Contemporary Considerations for Cochlear Implantation for Children With Multiple Disabilities

2009 ◽  
Vol 19 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Susan Waltzman

Abstract Due to advances in cochlear implant technology and the remarkable outcomes often achieved by persons with severe to profound hearing loss, cochlear implant candidacy criteria has expanded since the first children were implanted almost twenty years ago. Evidence of this can be seen in the increased willingness to provide cochlear implants for children with multiple disabilities. Over the last decade, several reports have appeared in the peer-reviewed literature describing cochlear implant outcomes of children with multiple disabilities. This paper will summarize those reports, discuss realistic expectations of implantation for children with multiple disabilities, and describe contemporary management protocols for the otologic, audiologic, and rehabilitative management of children with multiple disabilities.

2009 ◽  
Vol 19 (2) ◽  
pp. 54-62
Author(s):  
Jack King

Abstract Advances in cochlear implant technology have allowed for amazing outcomes for children with severe to profound hearing loss. As result, cochlear implants are now provided for some children prior to their first birthday and are also provided to children with multiple disabilities. Frequently, it is difficult to use conventional behavioral measures to set cochlear implant MAPs for these patients, so clinicians have often relied on objective measures as a guide to determining appropriate MAP levels. The following discussion reviews the advantages and limitations of using objective measures to administer audiological management for the pediatric cochlear implant patient.


Author(s):  
Gillian Robyn Kerr ◽  
Seppo Tuomi ◽  
Alida Müller

Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154) using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010) using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.


2013 ◽  
Vol 127 (9) ◽  
pp. 854-858 ◽  
Author(s):  
W-K Low ◽  
C A Tham ◽  
V-D D'Souza ◽  
S-W Teng

AbstractObjective:Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being.Study design, patients and intervention:A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010.Results:Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’.Conclusions:In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients' emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.


2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
B. Y. Roukema ◽  
M. C. Van Loon ◽  
C. Smits ◽  
C. F. Smit ◽  
S. T. Goverts ◽  
...  

Objective. To describe the audiological, anesthesiological, and surgical key points of cochlear implantation after bacterial meningitis in very young infants.Material and Methods. Between 2005 and 2010, 4 patients received 7 cochlear implants before the age of 9 months (range 4–8 months) because of profound hearing loss after pneumococcal meningitis.Results. Full electrode insertions were achieved in all operated ears. The audiological and linguistic outcome varied considerably, with categories of auditory performance (CAP) scores between 3 and 6, and speech intelligibility rating (SIR) scores between 0 and 5. The audiological, anesthesiological, and surgical issues that apply in this patient group are discussed.Conclusion. Cochlear implantation in very young postmeningitic infants is challenging due to their young age, sequelae of meningitis, and the risk of cochlear obliteration. A swift diagnostic workup is essential, specific audiological, anesthesiological, and surgical considerations apply, and the outcome is variable even in successful implantations.


2009 ◽  
Vol 19 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Tamala S. Bradham ◽  
Geneine Snell ◽  
David Haynes

Abstract Technological advances, specifically cochlear implants, have significantly impacted the treatment of children with severe to profound hearing loss. There are, however, very few professional guidelines or resources providing direction for hearing healthcare providers who are serving children with cochlear implants. The following article discusses a comprehensive management protocol for interdisciplinary teams providing cochlear implant services for children.


1992 ◽  
Vol 107 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Michael A. Seicshnaydre ◽  
Michele H. Johnson ◽  
M. Suzanne Hasenstab ◽  
George H. Williams

Preoperative temporal bone computed tomography (CT) can demonstrate anatomic details relevant to surgical management and is therefore essential in the presurgical evaluation of patients receiving cochlear implants. The purpose of this study was to evaluate preoperative CT studies and compare them to surgical findings in 34 children who received the Nucleus multichannel cochlear implant. The focus of this report is to discuss the dependability of CT scans in predicting surgical findings at the time of cochlear implantation. Results indicate that agreement of CT interpretations with surgical findings is partially related to the etiology of hearing loss and the experience of the surgeon and neuroradiologist. Advantages and limitations of the CT scans in predicting surgical findings are discussed.


2021 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Santosh Kumar Swain

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.


2007 ◽  
Vol 86 (10) ◽  
pp. 612-613 ◽  
Author(s):  
Robert J. Stokroos ◽  
Pirn van Dijk

Cochlear implantation is considered to be a safe and effective treatment for severe to profound sensorineural hearing loss. Device failures are rare. We report the cases of 2 patients—a 44-year-old woman and a 3-year-old boy—with cochlear implants who were referred to our tertiary cochlear implant center for treatment of magnet migration secondary to mild head trauma. The migration had led to device failure in both cases. Surgical re-exploration was performed with nonmagnetic instruments, and both magnets were easily returned to their proper place. Postoperatively, implant function was restored to previous levels, and wound healing was uncomplicated. The incidence of magnet migration in cochlear implant patients is unknown. A few cases have been reported in children, but to the best of our knowledge, ours is the first report of magnet migration in an adult.


2019 ◽  
Vol 73 (6) ◽  
pp. 8-17 ◽  
Author(s):  
Maria Drela ◽  
Karolina Haber ◽  
Iwona Wrukowska ◽  
Michael Puricelli ◽  
Anna Sinkiewicz ◽  
...  

Introduction: Although it is recommended to perform cochlear implantation in both ears at the same time for management of profound hearing loss in children, many centers prefer to perform sequential implantation. There are many reasons as to why a simultaneous bilateral implantation is not commonly accepted and performed. The major risk is the possibility of bilateral vestibular organ impairment. However, it is beyond doubt that children who received the first implant should be given a chance for binaural hearing and associated benefits. In the literature, there are no homogenous criteria for bilateral implantation, and it is hard to find uniform and convincing algorithms for second cochlear implantation. The aim of this study is an attempt to identify a safe way of qualifying for second cochlear implantation in children. Material and methods: Forty children with one cochlear implant were qualified for the second implantation. During qualification, the following were taken into account: time of the first implantation, audiometry results, use of the hearing aid in the ear without an implant and benefit of the device, speech and hearing development, and vestibular organ function. R esults: Fifteen out of forty children (38%) were qualified for the second implantation. In 35% of children, the decision was delayed with possible second implantation in the future. Eleven children (27%) were disqualified from the second surgery. Discussion: During evaluation according to the protocol presented in our study, 38% of children with a single cochlear implant were qualified for the second implantation with a chance for an optimal development and effective use of the second cochlear implant. We are convinced that sequential implantation with a short interval between surgeries and with an examination of the vestibular organ, hearing and speech development as well as an assessment of potential benefits from the second implant (bimodal stimulation) before the second implantation is the safest and most beneficial solution for children with severe hearing loss.


2004 ◽  
Vol 118 (12) ◽  
pp. 980-982 ◽  
Author(s):  
V.S. Sunkaraneni ◽  
A. Banerjee ◽  
R.F. Gray

Cochlear implants have transformed the treatment of sensorineural hearing loss. They have few major complications. The authors describe the case of a man fitted with a cochlear implant who suffered a postoperative subdural haematoma. The haematoma is thought to have been caused by bleeding from emissary veins opened by the drill passages used to anchor the sutures for the receiver/stimulator. The authors have abandoned tie down sutures in cochlear implants, preferring an appropriately deep well with squared-off rims, which would secure the implant in place. They have had no further complications of this nature.


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