Cochlear implants are being used by people of all ages with severe and profound hearing loss who no longer benefit from hearing aids.
By Dr. Claudia Emery, senior audiologist and cochlear implant specialist at Texas Children’s Hospital
For people with severe-to-profound sensorineural hearing loss (nerve deafness) in both ears, even the most advanced and powerful hearing aids may not help. In such cases, may be the answer.
According to the National Institute on Deafness and Other Communication Disorders, about two to three out of every 1,000 children in the United States are born deaf or hard-of-hearing. Nine out of every 10 children who are born deaf are born to parents who can hear.
In a study completed in 2000, 12,816 children between the ages of 12 months and 6 years old were identified with severe to profound hearing loss. Only about 55 percent actually received a cochlear implant.
In 2013, Texas Children’s Hospital’s Cochlear Implant team performed 49 implant surgeries. In 2014, a total of 44 surgeries were completed. In order to bring a better understanding about cochlear implants, below is some general information for families.
Cochlear implants consist of both an internal and an external component. The internal component is surgically inserted under the skin behind the ear to be implanted, and a narrow wire (the electrode array) is threaded into the cochlea. The external component, which looks somewhat like a behind-the-ear hearing aid, connects to the internal component via a magnetic disk also known as a coil or headpiece.
According to the Food and Drug Administration, the guidelines for candidacy for a cochlear implant include children ages 12 to 24 months old with profound SNHL, children 2 to 17 years old with severe-to-profound SNHL and adults 18 years and up with moderate-to-profound SNHL. All ages must demonstrate limited-to-no-benefit from traditional hearing aid use in both ears.
Although the range for candidacy for a cochlear implant is vast, there is not a “most common age,” though the earlier a child is implanted the better outcomes they will have. The FDA guidelines allow hospitals to implant as young as 12 months. Texas Children’s has implanted as young as 8 months of age, but only for medical reasons.
In order to become a candidate for a cochlear implant, patients must undergo a series of medical and audiological evaluations. Texas Children’s offers a multidisciplinary team approach to cochlear implantation. The team consists of the following disciplines: audiology, speech language and learning, ophthalmology, neuropsychology, otology, genetics, and other disciplines as indicated by the surgeon, such as cardiology. Once the child has gone through the team assessments, a team decision will be made whether to implant the child or not.
One of the most common questions doctors are asked is how long the implant is supposed to last. Although the surgically implanted device is meant to last a lifetime, there have been some cases in which the device needed to be surgically replaced. Because the technology of the external processing system continues to evolve, at some point in time, the internal technology may not be compatible with the external technology. If this occurs, further medical intervention may be needed.
The surgery lasts approximately 2 to 3 hours, and the recovery period can be between 1 to 4 days depending on the child. Following surgery, the child will be seen two weeks later to follow-up with the surgeon to evaluate the surgery site.
Approximately 188,000 people worldwide have received cochlear implants. In the United States, roughly 41,500 adults and 25,500 children have received them.
