Cochlear Implant Update
Presented on Thursday, 12 May 2011
Agnes Allen, Scientific Head of Service/Consultant Clinical Physicist
Cochlear implant users – 2011
There are ~ 250,000 cochlear implant users in the world.
- ~10,000 are within the UK
- anticipate ~1000 in Scotland?
~ 860 cochlear implant users in Scotland
- ~85 under 5s
- ~155 primary school
- ~100 secondary school
- ~300 19–60 year-olds
- ~220 over 60s
- Approximately 130 bilateral CI users
Scottish Cochlear Implant Programme for Adults & Children, Crosshouse Hospital, Kilmarnock
Multidisciplinary Team
- Audiologists
- Clinical Physicists
- ENT Surgeons
- Rehabilitation Specialists
- Support Staff
Cochlear Implant
- Sensory aid
- For those with a bilateral profound hearing loss who receive little or no benefit from conventional hearing aids
- Provide access to spoken language through hearing
Puretone thresholds
Electrode array
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Selection Criteria
- Bilateral Severe-to-Profound Hearing Loss
- Limited benefit from hearing aids
- Fit enough to undergo GA/surgery
- Able to participate in programming sessions
- Ability to process auditory information from Cochlear Implant
- No upper age limit for children who present with functional spoken language
- Upper age limit of 5 years old for children who present with little or no spoken language
Cochlear Implant
- 2 to 3 hour Surgical procedure
- In hospital for 2 to 3 days
- Passive device
- Designed to last a lifetime
Speech Processor
- Active device
- Externally worn
- Removable
- Needs to be programmed, maintained & replaced
Initial fitting
- 4 weeks post-surgery – 'switch-on'
- External Equipment Issued
- Electrodes activated for the first time
- Mode of Stimulation, Stimulus Levels etc.
- Speech coding strategy (SPEAK, ACE etc.)
(Programming/Mapping)
Regular follow-up Life-long support
Early intervention is crucial for spoken language development in deaf children
- Auditory deprivation has a detrimental effect on the development of central
auditory pathways.
- Auditory stimulation is required for pathways/language centres to form.
- This happens within a critical time period (neuroplasticity).
- Generally believed to be 5 years old.
The 'Hearing Brain'
Cochlear implantation can enable profoundly deaf children to:
- Acquire and understand spoken language, speak intelligibly and use the telephone
- Have improved literacy and educational attainments
- Attend mainstream school
Do cochlear implants work equally well for everyone?
All cochlear implant users have exactly the same audiogram
- It is flat across the full frequency range
- Hearing thresholds are equivalent to a mild hearing loss
- Hearing does not deteriorate
Factors influencing outcome
- Hearing history
- Age at time of implant
- Home environment
- Device use
- Communication approach
- Co-existing morbidity
Outcomes in children
The earlier children are implanted, the better the outcomes; provided that they wear the CI device all day/every day and immersed in spoken language.