What is a cochlear implant?
A cochlear implant is a device that is designed to provide hearing to individuals with severe to profound sensorineural hearing loss that do not benefit from traditional hearing aids. The cochlear implant consists of two parts, an internal component that is surgically implanted into the inner ear and mastoid, and an external component that includes a microphone and speech processor. The cochlear implant directly stimulates the auditory nerve fibers in the inner ear, and provides information about spoken language and environmental sounds. The cochlear implant does not “restore” natural hearing or “cure” hearing loss.
How does a cochlear implant work?
A cochlear implant bypasses the damaged hair cells in the inner ear, and directly stimulates the auditory nerve. It consists of two parts, an internal component and an external component.
- An internal receiver/stimulator (2) is surgically implanted under the skin behind the ear, and a connected electrode array (3) is inserted inside the cochlea.
- The external component (1) consists of a sound processor, headpiece, and battery compartment. This device is usually worn behind the ear, but off the ear options are also available.
The microphone captures sound and speech in the environment and sends it to the sound processor. The processor then converts the sound into electrical signals, which travel up a thin cable to the headpiece, and are then sent across the skin to the internal receiver/stimulator. The internal component sends electrical pulses to the electrode array within the cochlea, which then stimulates the auditory nerve fibers (4) responsible for sending sound information to the brain.
Who is a candidate for a cochlear implant?
Both children (12 months and older) and adults with severe to profound sensorineural hearing loss may be candidates for a cochlear implant. Specific procedures are done to determine cochlear implant candidacy, including: audiologic testing, medical examination, imaging, and consultation with the surgeon. A thorough discussion of realistic expectations and follow-up care also takes place in order to ensure that the individual and his/her family have the appropriate commitment and motivation to participate in the process. It is very important to understand what is required following cochlear implantation.
The best adult candidates are those who:
- Have severe to profound sensorineural hearing loss in both ears
- Have limited benefit from hearing aids
- Have the commitment necessary to participate in follow-up care and services
The best child candidates are those who:
- Have profound sensorineural hearing loss in both ears
- Have had limited benefit from hearing aids
- Have family that is committed to the steps in the process and understand their role in the success of the cochlear implant(s)
- Have family with realistic expectations for cochlear implant use
- Have support from their educational program to emphasize the development of auditory skills
(Adapted from ASHA.org)
What are the benefits of cochlear implantation?
Benefits range from the ability to detect sounds to understanding speech without visual cues. Most adults notice an immediate benefit in their communication skills following cochlear implantation, and those benefits continue to increase as an individual adjusts to the cochlear implant. Both adults and children require time to benefit from the cochlear implant, as their brains need to learn to interpret the new electrical sound input. Children who are implanted early in life and receive intensive auditory and speech therapy are most likely to maximize their benefit from the cochlear implant, including the development of age appropriate spoken language and literacy. While cochlear implants do not restore normal hearing, and benefits vary from individual to individual, cochlear implants help most users communicate better through improved lip-reading.
What to expect after receiving a cochlear implant
A cochlear implant does not sound like natural speech when it is first turned on. Instead, many adults report that it sounds robotic, unnatural, and difficult to understand. Some people only hear beeps or whistle sounds when the cochlear implant is initially activated. Over time however, the brain adjusts to the new electrical sound input and speech begins to sound more natural. The speed at which this happens is different for every individual, with some understanding speech in the first several weeks and others taking many months. During this time those with cochlear implants meet regularly with their audiologist to make adjustments to the speech processor in order to optimize speech understanding.
For children it is especially important that they receive extensive rehabilitation services from audiologists, speech-language therapists, and teachers as they learn to listen, and improve expressive and receptive speech and language abilities. The family must be committed to following through with these services in order for their child to receive maximum benefit from the cochlear implant.
Part I Jennifer’s Journey
Part II Jennifer’s Journey
Part III Jennifer’s Journey-One Year Later
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