each individual patient

Post-activation:

• Patients are seen initially on a weekly basis and then as needed in order to monitor progress.
• Standard follow-up audiological evaluations are performed at 3 months, 6 months, and 1 year.
• Research has shown that patients are still progressing after 5 years.
  

Rehabilitation

Importance

• Essential for language development
• Increased Intelligibility
• Social Development
• Academic progress
• Self-esteem
• Quality of Life
• Independence
  

Pre-operatively 

• Speech and/or Language Evaluations
• Functional Auditory Skills Assessment
• Discussion of Expectations
• Hearing History

Post-activation 
 

• Frequency of therapy based on individual need
• Concentration of Levels of Auditory Skill development:
• • Sound detection (awareness)
  • Sound discrimination
  • Sound identification
  • Comprehension
• Listening in numerous settings
• Speech and Environmental sounds
• Articulation and Language addressed as needed
• Re-evaluations periodically to chart progress
  

Recommended vaccinations

The FDA has indicated that cochlear implant recipients may be at greater risk for meningitis and have recommended vaccinations. There are risks and benefits of cochlear implant surgery as it relates to the risks of meningitis.  The U.S. Food and Drug Administration is recommending that, prior to implantation, cochlear implant candidates consider vaccination against organisms that commonly cause bacterial meningitis.  These vaccinations include the pneumococcal vaccination and haemophilus influeanzae.  Your primary care physician can provide the vaccination for you.  Cochlear implant manufacturers are providing reimbursement for any vaccinations not covered by the patient’s insurance.