COCHLEAR IMPLANT PROGRAMME

Introduction
Cochlear Implant (CI) programme conducts comprehensive assessments to determine whether hearing-impaired children/adults are suitable candidates for CI surgery. We provide services like the surgery and coordinate the post-operative services to those patients who were implanted.

What is a cochlear Implant?
Cochlear Implant is a hearing device that bypasses the inner ear and directly stimulates the hearing nerve thereby giving the sensation of sounds for people who have partially or totally lost their hearing. It is composed of two parts: (1) implant-which is surgically implanted and inserted into the inner ear and (2) speech/sound processor-worn outside and usually hangs over the ears similar to behind-the-ear hearing aids. Cochlear implants do not replace normal hearing and the benefits vary from one individual to another. There are many factors that contribute to the degree of benefit a user receives from a cochlear implant, including:
• Duration of deafness
• Age of deafness onset
• The number of surviving auditory nerve fibers
• The patient’s motivation to learn to hear and speak
• Parental support in habilitation program e.g. AV/ Speech-language therapy

Who needs a cochlear implant?
Patients who were diagnosed with severe to profound hearing loss who were fitted with appropriate hearing aids for at least 3-6 months, and found not to be benefiting from hearing aids amplification and/or those who are not receiving sufficient amplification are referred for CI evaluation. This evaluation will determine whether the patient is a suitable CI candidate or not.

Evaluation
A comprehensive assessment will include medical, audiological, speech and language and psychological (for children) investigations. An audiologist will assess the functional hearing with hearing aids while the speech therapist will conduct a specific speech and language assessments prior to the implantation. In order to qualify for a cochlear implant, patients (and his/her family) is(are) required to attend recommended assessments before the final evaluation can be made. After all the assessments and prior to the surgery, the doctor will order radiological examinations, which include X-ray and MRI.

Surgery
Cochlear implant surgery is performed by Otolaryngologist (ENT Specialist) under general anesthesia. An incision is made just behind the ear to access the mastoid cavity that leads to the middle and inner ears for electrode insertion. The surgery generally takes about two to three hours. An x-ray is taken after surgery to confirm the position of the implant. Generally, the patient will stay in the hospital for one or two days after surgery.

Post surgical management
About 3-4 weeks after the surgery, the surgeon will check the patient’s wound and clear the patient for CI activation. CI activation, or commonly known as “switch-on”, will be done by the audiologist. No testing will be done at this stage because the patient will have to adjust to how sounds are like with the CI activated. All issues relevant to the processor will also be discussed during this session. Switch-on sessions usually take about 1-1½ hours for unilateral cases and 2-2 ½ hours for bilateral patients.

In the first year post-implantation, frequent follow-ups are necessary to optimize the setting of the processor (also called MAPping). The audiologist will inform the patient or parents when they are supposed to come for MAPping. After the first year, when the MAPs become stable, we ask the patient to come annually and as the need arises (repairs, re-programming, etc.). Patients will continue with regular AV/ speech-language therapy after switch-on of the implant.


Visit our NUH Website