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Care of Children Who Use a Cochlear Implant
| Date post: | 13-Jul-2015 |
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Health & Medicine |
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Care of Children Who Use a Cochlear Implant
Overview
Overview
Overview
Overview
Overview
● T levels – thresholds levels
– Measured behaviorally or generated in software● M or C levels – comfort levels
– Measured behaviorally or estimated by electrical compound action potential or electrical stapedial reflex threshold
● Range between T level and M/C level between 40 to 60 dB
Overview
● T levels – thresholds levels
– Measured behaviorally or generated in software● M or C levels – comfort levels
– Measured behaviorally or estimated by electrical compound action potential or electrical stapedial reflex threshold
● Range between T level and M/C level between 40 to 60 dB
Overview
● T levels – thresholds levels
– Measured behaviorally or generated in software● M or C levels – comfort levels
– Measured behaviorally or estimated by electrical compound action potential or electrical stapedial reflex threshold
● Range between T level and M/C level between 40 to 60 dB
Overview
● T levels – thresholds levels
– Measured behaviorally or generated in software● M or C levels – comfort levels
– Measured behaviorally or estimated by electrical compound action potential or electrical stapedial reflex threshold
● Range between T level and M/C level between 40 to 60 dB
Overview
● T levels – thresholds levels
– Measured behaviorally or generated in software● M or C levels – comfort levels
– Measured behaviorally or estimated by electrical compound action potential or electrical stapedial reflex threshold
● Range between T level and M/C level between 40 to 60 dB
Candidacy
● FDA approval for Cochlear Implants is device-specific (slight differences between manufacturers)
● Minimum age approved by FDA = 12 months for children with bilateral, profound hearing loss and 24 months for severe hearing loss (bilateral or better ear)
● Implanting under 12 months for special cases but increased risk
Candidacy
● FDA approval for Cochlear Implants is device-specific (slight differences between manufacturers)
● Minimum age approved by FDA = 12 months for children with bilateral, profound hearing loss and 24 months for severe hearing loss (bilateral or better ear)
● Implanting under 12 months for special cases but increased risk
Candidacy
● FDA approval for Cochlear Implants is device-specific (slight differences between manufacturers)
● Minimum age approved by FDA = 12 months for children with bilateral, profound hearing loss and 24 months for severe hearing loss (bilateral or better ear)
● Implanting under 12 months for special cases but increased risk
Candidacy
● Audiologist assesses word recognition with either questionnaires (e.g., IT-MAIS, MAIS) or speech audiometry (MLNT, LNT, HINT-Q).
● Speech-language evaluation● Developmental evaluation● Otological/Radiological evaluation
Candidacy
● Audiologist assesses word recognition with either questionnaires (e.g., IT-MAIS, MAIS) or speech audiometry (MLNT, LNT, HINT-Q).
● Speech-language evaluation● Developmental evaluation● Otological/Radiological evaluation
Candidacy
● Audiologist assesses word recognition with either questionnaires (e.g., IT-MAIS, MAIS) or speech audiometry (MLNT, LNT, HINT-Q).
● Speech-language evaluation● Developmental evaluation● Otological/Radiological evaluation
Candidacy
● Audiologist assesses word recognition with either questionnaires (e.g., IT-MAIS, MAIS) or speech audiometry (MLNT, LNT, HINT-Q).
● Speech-language evaluation● Developmental evaluation● Otological/Radiological evaluation
Intraoperative Testing
● Impedance telemetry to detect short or open circuits
– Short circuit = impedance too low– Open circuit = impedance to high
● Measure the electrically-evoked compound action potential (a.k.a., NRT, NRI, or ART)
Intraoperative Testing
● Impedance telemetry to detect short or open circuits
– Short circuit = impedance too low– Open circuit = impedance to high
● Measure the electrically-evoked compound action potential (a.k.a., NRT, NRI, or ART)
Intraoperative Testing
● Impedance telemetry to detect short or open circuits
– Short circuit = impedance too low– Open circuit = impedance to high
● Measure the electrically-evoked compound action potential (a.k.a., NRT, NRI, or ART)
Intraoperative Testing
Activation of CI● Activation is 1 to 4 weeks postsurgery
● Familiarization prior to activation (toys, books)
Activation of CI
● Activation is 1 to 4 weeks postsurgery
● Familiarization prior to activation (toys, books)
● At activation/programming, audiometry may be performed (depending on age)
● Electricallyevoked compound action potentials may also be performed in the office during programming
– Better than in operating room (less electrical interference)
– But exposes child to loudness discomfort
Activation of CI
● Activation is 1 to 4 weeks postsurgery
● Familiarization prior to activation (toys, books)
● At activation/programming, audiometry may be performed (depending on age)
● Electricallyevoked compound action potentials may also be performed in the office during programming
– Better than in operating room (less electrical interference)
– But exposes child to loudness discomfort
The Other Ear
● Contralateral stimulation is often beneficial (hearing aid or cochlear implant) --- bimodal hearing
● Bilateral implants (re: unilateral implant) eliminates the head shadow effect and provides superior sound localization, detection of soft sounds, speech perception in noise.
The Other Ear
● Contralateral stimulation is often beneficial (hearing aid or cochlear implant) --- bimodal hearing
● Bilateral implants (re: unilateral implant) eliminates the head shadow effect and provides superior sound localization, detection of soft sounds, speech perception in noise.
The Other Ear
● Contralateral stimulation is often beneficial (hearing aid or cochlear implant) bimodal hearing
● Bilateral implants (re: unilateral implant) eliminates the head shadow effect and provides superior sound localization, detection of soft sounds, speech perception in noise.
Monitoring
● Unaided audiogram every 12 months● Aided audiogram every 6 months● Aided thresholds should typically be between 20
to 30 dB HL (pulsed tones in soundfield)● Questionnaires to track progress● Aided speech perception testing (closed vs open
set)
Monitoring
● Unaided audiogram every 12 months● Aided audiogram every 6 months● Aided thresholds should typically be between 20
to 30 dB HL (pulsed tones in soundfield)● Questionnaires to track progress● Aided speech perception testing (closed vs open
set)
Monitoring
● Unaided audiogram every 12 months● Aided audiogram every 6 months● Aided thresholds should typically be between 20
to 30 dB HL (pulsed tones in soundfield)● Questionnaires to track progress● Aided speech perception testing (closed vs open
set)
Monitoring
● Unaided audiogram every 12 months● Aided audiogram every 6 months● Aided thresholds should typically be between 20
to 30 dB HL (pulsed tones in soundfield)● Questionnaires to track progress● Aided speech perception testing (closed vs open
set)
