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Understanding Cochlear Implants

Who is a good candidate for a cochlear implant?

According to the American Speech-Language-Hearing Association, the best adult candidates have the following characteristics:

  • severe to profound hearing loss in both ears
  • loss of hearing after having already developed speech and language
  • limited help from using from hearing aids
  • no medical problems that would make surgery risky
  • strong motivation to be part of the hearing world
  • realistic expectations

Also, cochlear implants are more effective in people who have lost their hearing recently, as well as those who used a hearing aid successfully before getting a cochlear implant.

Are children good candidates?

The FDA has lowered the age limit to 12 months, and most children who are identified with significant hearing loss as a baby are implanted as soon as possible. Getting a cochlear implant in early childhood exposes children to sound during the critical period in which they learn speech and language skills.

The devices work best for children who have the following characteristics:

  • profound hearing loss in both ears
  • limited help from using hearing aids
  • in good health, with no medical conditions that would make surgery risky
  • willingness to learn how to communicate with the use of the cochlear implant
  • support from their caretakers, teachers, and school programs to help them develop hearing skills
  • younger than age 5. In a recent study, children who received a cochlear implant before the age of 18 months had vast improvement in their ability to hear, speak, and learn. (Older children who lose their hearing after they have developed the ability to speak can also be helped by a cochlear implant.)
  • involved in intensive speech therapy and oral communication programs

How do I know if I’m a good candidate for a cochlear implant?

If you have severe or profound hearing loss, a team of experts at a cochlear implant center can help you decide whether you're a good candidate for this surgery. Typically, these experts include an ear doctor (otologist), audiologist, psychologist, counselor, and speech-language pathologist. The team works together to evaluate you, perform the surgery, and offer follow-up care.

You may have tests, such as:

  • an exam of the external, middle, and inner ear to check for infection or other issues
  • various hearing tests, such as an audiogram. This is a graph that charts how you respond to specific sounds.
  • a hearing aid evaluation
  • CT or MRI scans to check the inner ear and hearing nerve, in part to see whether the cochlea has a normal shape
  • a physical exam to prepare for general anesthesia
  • a psychological exam to assess whether you can cope with the implant (more common with children)

When you're being evaluated for a cochlear implant, counseling will help you to have realistic expectations, as well as make sure that you understand the commitment required for learning how to use the implant. After receiving an implant, many people benefit from a rehabilitation program. The goal is to develop listening skills through the implant. It is always recommended that children who receive implants participate in a rehabilitation program.

WebMD Medical Reference

Reviewed by Brandon Isaacson, MD on January 30, 2014
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