What are cochlear implants?

Cochlear implants are an increasingly common option for managing hearing loss. A cochlear implant, which resembles a behind-the-ear hearing device, has several key components. The external piece of the implant is the speech processor, which is typically worn behind the ear. The processor has a microphone that picks up sound and a computer that codes the sound into electrical signals. These signals are sent up a cable to a transmitting coil, which is about one inch in diameter, held onto the side of the child’s head with a magnet.

The transmitting coil then sends the signal to a receiving coil in the internally implanted part of the system (the receiver/stimulator placed just below the skin.) The signal is then sent down a thin wire lead to an array of electrodes implanted in the inner ear. The coded signal is transmitted through the electrodes to stimulate the hearing nerve, taking over the function of damaged or missing cells that are unable to transmit hearing information themselves.

Normal hearing with cochlear implants?

A cochlear implant provides access to many sounds including speech but does not “fix” hearing loss or restore normal hearing. With consistent aural habilitation (a form of “listening” therapy) and practice, a cochlear implant user can often learn to understand spoken language.

Adults and children who learned to talk before they became deaf and/or used to have normal hearing or partial hearing often benefit from a cochlear implant.

If your child was born deaf or became deaf before she learned to talk, cochlear implants can provide access to spoken language, maximizing your child’s language potential. In either case, the shorter the duration of deafness, the greater the potential benefit.

Is my child a candidate for cochlear implants?

To be a candidate for a cochlear implant, your child must have a severe or profound sensorineural hearing loss in both ears. A child with auditory neuropathy spectrum disorder, a hearing disorder where sound enters the inner ear normally, but the transmission of signals from the inner ear to the brain is impaired, may also be considered for a cochlear implant.

At what age should my child receive a cochlear implant?

Children can receive a cochlear implant beginning at 10-12 months of age. For a child hoping to receive a cochlear implant at this age, evaluations should start around 3-4 months of age. A congenitally deaf child should have cochlear implant surgery before 3 years old, earlier if possible. This early implantation gives your child the best chance to learn to use sound while language skills are developing. If your child once had normal hearing or partial hearing and then became deaf and can no longer benefit from a hearing aid, she should be implanted as soon as possible.

How is cochlear implant surgery performed?

Implant surgery is performed under general anesthesia and takes two to four hours per ear. During the surgery, an incision is made behind the ear exposing the area where the implant will be placed.

The surgeon will place the receiver/stimulator in this small area under the skin. The electrode array is inserted into your child’s inner ear at the cochlea, and the receiver/stimulator is fixed in place. Electrical recordings are made to show that the electrodes are providing stimulation. Then the area is reconstructed.

Depending on your child’s age and health, they may spend the night in the hospital.  The child is then sent home with a head wrap to cover the incision. Parents are provided with information on how to care for the incision.

What are the risks of cochlear implant surgery?

Although the surgical risks of cochlear implantation are very rare, facial nerve paralysis, loss of taste sensation, dizziness, or ringing in the ear may occur.

It is also important to understand the surgery typically removes any ability the individual may have had to hear in the ear where the implant is placed. Hearing can be enhanced with a conventional hearing aid in the opposite ear when appropriate.