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Cochlear Implant Program

A cochlear implant is an electronic prosthetic replacement for damaged cells in the inner ear. The implant is a small electronic device that can help "make" sound if you have severe or total hearing loss. The implant does the job of the damaged or absent nerve cells that in a normal ear make it possible to hear (auditory nerves). Cochlear implants can be programmed according to your specific needs and degree of hearing loss.

Cochlear implants may help people with severe or total hearing loss in both ears who do not get any benefit from hearing aids. Cochlear implants have been shown to improve a person's ability to understand speech and speak clearly. Unlike hearing aids, cochlear implants do not make sounds louder but improve how well you hear sound.

A cochlear implant consists of a:

  • Microphone worn behind the ear, to pick up sound.

  • Speech processor worn on the body. Some types may be worn behind the ear.

  • Small device placed under the skin near the ear, with electrodes placed in the cochlea.

The microphone picks up sound and sends it to the speech processor, which changes the sound to information the cochlear implant can understand. The implant then tells the nerves in the ear to send a message to the brain. The message is understood as sound.

There are no tests to predict the level of benefit a particular individual will receive from a cochlear implant. The degree of improvement varies among individuals. However, most adults who receive a cochlear implant report many benefits that include improved communication ability and a personal sense of emotional well being.

With the implant, and the appropriate post-operative training, most patients are able to improve their accuracy in understanding speech in combination with speechreading. The average patient is able to carry on a conversation on the telephone if he or she uses effective strategies to clarify what has been said to them.

Almost all are able to differentiate environmental sounds and monitor the volume and quality of their own voice. Many patients report that they experience less stress communicating with family, friends, employers and co-workers; they feel the implant has had a positive effect on involvement in daily life and relationships.

The specialists in the Adult Cochlear Implant Program in the Department of Otolaryngology at Washington University School of Medicine provide a comprehensive evaluation and treatment program for patients eighteen years and older. Candidates for a cochlear implant are those who are severely or profoundly hearing impaired in both ears (including those with nerve deafness). These individuals typically receive limited benefit from hearing aids and communicate using the limited auditory information they do receive in combination with speechreading (lipreading).

The cochlear implant team includes skilled clinical, rehabilitative and research audiologists, two otolaryngologic surgeons, a neuropsychologist, a biomedical engineer and a medical secretary. The program has extensive experience in providing a thorough pre-surgical evaluation, performing the surgery, conducting the all important post surgical training and device programming that is critical to successful cochlear implant use, and coordinating all the administrative details.

After surgery, speech therapy will help you make the most of your cochlear implant. Training in listening, language, and speech-reading skills (paying attention to people's gestures, facial expressions, posture, and tone of voice) also help you.

Cochlear implants have a low rate of complications, which may include:

  • Risks of surgery, such as infection and medicine that numbs your senses during surgery (general anesthesia).

  • The implant moving out of its proper location. You may need a second surgery to relocate the implant.

  • The implant not working. It may not work because it was made incorrectly or because of an injury to or problem within the ear.

  • Twitching of the face (such as a tic) or not being able to move muscles in the face. This is uncommon and rarely permanent.

The cochlear implant was invented about twenty five years ago to help severely to profoundly deaf persons communicate more easily. Thanks to extensive research and evolving technology the device has come to be accepted as a most valuable one for persons with this much hearing loss. Cochlear implants are recognized by the American Medical Association (AMA) and the American Academy of Otolaryngology - Head and Neck Surgery (AAO- HNS) as an approved medical procedure for adults and children. They were approved by the Food and Drug Administration (FDA) in the mid-1980s and are covered by insurance policies, Medicare, Medicaid and Vocational Rehabilitation. There are now more than 60,000 individuals worldwide who have received cochlear implants.

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