Cochlear Implant.pptVIP

Cochlear Implants and Other Implantable Auditory Prostheses Cummings, 4th, 2005 Chapter 158?–? Patient Evaluation and Device Selection for Cochlear Implantation Chapter 159?–? Medical and Surgical Considerations in Cochlear Implantation Chapter 160?–? Cochlear Implants: Results, Outcomes, And Rehabilitation ????Ballenger, 16th, 2003 Chapter 23 - Cochlear Implants DeWeese and Saunders, 7th, 1988 None Patient Selection - Adult =18 y/o Bil. severe-to-profound hearing loss Minimal benefit from conventional hearing aids (typical defined as sentence recognition scores 40~50% correct in the best aided condition) No medical contraindication Adult Candidacy No upper age limit Limited to postlingually deafened adults With a recent onset of deafness, the most beneficiary of CI Patient Selection – ChildrenAged 12 mo to 24 mo Bilateral profound hearing loss Lack of auditory skills development and minimal hearing aid benefit (documented by parent questionnaire) No medical contraindications Enrollment in a therapy of education program emphasizing auditory development Patient Selection – ChildrenAged 25 mo to 17y +11 mo Bilateral severe-to-profound hearing loss Lack of auditory skills development and minimal hearing aid benefit (word recognition scores 30% correct) No medical contraindications Enrollment in a therapy of education program emphasizing auditory development Children Candicacy Both prelingually and postlingually deadened children are candidates Current FDA guidelines permit as young as 12 mo Early auditory experience is critical for development of neural connections Early Implanation If etiology is meningitis, CI may be important because of progressive intracochlear ossification for difficult electrode insertion. CI in very young children is controversial because of availability of benefit from conventional hearing aids. Classification of CI Recipients Postlingually deafened adults and children Congenitally or early deafened children Congenitally or early deafen