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Cochlear Implants

  • Cochlear implants are an increasingly common option for managing hearing loss. The cochlear implant system, which possess external speech processor (about the size of a hearing aid and worn in a similar way) and an internal device (surgically implanted underneath the skin and into a child's inner ear), which provide the child with the sensation of hearing. With 97 percent of deaf children born to hearing parents, this surgery can be life-changing for the child, and her family.

    How does Boston Children's Hospital approach cochlear implants?

    Our Cochlear Implant Program is an interdisciplinary program located within the Department of Otolaryngology and Communication Enhancement and led by Greg Licameli, MD. It is the largest and most comprehensive pediatric cochlear implant program in New England with expert staff providing advanced technology and unparalleled personal care.

    To schedule an appointment or speak with a member of our team, call 781-216-2250.

  • How does a cochlear implant work?

    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 on to 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.

    Will a cochlear implant provide normal hearing?

    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.

    Who can benefit from a cochlear implant?

    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.

    What range of hearing loss must my child have to benefit from an implant?

    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 then became deaf and can no longer benefit from a hearing aid, she should be implanted as soon as possible.

    What factors might favor or limit my child's benefit from a cochlear implant?

    Ask yourself and your physician:

    • Does my child have good cochlear anatomy?
    • Does my child have good underlying language abilities?
    • Did my child have a solid base of language development prior to surgery?
    • Will we participate in regular speech/language/listening therapy given by a clinician trained in working with children who use cochlear implants?
    • Am I willing to support my child in using the cochlear implant during all waking hours?
    • Is my family able and willing to attend the programming sessions necessary to optimize hearing?
    • Are we able to maintain the equipment in good working order?
  • How is cochlear implant surgery performed?

    Implant surgery is performed under general anesthesia and takes three to six hours. A child usually stays in the hospital one night after the surgery, and one parent or caregiver is encouraged to stay in the child's room during recovery.

    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, 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. The the area is reconstructed.

    For an in-depth overview of the surgical procedure, please call our Cochlear Implant Program at 781-216-2250.

    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.

  • Research scientists in Boston Children’s Hospital Department of Otolaryngology are working to develop biological treatments for deafness. The laboratory of Drs. Jeffrey R. Holt and Gwenaelle Geleoc have ongoing research projects that focus on development of gene therapy strategies for treatment of genetic deafness and development of stem cell therapies for treatment of congenital and acquired forms of deafness. Although these biological strategies hold great promise, they are still under development. As such, the Cochlear Implant Program is the best strategy for hearing restoration that is currently available.

    To learn more about these research activities please contact our clinic or speak to your doctor at your next visit.

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