A cochlear implant (CI) is a surgically implanted device that can enhance hearing and sensory perception for children who are hearing impaired.
In order to understand how a cochlear implant works, you will need a basic understanding of how sound is transmitted in a normally functioning ear:
- Sounds are transmitted as acoustic waves from the outer ear to the eardrum.
- The sound waves cause the eardrum to vibrate, which set the bones in the middle ear in motion.
- The motion of these bones causes the fluid within the inner ear (cochlea) to move. This fluid motion triggers sensory cells (hair cells) within the cochlea to bend and stimulate the auditory nerve.
- The auditory nerve transmits the signal to the brain that interprets and processes the signal as a hearing sensation.
Most profound hearing loss is sensorineural hearing loss (SNHL) in nature, which means that the outer ear and middle ear are intact and functioning but most commonly the hair cells in the inner ear—or cochlea—are damaged or absent. In this case, sound waves are lost or distorted and cannot be transmitted through the hearing nerve to the brain. Cochlear implants bypass the damaged hair cells by directly stimulating the auditory nerve.
A cochlear implant is inserted through outpatient surgery at Riley at IU Health. Some CI recipients may be required to stay in the hospital overnight after the surgery.
What to Expect
What to Expect
Cochlear implantation (CI) is performed as an outpatient surgery under surgical anesthesia and typically takes about two to three hours. A surgeon gains surgical access to the inner ear with minimally invasive techniques and vigilant monitoring of neighboring nerves, thus allowing for a safe and effective operation and a short recovery time. CI recipients may be required to stay in the hospital overnight following surgery for postoperative monitoring. If there are no complications, a CI recipient can return home the morning following surgery. Following your child’s surgery, the surgeon will determine if a hospital stay will be required.
The cochlear implant is an electronic device that provides access to sound for those who do not benefit from traditional amplification, such as a hearing aid. The two-part device converts audible sounds in the outside environment into electrical signals, which are converted into meaning in your child’s brain. Though a cochlear implant will not provide “normal” hearing for your child, it can provide the means for your child to interact with his or her environment in a more meaningful way.
A CI consists of an internal and an external device. The internal device consists of a receiver/stimulator and is placed inside of the cochlea during surgery. The external device consists of a microphone and speech processor and must be worn on your child’s body or ear. The external device picks up the sound and interprets and processes the signal that is sent to the electrodes on the inside of the device.
Cochlear implantation is not the right choice for all children and families. Before deciding whether or not a cochlear implant is right for your child and your family, there are a number of factors you should carefully consider, including:
- Determine the primary method of communication that you desire for your child. Most people who choose a CI for their child have the goal of spoken language in mind; a goal that can be reached only with a tremendous amount of personal motivation and effort on the part of the child and family. Others explore CI in hopes of their child gaining greater sound awareness from the implant, which can also be accomplished. However, there are other modes of communication that work well for many children and families with hearing impairment. Be sure to openly and honestly discuss these options with your child’s cochlear implant team.
- Understand that a successful cochlear implant requires major family effort. Each and every member of the family—not just the CI recipient—must be willing to put in years of effort to make the CI successful. Family members can help with language development skills by teaching communication through good modeling. Family members must be willing to talk and talk and talk some more to the child with a CI to help him or her with hearing and speaking development. Your child will need to go to regular follow-up appointments for months or years, and his or her CI equipment must be kept in good working condition in order to be effective.
- Be sure that you are committed to regular therapy and follow-up care. In order for a CI to be successful, your child must attend regular therapy sessions with a pediatric speech therapist. Your child's cochlear implant team can recommend a speech therapist who is familiar with CI patients and who is conveniently located close to you. You and your family must also be willing to practice the strategies learned in therapy with your child on a daily basis.
It is critical to understand that a cochlear implant is not going to immediately give your child the ability to hear and speak normally. As outlined above, major effort is required of everyone in your family.
Furthermore, there are specific criteria related to age, degree of hearing loss, insurance coverage and other factors that influence CI candidacy. The CI team will more fully explain whether or not your child is a candidate for implantation based on his or her specific situation and the above factors.
Key Points to Remember
Key Points to Remember
- A cochlear implant (CI) is a surgically implanted device that can enhance hearing and sensory perception for children who are hearing impaired.
- Though a cochlear implant will not provide “normal” hearing for your child, it can enhance your child’s hearing and awareness of his or her environment.
- The success of a cochlear implant is heavily dependent on the efforts of the child and family members to receive proper therapy and practice the therapeutic techniques at home.