COCHLEAR

IMPLANTS

ANJALI BENIWAL
C-8
 A cochlear implant is an electronic
device that can provide useful hearing
and improved communication
abilities for persons who have severe
to profound sensorineural hearing
loss and who cannot benefit from
hearing aids
COMPONENTS AND FUNCTIONING
TYPES
 CANDIDANCY PROFILE
1. Bilateral severe to profound sensorineural
hearing loss.
2. Little or no benefit from hearing aids.
3. No medical contraindications for surgery.
4. Realistic expectation.
5. Good family and social support toward
habilitation.
6. Adequate cognitive function to be able to use
the device.
• Candidates with such hearing impairment may
be defined as prelingual or postlingual
depending on whether they were deafened
before or after the acquisition of speech and
language.
• Cochlear implant is vital for who have hearing
impairment at birth or in early childhood. Lack
in auditory stimulus will lead to degeneration
in central auditory pathways. It can implanted
at the age of 12 months.
 OUTCOME OF COCHLEAR
IMPLANATION
Factors that predict a successful clinical outcome
are :
• Previous auditory experience (Post lingual
patients or prior use of hearing aids )
• Younger age at implantation ( Especially for
prelingual children )
• Shorter duration of deafness
• Neural plasticity within the auditory system .
 EVALUATION
Purpose :
1. To determine if the patient is medically and
audiologically suitable for an implant.
2. To predict and counsel the family regarding
outcomes following the procedure.
Vaccines against :
Haemophilus influenza type B (meningitis),
Pneumococcus, Meningococcus
1.CT and MRI - temporal bone, cochlea, auditory nerve,
brain to provide an image of the structure of the
cochlea and help identify any anomalies or pathology
that may complicate the implantation process.
2. Audiological evaluation-
Pure tone audiogram
Speech discrimination tests
Otoacoustic emissions
Auditory brainstem response
Auditory steady state response
3. Hearing aid trial
4. Speech and language evaluation
5.Psychological evaluation
 SURGERY
• Principle- to place the electrode array within the
scala tympani of the cochlea. This allows the
electrodes to be in close proximity to the spiral
ganglion cells and their dendrites.
• It is carried out under general anesthesia.
• Two surgical techniques :
1) Facial recess approach
2) Pericanal technique
• Postoperative mapping of device and
habilitation- Activation of the implant is done 3-
4 weeks after implantation and auditory verbal
therapy is given for rehabilitation.
THANK YOU