Kids and Cochlear Implants: When Hearing Aids Aren't an Option

In the past, children with profound hearing loss had few treatment options. In 1990, the cochlear implant was approved for use in children with nerve deafness (called sensorineural hearing loss). A cochlear implant is an electronic device. It directly stimulates the auditory nerve, allowing a deaf child to have a sense of sound. About 15,000 children in the United States have these implants.

Cochlear implants are especially helpful in young children in the early stages of speech and language development. But they also offer speech and language benefits for older children and adults.

What is a cochlear implant and how does it work?
Normally, cells in the inner ear translate sound into signals. The signals are sent via the auditory (hearing) nerve to the brain. A cochlear implant uses technology to bypass the damaged parts of the inner ear. The device directly stimulates the auditory nerve, which then sends sound signals to the brain. Although the implant does not restore normal hearing, it does produce the sensation of sound that the brain can learn to interpret. After implantation, the child works with a speech and language therapist who can help him or her learn to interpret the sensations.

The cochlear implant consists of:

External parts:

• A microphone picks up sounds.
• A speech processor transforms the sounds into electrical signals.
• A transmitter, a small disk that sends the electrical signals to the receiver.

Internal (surgically implanted) parts:

• A receiver is placed under the skin behind the ear. It sends the electrical signals to electrodes that have been implanted in the inner ear to stimulate the auditory nerve.

Is a cochlear implant right for my child?
Your child may be a good candidate for a cochlear implant if he or she:

• Has severe sensorineural (caused by nerve damage) hearing loss in one or both ears and gets little or no benefit from hearing aids
• Has not developed appropriate speech, listening or language skills
• Has an intact auditory nerve
• Is in adequate health for surgery
• Has a family willing to support the necessary follow-up procedures

How is it done?
Cochlear implant surgery is done using general anesthesia. The procedure to implant the internal parts usually takes two to three hours. Most children go home the same day or after a one-night stay in the hospital.

Fitting and follow-up
Four to six weeks after surgery, your child will be fitted with the external parts of the cochlear implant system. Measurements will be taken to program the implant and speech processor. This can take several days. Regular visits are then needed for adjustments.

Implant center staff will teach your child how to use the device and to develop and improve communication skills. Your child will need to return for monitoring and adjustments every six months to a year.

Risks of cochlear implants
Children who have cochlear implants have an increased risk of bacterial meningitis. This is a serious infection in the fluid around the brain and spinal cord. It can be fatal. For this reason, it's important to keep your child's immunizations up to date and be aware of possible signs of meningitis, including:

• High fever
• Headache
• Stiff neck
• Nausea and vomiting
• Sleepiness
• Aversion to bright light
• Irritability

It is also important to tell your doctor about any signs of ear infection (ear pain, fever and irritability) in a child who has a cochlear implant. You must also follow instructions for taking antibiotics exactly as prescribed. Other risks include:

• Dizziness
• Infections
• Leakage of fluid from the brain or inner ear or ringing in the ear
• Facial nerve damage from surgery

Related Articles Checking Hearing in Newborns Medical Treatment for Hearing Loss

External Sources Alexander Graham Bell Association for the Deaf and Hard of Hearing. Cochlear implants. Accessed November 13, 2007. American Speech-Language-Hearing Association. Cochlear implants. Accessed November 13, 2007. U.S. Food and Drug Administration. Coclear implants. Accessed November 13, 2007. Gallaudet University. Laurent Clerc National Deaf Education Center. Cochlear implant candidacy. Accessed November 13, 2007. Koch DB, Staller S, Jaax K, Martin E. Bioengineering solutions for hearing loss and related disorders. Otolaryngologic Clinics of North America. 2005;38:255-272. National Institute on Deafness and Other Communication Disorders. Cochlear implants. Accessed November 13, 2007. FDA Public Health Notification: Continued risk of bacterial meningitis in children with cochlear implants with a positioner beyond twenty-four months post-implantation. Accessed November 13, 2007.

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