Ear, Nose and Throat Associates now offers Cochlear Implantation Surgery in collaboration with Morton Plant Hospital Health Hearing Center. Our physicians are experts in their field, specially trained and dedicated to helping qualified patients successfully restore their hearing health.
Our team will diagnostically assess your hearing loss to determine if cochlear implants are a viable option, then oversee the cochlear implant surgery and activation, and provide the education, resources and ongoing after-care to help patients hear happily and healthily again.
What is a cochlear implant?
A cochlear implant is a small, safe, electronic device approved by the FDA that can help to provide a sense of sound to a person who has moderate to profound hearing loss in both ears, receiving little or no benefit from hearing aids. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin (see figure below). An implant has the following parts:
- A microphone, which picks up sound from the environment.
- A speech processor, which selects and arranges sounds picked up by the microphone.
- A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.
- An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.
- Ear canal: Sound moves through the ear canal and strikes the eardrum.
- Eardrum and bones: Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion.
- Inner ear: This motion causes the fluid inside the inner ear (cochlea) to move the hair cells.
- Hearing nerve: Hair cells change the movement into electric impulses, which are sent to the hearing nerve into the brain; you hear sound.
LEARN MORE ABOUT THE DIFFERENT TYPES OF HEARING LOSS – Click Here
How does a cochlear implant work?
A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn. However, it allows many people to substantially regain the ability to hear and once again enjoy the sounds of life.
- Microphones on the sound processor pick up sounds and the processor converts them into digital information.
- The digital information is transferred through the coil to the implant under the skin.
- The implant sends electrical signals down the electrode to the cochlea.
- The hearing nerve fibers in the cochlea pick up the signals and send them to the brain, giving the sensation of sound.
SEE HOW A COCHLEAR IMPLANT WORKS
Who gets cochlear implants?
Children and adults can qualify as candidates for cochlear implants depending on the type and magnitude of hearing loss. Candidacy is determined on a case-by-case basis by our Otolaryngologist and Audiologist.
Adults may qualify for cochlear implantation regardless of whether they lost their hearing before or after learning language. Those adults who developed language before losing their hearing typically have greater success with cochlear implants than those who had not developed language before losing their hearing. Adult candidates are generally eligible for an implant if they:
- Have moderate to severe to profound hearing loss in both ears.
- Get little or no benefit from hearing aids.
- Have no medical problems that could put them at risk during surgery.
- Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading.
Children with hearing loss as young as 12 months old can be eligible for a cochlear implant. Experts recommend implantation as early as possible to expose children to sounds during the critical period of language acquisition. After implantation, they must undergo intense speech and language therapy in order to achieve the best possible outcome from the device.
Children are considered viable candidates when they:
- Have profound hearing loss in both ears.
- Get little or no benefit through the use of hearing aids.
- Are healthy and any medical conditions would not compromise surgery.
- Understand (when able), along with their parents, their role in the successful use of cochlear implants.
- Have support from an educational program that will emphasize the development of auditory skills.
The cochlear implant process.
A potential cochlear implant candidate is scheduled to meet with the ENT physician and an Audiologist. At our centers, the candidate will undergo audiological and psychological testing, a medical exam and imaging studies to determine if they will benefit from a cochlear implant. There will also be counseling for the candidate, to make sure he or she – or parents, for a child – understand the large follow-up commitment required after the implant surgery, as well as what to expect regarding device performance and limitations.
After a child or adult is considered a viable candidate, he or she will undergo the implantation surgery, which is done under general anesthesia on an outpatient basis, and typically takes between two and four hours. Only a thin area of hair needs to be shaved along the incision line. To implant the internal receiver, the ENT surgeon creates a pocket in the skull behind the affected ear. Then, using a surgical microscope, the surgeon accesses the cochlea to connect the electrode array. Tests are done at this time to assure the device technology is functioning properly. NOTE: Although the internal components have been placed, hearing is not immediately restored. The surgical site must heal before the external device is placed and the implant activated.
About two weeks after the surgery, the patient will return to the cochlear implantation center to be fitted with the external device. At this appointment, the audiologist will activate the cochlear implant and begin the process of mapping the processor for the individual’s specific needs. When the cochlear implant is “turned on,” this is the first time many children and adults are experiencing sound. Whether first hearing a spouse’s voice, their own voice, a parent’s voice or the audiologist, it’s quite an emotional and memorable milestone for the patient or parent.
This first appointment will be followed by other fine-tuning and adjustments to the cochlear implant map as the patient begins his or her new hearing journey. Many individuals need several follow-up visits over a few months to adjust the mapping of signal to the electrodes, as well as to help the person become accustomed to his or her device. Especially for those who’ve never heard sound before, an auditory training program is necessary to help the brain learn how to process the new auditory stimulation. Much like hearing aids, individuals will want to schedule regular visits with their audiologist for occasional adjustments and hearing tests.
Cochlear implant benefits and expectations.
Most adult cochlear implant patients notice an immediate improvement in their communication skills. Children require time to benefit from their cochlear implant as the brain needs to learn to correctly interpret the electrical sound input. While cochlear implants do not restore normal hearing, 90 percent of adult cochlear implant patients are able better to discriminate speech without the use of visual cues. There are many factors that contribute to the degree of benefit a user receives from a cochlear implant, including:
- How long a person has been deaf;
- The number of surviving auditory nerve fibers; and
- A patient’s motivation to learn to hear.
Your team will explain what you can reasonably expect. Before deciding whether your implant is working well, you need to understand clearly how much time you must commit.