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.

What is the candidacy process?

Initial consultation

• Introduction to cochlear implant technology, candidacy, and process
• Completion of intake forms
• Otoacoustic emissions test
• Acoustic reflexes
• Impedance
• Audiogram with and without hearing aids
• Speech perception testing
• Counseling regarding results and expectations

Rehabilitation/auditory skills evaluation 

• Intervention history
• Auditory skills evaluation
• Language development consultation

Medical evaluation (1-2 appointments)

• CT scan or MRI
• Initial medical/otological evaluation (please bring copy of scan with you to this appointment)

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)

• Outpatient surgery at the Sherwood Medical Center
• Lasts approximately 2 hours
• Visit physician 1 week after surgery for post-operative visit

Audiology

• Initial activation (2 hours) – 3 weeks following surgery
• Follow-up appointments will occur at 1, 3, 6 and 12 months or more as necessary
• Annual follow-up appointments after 1 year of implantation.

Rehabilitation 

• Rehabilitation therapy sessions will be scheduled as needed.

Who can be a cochlear implant candidate?

Children:

Ages 1 - 17 years:

• 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

Adults:

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 an implant?

Most insurance companies 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 and risks

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

Activation and follow-up

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

Activation Week:

• First appointment lasts 2- hours
• Second appointment 1 hour
• Sound quality differs for each patient
• Initial responses vary for each individual patient

Post-activation:

• Standard follow-up audiological evaluations are performed at 1 month, 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 vaccinations (23-valent and 13-valent) and haemophilus influeanzae. Your primary care physician can provide these vaccinations to you. Cochlear implant manufacturers are providing reimbursement for any vaccinations not covered by the patient's insurance.