Becoming Familiar with Cochlear Implants Name Title Becoming Familiar_V3_Dec2008.

transcript

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

The ear consists of four main parts:

Ear Drum

Bones of the Middle Ear

The Outer and Middle Ear

Cochlea

Auditory Nerve

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

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

ox ox oxox

Moderate to Severe

ox ox oxSevere to Profound

Types of Hearing Loss

1. Sensorineural

2. Conductive

3. Mixed

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

• Cochlear Implant Candidacy• Candidacy Guidelines• Steps to determine candidacy

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

Audiologist

Care Givers

Surgeon &Pediatrician

Teacher ofThe Deaf

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

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?

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?

• 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!

Becoming Familiar with Cochlear Implants Name Title Becoming Familiar_V3_Dec2008.

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