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Cochlear Implant

Cochlear Implant

Cochlear Implant Mapping

We are working on Cochlear Implant Mapping. Please bear with us as we prepare and train for these important services. 

FAQs on Cochlear Implants and Mapping

What is a cochlear implant?

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin (see figure). An implant has the following parts:

  • A microphone, which picks up sound from the environment.
  • A speech processor, which selects and arranges sounds picked up by the microphone.
  • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.
  • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.

An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.

From National Institute on Deafness and other Communicative Disorders (NIDCD) 

How does a cochlear implant work?

A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn. However, it allows many people to recognize warning signals, understand other sounds in the environment, and enjoy a conversation in person or by telephone. No matter the manufacturer, all cochlear implants basically work the same. 

From National Institute on Deafness and other Communicative Disorders (NIDCD)

Who is a candidate for a cochlear implant?

The current pediatric candidacy criteria for cochlear implants set by the Food and Drug Administration (FDA) include:

  • About 12 months of age or older(some surgeons will implant younger than 12 months)
  • Severe to profound hearing loss or Auditory Neuropathy in both ears.
  • Little benefit from hearing aids.
  • No medical contraindications.
  • Lack of progress in auditory skill development.

To determine if your child is a candidate for a cochlear implant, a comprehensive evaluation must be completed.

What is Mapping?

Mapping is the process where the audiologist determines the amount of electrical stimulation each electrode delivers to the auditory nerve so that the patient can respond. MAPs are adjusted over time. Sometimes the mapping process takes several appointments to ensure correct settings.  It is important to see the audiologist as recommended to make sure your child has the most appropriate MAP.

 What happens during the initial stimulation or hook up of the cochlear implant?

During the initial stimulation, which occurs a few weeks after surgery, the audiologist will create an initial MAP for the child and discuss in detail how the external equipment works. Children react very differently during this initial stimulation - some cry, some smile and some show little reaction. The audiologist will make sure your child is comfortable when he/she leaves the office.

Where can I get MApping services?

The Speech & Hearing Center is the only facility in southeast Tennessee that offers cochlear implant mapping services. The next closest facilities are more than 100 miles from Chattanooga. 

How often will my child have to see the audiologist once they receive a cochlear implant?

During the first year after receiving the implant, children are seen frequently. Typically, children are seen the day of the initial stimulation, frequently during the first year and then annually thereafter. Of course, some children may need to be seen more often.

What kind of speech-language therapy does my child need?

The individual speech-language therapy needs of children with cochlear implants are specific to each child.  However, in general, children need weekly individual therapy sessions that emphasize listening with a cochlear implant and improving their communication skills. Please discuss your child’s specific needs with our speech-language pathologists. Auditory Verbal Therapy (AVT) is highly recommended. Parents are actively involved in each session of AVT with the child.

Where can I go for Auditory Verbal Therapy (AVT)?

The Speech & Hearing Center is the only facility in southeast Tennessee that has a certified Auditory Verbal Therapist (AVT). We are the only facility within a more than 100 mile radius from Chattanooga who offers AVT services.

Why is AVT important for Cochear Implant/How is AVT different from Speech Therapy?

  • AVT can begin as soon as a child has been diagnosed with a hearing loss (this includes infants). The earlier the therapy is initiated, the better the results. Even before a cochlear implant (if that is the medical decision the family makes).
  • Auditory verbal therapists have been highly trained to use specialized techniques in order to maximize hearing as the primary sense responsible to learning language.
  • Parent guidance, coaching, and demonstration is a primary pillar of this therapy so that parents ultimately become the primary facilitator of their child’s spoken language development.
  • Auditory skills are constantly monitored in order to provide the highest quality of hearing technology in collaboration with the patient’s audiologist.
  • Like speech therapy, AVT addresses speech and language as well as:
  • The hierarchy of auditory skills needed to comprehend speech and language
  • Social/pragmatic skills necessary to integrate into the “hearing world”
  • Cognitive skills needed to succeed in the mainstream classroom

 What should I do if I think my child’s cochlear implant equipment is not working?

First, attempt some of the basic troubleshooting procedures listed in your user’s guide. Attempt to determine which part (processor, cable/cord, coil, battery pack/BTE controller or batteries) of your child’s device is not working. You can access specific troubleshooting information on the manufacturers’ Web sites.

Troubleshooting information for specific devices may be found at:
    
Advanced Bionics
MED-EL

Who do I call to get help with troubleshooting my child’s cochlear implant equipment? How do I report broken equipment?

Patients can contact the cochlear implant manufacturer’s customer service department directly.
           
Advanced Bionics Customer Service: 877-829-0026
MED-EL Customer Service: 888-633-3524

Who do I call with insurance questions?  Will my insurance cover hardware and batteries related to the cochlear implant?

It is always recommended that you contact your insurance carrier directly for questions related to your specific insurance plan. 

What is an FM system?

An FM system is an assistive listening device that helps the patient in noisy situations or when the speaker is not up close to them. Many children utilize FM systems in classroom settings.  Please discuss the use of a personal FM receiver with your cochlear implant audiologist.

Are cochlear implants compatible with assistive listening devices? 

Yes, cochlear implants are compatible with assistive listening devices.  Each cochlear implant manufacturer has a different approach in terms on compatibility.

Who are the manufacturers of cochlear implants that the Speech & Hearing Center will be servicing?

Advanced Bionics

MED-EL 

Cochlear