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4 hours for 88 dB
2 hours for 91 dB (subway, lawnmower)
hour for 97 dB (motorcycle)
15 minutes at 100 dB (school dance)
for a concert which can be 110 dB and above less
than a minute!
Damaged Ear
Inner
Hair Cells
Outer
BAHA
Cochlear Implant
Vibrant Soundbridge
What is a Cochlear
Implant ?
Surgically implanted device.
Electrode Array and a Receiver-Stimulator
To work, it needs:
Programming with a computer
Children Candidacy
Severe to profound sensorineural
hearing loss in both ears
Lack of benefit from hearing aids and
therapy
No medical contraindications
High motivation and appropriate
expectations for child and family
Placement in educational program that
emphasizes auditory skills
12 months and up; may be indicated
earlier for special cases
Other considerations
Age
Duration of deafness
Language
Mode of Communication
Other handicaps
Motivation
How is a Cochlear
Implant Different from
a Hearing Aid?
Hearing Aids:
Cochlear Implants:
bypass damaged hair cells
Convert the acoustic input signal into electrical
impulses to stimulate the auditory nerve fibers
in the cochlea. The resulting electrical sound
information is sent through the auditory
system to the brain for interpretation.
2. Implant
3. Hearing Nerve
Evaluation Process
Audiological
Medical
Psychological & Social Worker
(children)
Auditory-Verbal Therapy (children)
Speech Language Pathology (for
adults, when required)
Audiological
Assessment
Diagnostic testing:
Audiogram
Tympanometry & Acoustic Reflexes
Auditory Brainstem Response
Otoacoustic Emissions
Medical Assessment
Otologic history & examination
General medical health
Pneumococcal meningitis vaccine:
Pneumovax
Diagnostic Imaging
Surgery
Inpatient procedure
Requires general
anesthesia
Duration ~ 3-4 hours
The Behind-the-Ear/Device
Marking Template is used to
allow adequate clearance
between the pinna, the speech
processor and the headpiece.
Incision Line
After completion of a
mastoidectomy-facial
recess approach, the
implant-receiver well/recess
bed and electrode lead
channel are drilled.
Suture tie-down holes to
stabilize the implant are
placed.
A standard cochleostomy is
used.
Electrode Insertion
Closure
Electrode Array
Placement Within the
Cochlea
X-Ray to confirm
position
of internal device
Positive psychological
& social benefits
Increase in:
Decline in:
Self-esteem
-Loneliness
Independence
-Depression
Social integration
-Social isolation
Vocational
prospect
Negative psychological
& social impacts
Concerns about the maintenance
and/or malfunctioning of the
Cochlear Implant
Difficulty in background noise
Unreasonable expectations of
aural-only benefit on the part of
the implant user or their family and
friends
Potential Benefits
1. Better speech understanding compared to a hearing
aid
2. Awareness and responsiveness to environmental
sounds
3. Less dependence on family members for day to day
living
4. Reconnection with the world of sound
5. Facilitation of communication with family and loved
ones
6. Ability to talk on the phone
7. Better appreciation of music