1. Cochlear Implants
Presented by:
Marcia Tonya Outler

2. Cochlear Implants
The purpose of this presentation is to discuss the medical and scientific aspects of cochlear implantation including:
Possible benefits and risks
History of cochlear implants
Choices in deafness
Deaf culture
Ethics
Educating children with cochlear implants
3. Cochlear Implantation:a Medical and Scientific Procedure
A cochlear implant is a small electronic device that provides sound to children and adults who have a severe to profound hearingloss (70 to 90 dB) who do not benefit from hearing aids.
Cochlear implants enable sound to reach the brain by effectively bypassing the part of the ear which is damaged, to directly stimulate the hearing nerve electronically.
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6. Hearing Loss, Americas Invisible Disability
Affects approximately 10% of the population28 million people
Over 4,000 babies are born deaf each year
Every day, 33 babies are born with a hearing loss in America (8-9 with a profound loss)
Almost 1/3 of all cases are caused by loud noise
Noise induced hearing loss is the most common work related disability
Loy and Roland (2009)
7. 8. Hearing loss effects every aspect of a persons life and lives around them.
Communication
Childhood
Marriages
Parenting
Friendship
Dating
Workplace
Ability to acquire information
9. Hearing loss can also affect one:
Physically
Cognitively
Behaviorally
Socially
10. Cochlear Implant Three Parts:
Receiver- surgically implanted beneath the skin above the ear. A small wire containing an array of electrodes is threaded through the cochlea.
Microphone-part of the headpiece that rest on the outer side of the skin that covers the internal receiver. The microphone picks up sound and transmits it to the speech processor.
Speech Processor-a microcomputer that can be worn behind the ear that transmits the signal to the receiver and electrodes, which then stimulates the auditory nerve fibers, which in transmits the signal to the brain where sound is interpreted.
11. 12. 13. Cochlear Implant Surgery
Operation lasts about three hours
Usually performed as outpatient
Performed by Otolaryngologist
14. Pre-implantation Process
Medical Evaluation. ENT examines the outer, middle and inner ear (otological examination)
Physical examination
Imagery Evaluation: x-ray, CT scans, MRI
Audiological evaluation: Audiologist tests hearing.
Speech and Language Testing
Psychological examination
Farley (2002)
15. 16. Risks of Cochlear Implantation
General Anethesia Risk
Meningitis
Cerebrospinal fluid leakage
Infection of the skin wound
Blood or fluid collection at the site of surgery
Attacks of dizziness or vertigo
Tinnitus
Taste Disturbances
Numbness around the ear
Reparative granuloma FDA (2009)
17. Possible Positive Effects of CI
Many CI users are able to detect medium to loud sounds including speech sounds and can learn to recognize familiar sounds.
Many CI users find it easier to communicate. More than 50% are able to understand speech without visual cues.
In clinical studies of adults who experienced hearing loss after they had developed speech, 90% reported improved communication without speech reading.
75% reported communicating more effectively when at a dinner party, when driving a car, with family members, with family and when ordering at a restaurant.
Some can talk on a telephone and enjoy music.
Olsen (2003)
18. Researchers Proposed List of Factors Thought to Influence CI Success
Length of time the person was deaf before implantation
Length of time the implant was utilized
Language and Listening skills before implantation
Cognitive and attention abilities
Intensity of therapy after implantation
Type of language programming
Resources and involvement of patients family
19. No one can predict how much benefit any one person will receive from the implantation.
20. 21. History of Cochlear Implants
Two centuries ago Italian Count Alessandro Volta inserted metal rods in his ear canals and connected them to an electric circuit.
1957 in Paris Charles Eyries and A. Djourno
1961 William House and James Doyle
1970s F. Blair Simmons and Robert White-Stanford University and Donald Eddington University of California
1970s Parallel developments in Vienna, Austria and Australia
1977 Professor Kurt Burian implanted the first multichannel cochlear implant. The device had been developed by Scientists Ingeborg and Darwin Hochmair.
22. 1989 Australian Cochlear implant was approved by the U.S. FDA for adults.
1990 FDA approved age for ages 2 and up
1998 FDA approved 18 mos. and up
2002 FDA approved 12 mos. and up
2005 First three recipients were implanted with Cochlears TIKI device, a totally implantable cochlear implant in Melbourne, Australia as part of a research project.
23. Deaf Culture and Conflicts as the 21st Century Turned
Modern Language Association announced that American Sign Language was among the 15 most commonly taught languages.
Doctors and scientist were approaching a time when they would be able to identify and correct genetic deafness. Human Genome Project.
1970s Opposition to cochlear implants
1985 Deaf Position Paper-medical concerns and cultural genocide by doctors
24. 25. Characteristic of Educational Programsto Support Children with CIs
Display unconditional acceptance of a child with a CI
Recognize the potential asassistive technology
Respect the parents choice
Acknowledge the contribution that audition makes in spoken language
Places value on spoken language as an expressive communication tool
26. Provides aggressive auditory instruction
Offers age-appropriate and challenging instruction
Provides accommodations
Considers the childs communication needs
Provides administrative support of professionals
Chutes and Nevins (2008)
27. Communication Mode Options
American Sign Language
Signing Exact English
Total Communication
Cued Speech
Auditory/Oral
28. 29. My Reflection
History
Choices in Deafness
Deaf Culture
Technology and Medical Advances
Acceptance
30. 31. 32. References
Bahan, B., Hoffmeister, R. & Lane, H. (1996). A journey into the deaf world. San Diego, CA:Dawn Sign Press.
Biderman, B (1998). Wired for sound, a journey into hearing. Ontario, Canada: Trifolium Books, Inc.
Chute, P. & Nevins, M. School professionals working with children with cochlear implants. San Diego, CA: plural Publishing, Inc.
Farley, C. (2002). Bridge to sound with a bionic ear. MN: Periscope Press.
Humphries, T. & Padden, C. (2005). Inside deaf culture. Cambridge, MA. Harvard Univ. Press.
Loy, B. & Roland, P. (2009). Cochlear implants, what parents should know. San Diego, CA. Plural Publishing, Inc.
Murray, N. (1992). Cochlear implants and children: a handbook for parents, teachers and speech and hearing professionals. Washington DC: Alexander Graham Bell.
Olsen, W. (ed.) (2003). Mayo clinic on hear. Rochester, MN.: Mayo Clinic Health(ed.). Information & Kensington Publishing Corp., New York, NY.
Schwartz, S. (Ed.). (1996). Choices in deafness: a parents guide to communication options. Bethesda, MD: Woodbine House, Inc.
United States Food and Drug Administration. 2009 Center for devices and radiological health. Retrieved February 9, 2009, from http://www.fdagov/cdrh/cochlear/whatare.html. Retrieved February 9, 2009, from http:www.fdagov/cdrh/riskbeneft.html. Retrieved from http:www.fdagov/cdrh/faq.html.
Wikipedia. 2009. Retrieved February 9, 2009, from http://en.wikipedia.org/wiki/Cochlearimplants.