Audiology: Cochlear Implant
What is a cochlear implant:A cochlear implant is a surgically implanted prosthetic device that allows an individual with moderate to profound hearing loss to experience hearing. They are recommended for individuals who do not gain sufficient benefit from traditional hearing aids. There is no upper age limit on individuals who can experience benefit from a cochlear implant and the number of patients with cochlear implants continues to increase with advances in cochlear implant technology. In addition, Trinity Health’s affiliation with the Mayo Clinic has streamlined the referral process for opportunities to participate in several of the Mayo Clinic’s cochlear implant studies.
How does a cochlear implant work:There is an internal electrode array that is implanted into the cochlea (hearing organ). The electrode contacts send electrical stimulation to the auditory (hearing) nerve, which then sends the information to the brain for processing. The individual wears a speech processor, which looks similar to a hearing aid, on the ear. The speech processor has a microphone that collects sound, codes it, and sends that information to the internal device.
Who can benefit from a cochlear implant:Any individual who does not receive satisfactory benefit from a hearing aid and wishes to hear better should consider cochlear implant evaluation. When crucial parts of the hearing system are not working, individuals may need more than a hearing aid. A cochlear implant bypasses damaged parts of the inner ear to provide sound to the brain when a hearing aid cannot. The sooner cochlear implantation is considered for individuals with significant hearing loss, the better the outcomes will be.
How do I get a cochlear implant:Before receiving an implant, each individual is carefully evaluated at the implanting center by a number of professionals. During the evaluation, the team evaluates the individual’s hearing with and without hearing aids and determines the individual’s ability to hear and understand speech with well-fit hearing aids. These evaluations can be completed at Trinity Health in addition to the cochlear implant teams at Sanford in Bismarck and Fargo. Once a patient has been determined an audiological candidate for cochlear implantation, a referral will be made to the implanting center at Sanford in Fargo. Several other tests will be completed to determine the individual’s health and ability to undergo surgery.
After the patient has been determined both an audiological and surgical candidate for cochlear implantation, our audiologists provide information and education about the process of receiving a cochlear implant and the long-term follow-up care that will be needed. Counseling and guidance about the available implant systems and what can be expected are also discussed.
What happens after I get a cochlear implant:Three to four weeks after cochlear implantation surgery, the individual is seen for fitting of the external equipment and initial activation of the cochlear implant. A cochlear implant audiologist uses a computer to adjust each of the electrodes to levels that allow the individual to best hear sound. Those levels are stored on a speech processor, which analyzes sound received through a microphone, codes the sound and transmits the coded signal across the skin to the implanted device. The electrodes of the implanted device deliver electrical impulses to the hearing nerves that send the message to the brain.
Several appointments are needed initially to program the speech processor. Adjustments are made to the device periodically and progress is monitored closely. Cochlear implant recipients are typically seen for follow-up programming and evaluation appointments by the audiologist every 3-6 months for the first two years after the device activation and every 6-12 months thereafter. Aural rehabilitation is an important part of post-activation success. Much like receiving physical therapy after surgery to strengthen and retrain the muscles, the hearing system requires therapy to retrain the hearing system on how to hear with the implant. Aural rehabilitation is therapy geared toward listening, retraining and adjusting to the implant. Aural rehabilitation services may be weekly during the initial stages of follow-up care or more frequent depending on individual progress. Services will become less frequent over time.
Cochlear Implant Services at Trinity Health:The audiologists at Trinity Health have extensive experience with all three of the FDA approved cochlear implant manufacturers. The following services are available to any individual with a cochlear implant, despite the age of the individual or model of equipment:
- Pre-implantation candidacy evaluation
- Counseling about individual expectations with a cochlear implant
- Counseling about the three FDA approved manufacturers of cochlear implants:
- Advanced Bionics, Cochlear and Med El
- Initial activation (initial stimulation) of the cochlear implant
- Follow-up programming of the cochlear implant
- Cochlear implant device troubleshooting
- Diagnostic evaluation of speech processors and internal equipment
- Aural rehabilitation services through the Speech Therapy Department at Trinity Health