Pediatric Cochlear Implants

Pediatric Cochlear Implants

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Cochlear Implants

Cochlear implants are small, electronic devices that are inserted surgically into the inner ear and under the skin behind the ear to provide a sense of sound for someone who is profoundly deaf or hard of hearing. They include an external piece that sits behind the ear and an internal piece that is placed surgically under the skin.

Cochlear implants do not correct the cause of hearing loss and restore natural hearing.  However, they do provide access to sound and spoken language to a patient who would otherwise be deaf.

Cochlear implants are different than hearing aids; a hearing aid only amplifies sound. A cochlear implant bypasses your deaf child’s non-functioning inner ear and provides direct stimulation of the auditory nerve. The auditory nerve transmits those signals to the brain, which recognizes them as sound.

Is my child a candidate for a cochlear implant?

If your child is deaf or severely hard of hearing, a cochlear implant may expose them to sound and improve their ability to develop speech and language skills. The multidisciplinary team of experts at UT Pediatric Cochlear Implant Program at Children's Health work with you and your child to evaluate whether a cochlear implant can make the difference between sound and silence.

Cochlear implants are available for children age 6 months or older. Studies show that younger children most often have the best results when they are exposed to sound during the critical period when speech and language skills develop – when possible, before they are 18 months old.

Your child may be a candidate for a cochlear implant if he or she has:

  • Severe to profound hearing loss in both ears
  • Little or no benefit from hearing aids
  • No health conditions that eliminate it as an option
  • Lack of progress in auditory skill development

How do cochlear implants work?

In a typical ear, sound makes the eardrum and middle ear bones vibrate. Those vibrations are then converted into electrical signals by the cochlea and sent to the brain, which recognizes them as sound. Cochlear implants have parts located on both the inside and outside of your child’s ear to send sound signals to their brain and mimic this process.

Cochlear implants consist of four main parts:

  • A microphone to pick up sounds in the environment
  • A speech processor to arrange those sounds into signals
  • A transmitter that takes signals and converts them to electronic impulses
  • An electrode array that takes the impulses and sends them to different parts of the auditory nerve

The speech processor is attached externally and resembles a traditional, behind-the-ear hearing aid. It contains a microphone and computer that recognize sound and converts it into electrical signals.

The electrical signals are routed to the transmitter, which is about one-inch around and attached to the side of your child’s head with a strong magnet. The transmitter then sends the signals through your child’s skin to a receiver and on to the electrode array inside your child’s inner ear. This stimulates the auditory nerve and allows your child to recognize sound.

Your child’s implant journey

At the UT Pediatric Cochlear Implant Program, your child’s hearing needs are our only focus. Our team of audiologists, speech-language pathologists, surgeons and support team walks with you every step of the way to make cochlear implantation a pleasant event for you and your family.

Evaluation

The first step is a thorough evaluation of your child’s health and development, including:

  • Hearing tests 
  • Communication and language development tests
  • Medical exams
  • Social work consultation
  • Psychological assessment

We discuss your child’s results and outline our team’s recommendation in a family consultation once the evaluation has been completed. Our team gives you the information you need to make informed decisions about your child’s care.

Surgery

Cochlear implant surgery can be completed at Children’s Medical Center Dallas or Children’s Medical Center Plano. It is usually scheduled as an outpatient day surgery but, in some cases, your child may need to stay in the hospital overnight.

Follow-up care

Within one to two weeks of surgery, your child will have a follow-up visit with the doctor to check the surgery site and confirm that recovery is going as planned.

About a month after the surgery, you and your child will meet with an audiologist for programming (also called MAPping) to begin activation of their cochlear implant. The process takes place in increments to avoid overwhelming your child with new sounds and experiences too quickly. Your child typically attends seven MAPping appointments with an audiologist during the first year following the surgery to determine the amount of electrical stimulation each electrode delivers to the auditory nerve. After the first year, your child will usually be seen twice a year for MAPping.

Your child will also require speech and language therapy to assist in their language development. The amount of therapy required is different for each child; however, in general, most children need weekly therapy sessions during the early stages of their treatment.

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