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Cochlear Implant Center

Children’s Hospital New Orleans Cochlear Implant Program and Other Implantable Hearing Devices (Bone Vibrating Hearing Aids)

Approximately 4,000 to 12,000 children are born in the United States each year with severe hearing impairment. While there can be inherited (genetic) causes of hearing loss, many children are often born to normal hearing parents. We serve to assist patients, parents, and pediatricians in understanding the nature of the hearing impairment, the options for supporting best hearing and speech performance for the individual child, and the benefits versus risks of each option.

At Children’s Hospital New Orleans, our collaborative team of otolaryngologists, audiologists, speech pathologists, nurse coordinators, and social service specialists follow children with hearing loss in an effort to help them achieve their best results for their learning and language development. For some children, the path leads to traditional hearing aids, while for other children with severe to profound hearing loss, that path may lead to cochlear implantation. Additionally, some children who cannot be fitted with a traditional hearing aid may benefit from one that vibrates the bone of the skull to transmit sound.

Cochlear implantation

Developed in the 1960s, the cochlear implant was not only the first technology to restore hearing in deaf patients, it was the first invention ever to restore one of the human senses. After success in the adult population, cochlear implantation was performed in children with newborn hearing loss in the 1980s, giving many the ability to hear and develop speech and spoken language.

A cochlear implant is a surgically implanted device that can provide a sense of hearing to a patient who is profoundly hearing impaired by stimulating the nerve of hearing directly using an electrode (a wire) placed within the inner ear, which is also known as the cochlea. An external sound processor, which looks similar to a hearing aid, contains a microphone that transmits the sound signal to the implant that is beneath the skin.

Cochlear Implant Center

Figure 1. The external processor attaches to a magnet underneath the skin on the internal implant. This processor captures sound using a microphone and converts it to a digital signal that is transmitted to the implant. Image courtesy of Cochlear Americas.

typical implanted device

Figure 2. This image shows a typical implanted device, which contains a magnet and a sound transmitter with an electrode array that is inserted into the cochlea. Image courtesy of Cochlear Americas.

Cochlear implantation can give patients the ability to hear at normal levels with potential for understanding speech and environmental sounds. Newer devices and upgraded software allow recipients to hear better in noise, enjoy music, and even use their implant processors while swimming. It is important to understand that surgery is just one step in successful cochlear implantation. In order for a child to develop the ability to hear and verbally communicate, the cochlear implant device must be worn consistently for all waking hours. A user must attend recommended appointments to “tune” its performance and go through language therapy sessions to allow a child to catch up to their appropriate level of hearing comprehension and language development.

Bone Conducting Hearing Aids and Osseo-integrated (Bone Anchored) Auditory Device Implantation

About 1 in 6,000 children are born annually with a defect of the outer ear or ear canal. Children with incompletely formed outer ears or ear canals often have difficulty with wearing a traditional hearing aid. In these instances, a specialized hearing aid, called a bone anchored hearing aid, can be placed onto the bone of the skull to capture the sound vibrations and allow for hearing. Many children with single-sided hearing loss (hearing loss affecting only one ear) may also need to use a bone-vibrating hearing aid to transmit sound to the opposite ear for sound localization.

Under the age of 5 years, children can use use a vibrating hearing device on a head band. Once the skull bone has achieved enough growth in thickness to support implantation, a small titanium mounting post above the skin (FDA-approved for 5 years and older) or a fully implantable device underneath the skin (FDA-approved for 12 years and older) can be placed surgically. A user can then place a bone conducting devices either on the post sitting just above the skin or on top of the implanted magnet.

Our process

Our team members meet monthly to discuss patients with new diagnoses of hearing loss and to review their progress with hearing and speech milestones. The team members determine if the current strategy is the best one or if another option should be recommended.

If a child will need to change strategies, the team members will discuss the options with the patient/family and collectively we will move forward with the next steps. For an implantable device, this may mean comprehensive evaluations for achievement, updated imaging studies, or scheduling surgery and appointments with team members.

Periodic assessments of progress with hearing, speech/language and developmental milestones are recommended every 3 months after the activation of a new device for the first year: hearing device programming may require more frequent evaluations and speech progress may require less frequent evaluations. After the first year, on-target patients may move to 6-month progress evaluations or 1-year progress evaluations depending upon their new achievements after implantation.

little girl with hearing device

Figure 3. Initial activation of the implant is typically done two weeks after surgery at the first postoperative visit.

little girl with hearing device

Figure 4. Newer technology has been developed where the external processor is only a single disc and eliminates the behind the ear component.

Children who are candidates for bilateral devices (for both ears) have the option to proceed to surgery on both sides in a single setting under most conditions. This helps children begin the progress of “habilitation” with balanced left and right hearing whenever possible. The benefits of bilateral implantation include improved sound localization and hearing sensitivity.

Please contact our office at 504.896.9551 to schedule an appointment with one of our pediatric hearing loss specialists.

For further reading, a list of helpful websites discussing hearing loss, hearing aids, and cochlear implantation are listed below.

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