Download Becoming Familiar with Cochlear Implants

Becoming Familiar with
Cochlear Implants
Name
Title
Sonova and Advanced Bionics
Our Commitment to the Future of Hearing
• Advanced Bionics
• Most advanced cochlear implants
• Cutting-edge technology
• Sonova
• Global market leader
• Full spectrum of hearing solutions
• Medical division
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear implant candidacy
• Treatment options for hearing loss
• Management of a child with a cochlear implant
The ear consists of four main parts:
Brain
Inner Ear
Outer Ear
Auditory
Nerve
Middle Ear
The Outer and Middle Ear
Ear Drum
Bones of the
Middle Ear
The Inner Ear
Brain
Cochlea
Auditory Nerve
Hearing Loss
Brain
Without functioning
sensory cells in the
cochlea, sound
information cannot
reach the brain for
processing.
Damaged Sensory
Cells in Cochlea
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear implant candidacy
• Treatment options for hearing loss
• Management of a child with a cochlear implant
The Audiogram
Audiogram: A graph that shows an individual’s
type and degree of hearing loss.
Frequency Low Pitch to High Pitch
Loudness
Soft to
Loud
Normal
Hearing
xo
xo
xo
xo
xo
Moderateto-Severe
Loss
xo
xo
xo
xo
xo
xo
Severe-toProfound
Loss
xo
xo
xo
xo
xo
Types of Hearing Loss
Sensorineural
Conductive
Mixed
Sensorineural
Hearing Loss
xo<
xo<
xo< xo< xo<
xo
Conductive
Hearing Loss
<
xo
<
xo
<
xo
<
xo
<
xo
xo
Mixed
Hearing loss
<
xo
<
<
xo
<
xo
xo
xo
<
xo
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear implant candidacy
• Candidacy guidelines
• Steps to determine candidacy
• Treatment options for hearing loss
• Management of a child with a cochlear implant
Who is a Candidate for a
Cochlear Implant?
Range of
hearing for a
cochlear
implant
candidate.
Who is a Candidate for a
Cochlear Implant?
Adults (18 years+)
• Severe-to-profound, bilateral sensorineural hearing loss
• Less than 50% speech recognition with hearing aids on
open-set sentence recognition
Children (12 months - 2 years)
• Profound, bilateral sensorineural deafness (> 90 dB HL)
• Little or no benefit from hearing aids
Children (2 years - 17 years)
• Severe-to-profound, bilateral sensorineural deafness
• Little or no benefit from hearing aids
Pediatric Cochlear Implant Candidacy
•
Audiologic Evaluation
•
Medical Evaluation
•
Speech Language Evaluation
•
Psychological Evaluation
•
Educational Evaluation
Team Approach
Teacher
Surgeon &
Pediatrician
Psychologist
Child
SLP
Caregivers
Audiologist
Audiological Evaluation
• Determine the type and degree of hearing loss
• Air & bone conduction thresholds for each ear
• ABR & OAEs
• Assess the child’s current amplification system
• Aided sound field testing
• Aided speech perception testing
• Counseling
• Address realistic expectations
• Device selection
• Post-operative follow-up
Medical Evaluation
•
•
•
•
Determine cause of hearing loss
Assess status of middle ear & cochlea
CT scan/MRI
Counseling
• Hearing loss
• The surgical procedure
• Typically out-patient and performed by an
otolaryngologist (ENT) or otologist (ear specialist)
• Post-surgical considerations
Bilateral Cochlear Implants
• Bilateral Implants
• Industry trend
• Simultaneous vs. sequential
• Benefits:
•
•
•
•
Improved directionality
Improved listening in noise
Clarity of speech
Developmental
Speech & Language Evaluation
• Areas assessed
• Vocabulary - knowledge of single words
• receptive
• expressive
• Language - word combinations, grammar
• receptive
• expressive
• Articulation/Intelligibility
• Reading skills
Developmental Evaluation
• Assessment of non-verbal & verbal
IQ
• Verbal IQ assessed when appropriate
• Counseling for family
• Impact of hearing loss on the family unit
• Assessment of child’s learning style
• Assessment of any other underlying
issues
• Serves as a baseline evaluation
Educational Evaluation
• Areas to consider:
• Communication methodology
• Support services
• Speech/language and
auditory skill development
• Professional training
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear implant candidacy
• Treatment options for hearing loss
• Management of a child with a cochlear implant
Treatment Options for Hearing Loss
Hearing Aids
Cochlear Implants Systems
Treatment Options for Hearing Loss
Hearing Aids
Behind-the-Ear
In-the-Canal
In-the-Ear
How is a Cochlear Implant
Different From a Hearing Aid?
