Post on 26-Mar-2015
Becoming Familiar with Cochlear
Implants
NameTitle
Becoming Familiar_V3_Dec2008
Advanced Bionics• Founded by Alfred E. Mann with a vision to fully
restore hearing for severe to profoundly deaf individuals
• Led by Jeff Greiner who has been the company’s operational leader since its founding providing experience and expertise in implantable medical products
• Only American cochlear implant company—based in Sylmar, CA
• More than 500 employees around the globe
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear Implant Candidacy
• Treatment Options for Hearing Loss
• Management of a child with a cochlear implant
Outer Ear
Middle Ear
Inner Ear
Auditory Nerve
Brain
The ear consists of four main parts:
Ear Drum
Bones of the Middle Ear
The Outer and Middle Ear
Cochlea
Auditory Nerve
Brain
The Inner Ear
Without functioning sensory cells in the cochlea, sound information cannot reach the brain for processing.
Damaged Sensory Cells in Cochlea
Hearing LossBrain
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear Implant Candidacy
• Treatment Options for Hearing Loss
• Management of a child with a cochlear implant
Audiogram: A graph that shows an individuals type and degree of hearing loss.
The Audiogram
Loudness
Soft to Loud
Frequency Low Pitch to High Pitch
xo ox xo ox xo
Normal Hearing
xoox
ox ox oxox
Moderate to Severe
Loss
xoox
ox ox oxSevere to Profound
Loss
Types of Hearing Loss
1. Sensorineural
2. Conductive
3. Mixed
xo<
xo<xo o ox x
xo< < <
Sensorineural Hearing Loss
< < < < <
xo xo xo o ox xxo
Conductive Hearing Loss
< <<
< <
xo xo xo o ox xxo
Mixed Hearing loss
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear Implant Candidacy• Candidacy Guidelines• Steps to determine candidacy
• Treatment Options for Hearing Loss
• Management of a child with a cochlear implant
Who is a Candidate for a Cochlear Implant?
Range of hearing for a cochlear implant candidate.
Adults (18 years+)• Severe to Profound, bilateral sensorineural hearing loss• Less than 50% speech recognition with hearing aids on
open-set sentence recognition
Children (12 months - 2 years)• Profound, bilateral sensorineural deafness (> 90 dB HL)• Little or no benefit from hearing aids
Children (2 years - 17 years)• Severe to Profound, bilateral sensorineural deafness • Little or no benefit from hearing aids
Who is a Candidate for a Cochlear Implant?
• Audiologic Evaluation
• Medical Evaluation
• Speech Language Evaluation
• Psychological Evaluation
• Educational Evaluation
Pediatric Cochlear Implant Candidacy
Team Approach
Psychologist
SLP
Audiologist
Care Givers
Surgeon &Pediatrician
Teacher ofThe Deaf
Child
Audiological Evaluation• Determine the type and degree of hearing loss
• Air & bone conduction thresholds for each ear• ABR & OAEs
• Assess the child’s current amplification system• Aided sound field testing• Aided speech perception testing
• Counseling• Address realistic expectations• Device selection• Post-operative follow-up
Medical Evaluation• Determine cause of hearing loss • Assess status of middle ear & cochlea• CT scan/MRI• Counseling
• Hearing loss• The surgical procedure
• Typically out-patient and performed by an otolaryngologist (ENT) or otologist (ear specialist)
• Post surgical considerations
• Bilateral Implants• Industry trend• Simultaneous vs.
Sequential• Benefits:
• Improved directionality• Improved listening in noise• Clarity of speech• Developmental
Bilateral Cochlear Implants
Speech & Language Evaluation• Areas assessed
• Vocabulary - knowledge of single words• receptive • expressive
• Language - word combinations, grammar• receptive
• expressive • Articulation/Intelligibility• Reading skills
Developmental Evaluation• Assessment of non verbal & verbal IQ
• Verbal IQ assessed when appropriate
• Counseling for family• Impact of hearing loss on the family unit
• Assessment of child’s learning style• Assessment of any other underlying
issues• Serves as a baseline evaluation
Educational Evaluation
• Areas to consider:• Communication Methodology• Support services • Speech/language and
auditory skill development• Professional training
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear Implant Candidacy
• Treatment Options for Hearing Loss
• Management of a child with a cochlear implant
Cochlear Implants
Treatment Options for Hearing Loss
Hearing Aids
Behind-the-ear
In-the-Ear
In-the-Canal
Treatment Options for Hearing LossHearing Aids
How is a Cochlear Implant Different From a Hearing Aid?
Hearing Aid Cochlear Implant
Acoustically amplify sound.
Convert sound into electrical signals.
Rely on the responsiveness of healthy inner ear sensory cells.
Bypass the inner ear sensory cells and stimulate the hearing nerve directly.
A Cochlear Implant consists of two main parts:
Internal Equipment
External Equipment
How Does a Cochlear Implant Work?
or
Electrode Array
3 turn gold wire coil
Internal Electronics
Removable Magnet
Internal EquipmentHiRes™ 90K
Harmony® HiResolution® Bionic Ear System
Engineered to be Reliable • Industry Standard Reliability
• 99.1% CSR at 2 ½ years for the current Harmony Bionic Ear System
• Built to withstand rain, perspiration, and moisture• Speech processor return rate is
1.5% (all returns including moisture)
Harmony® Sound Processor
• …to be able to hear like everyone else does
• …to fit in
• …to realize their potential
• …to be successful listening in today’s world
HiResolution® SoundWhat do parents want for their child?
• Sound waves enter through the microphone.
• The sound processor converts the sound into a distinctive digital code.
• The electrically coded signal is transmitted across the skin through the headpiece to the internal portion of the device.
• The internal device delivers the sound to the electrodes.
• The electrodes stimulate the hearing nerve.
• The hearing nerve sends the signal to the brain for processing.
How Does a Cochlear Implant Work?
How Does a Cochlear Implant Work?
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear Implant Candidacy
• Treatment Options for Hearing Loss
• Management of a child with a cochlear implant
• Audiologic Management
• Rehabilitation
• Family Commitment
• School Support
Pediatric Management
Audiologic Management• Goal is to assure access to sound adequate for
auditory development• Programming or “mapping” of the cochlear
implant device• Assessments at regular intervals to track
auditory development• Age appropriate techniques & materials
Audiologic Management
CI CI CI CI CI
Rehabilitation is KEYA cochlear implant is NOT a “cure”
Parent Commitment
School Support • Understand what a cochlear implant is & equipment
troubleshooting • Assist in the management of the device and child• Perform behavioral listening checks on a daily basis• Know where to find support and resource materials• Maintain communication b/w the student’s parents,
teachers and cochlear implant center
Summary• Cochlear implants are an effective treatment for severe to
profound sensorineural hearing loss.
• A multi-disciplinary approach is necessary when determining cochlear implant candidacy in children.
• Post-operative management of a child with a cochlear implant consists of programming of the sound processor and intensive rehabilitation.
• Parent commitment and school support are necessary components to ensure a child’s success with a cochlear implant.
Resources & Support:For Educators, Therapists, Recipients, and Families
• Online:• Online chat
• Click on icon • www.BionicEar.com• www.HearingJourney.com
• Customer Care:• Speak with an Audiologist at 1-877-829-0026• Monday through Friday, 5 am to 5 pm PST• Ask questions via Email:
• ToolsForSchools@AdvancedBionics.com• ListeningRoom@AdvancedBionics.com• Hear@advancedbionics.com
Education and rehabilitation are the keys to success with a
cochlear implant.Visit Advanced Bionics online today at
www.BionicEar.com!