Hearing Aid
Acoustically amplify
sound.
Cochlear Implant
Convert sound into
electrical signals.
Rely on the responsiveness Bypass the inner ear
of healthy inner ear
sensory cells and stimulate
sensory cells.
the hearing nerve directly.
How Does a Cochlear Implant Work?
A Cochlear implant system consists of two main parts:
Internal Implant
External Equipment
or
HiRes 90K Advantage
High-Performance Hearing
™
Unmatched Technology
•
•
•
•
•
•
•
Unlimited ways to deliver stimulation
16 independent current sources
Low-profile design
Removable magnet
Industry’s highest case impact resistance- up to 6 Joules1,2
Industry’s fastest stimulation rates
Reliability you can count on with 99.8% CSR at one year3
HiRes 90K™ Advantage Implant
1.
2.
3.
HiRes 90KTM Implant
Holtkamp V. Cochlear Implants Under Impact Loading. Evaluation of Accident Scenarios. Determination of Load Limits, and Development of a Standardizable Test
Procedure. Dissertation accepted by the Senate of Hannover Medical School, May 19, 2004.
Cochlear Nucleus CI512 Cochlear Implant Technical Specifications. N33741F 1ss1 Jun09.
Advanced Bionics Reliability Update. 2012.
Harmony™ Sound Processor
HiResolution™ Bionic Ear System
Engineered to be Reliable
•Industry Standard Reliability
•
99.8% CSR at 1 year³ for the current AB
HiRes 90K Implant
•Built
to withstand rain, perspiration and
moisture
3. Advanced Bionics Reliability Update. 2012.
The World’s First and Only
Waterproof Sound Processor
• Freestyle™ Design
• Durable and Easy to Use
• Built Kid Tough™
• Ideal for All Ages and Lifestyles
• Stylish and Discreet
Neptune Features
•
Neptune
Battery
Compartment
•
•
Cable
•
Headpiece
•
Waterproof
Removable Controls
Powered by 1 AAA Battery
• Cost Effective
• Full day of use with a single
disposable or rechargeable
battery
Universal Headpiece (UHP)
and AquaMic
Compatible with HiRes 90K™
and CII implant devices
HiResolution™ Sound
What do parents want for their child?
• …to be able to hear like everyone
else does
• …to fit in
• …to realize their potential
• …to be successful in today’s world
How Does a Cochlear Implant Work?
•
Sound waves enter through the microphone.
•
The sound processor converts the sound into a
distinctive digital code.
•
The electrically coded signal is transmitted
across the skin through the headpiece to the
implant.
•
The implant delivers the sound to the
electrodes.
•
The electrodes stimulate the hearing nerve.
•
The hearing nerve sends the signal to the brain
where it is perceived as sound.
How Does a Cochlear Implant Work?
What you will learn today:
• How the ear works
• How to interpret the audiogram
• Cochlear implant candidacy
• Treatment options for hearing loss
• Management of a child with a cochlear implant
Pediatric Management
•
Audiologic Management
•
Rehabilitation
•
Family Commitment
•
School Support
Audiologic Management
• Goal is to assure access to sound adequate for auditory
development
• Programming or “mapping” of the cochlear implant system
• Assessments at regular intervals to track auditory
development
• Age-appropriate techniques & materials
Audiologic Management
CI
CI
CI
CI
CI
Rehabilitation is KEY
Parent Commitment
School Support
•
•
•
•
•
Understand what a cochlear implant is & equipment
troubleshooting
Assist in the management of the device and child
Perform behavioral listening checks on a daily basis
Know where to find support and resource materials
Maintain communication between the student’s parents,
teachers and cochlear implant center
Summary
•
Cochlear implants are an effective treatment for severe-toprofound sensorineural hearing loss.
•
A multi-disciplinary approach is necessary when determining
cochlear implant candidacy in children.
•
Post-operative management of a child with a cochlear
implant consists of programming of the sound processor and
important rehabilitation.
•
Parent commitment and school support are necessary
components to ensure a child’s success with a cochlear
implant.
Resources & Support:
For Educators, Therapists, Recipients, and Families
• Online:
• Live chat
• Click on icon
• AdvancedBionics.com
• HearingJourney.com
• Customer Care:
• Speak with an audiologist at 1-877-829-0026
•
•
Monday through Friday, 5 am to 5 pm PST
Ask questions via email:
• [email protected]
• [email protected]
• [email protected]
Education and rehabilitation
are keys to success with a
cochlear implant.
Visit Advanced Bionics online today at
AdvancedBionics.com!