Cochlear Implant Brochure 2 Boklet
Cochlear Implant Brochure 2 Boklet
Cochlear Implant Brochure 2 Boklet
Table of Contents
What is a cochlear implant? 3
Listening practice 10
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What is a Cochlear Implant?
A cochlear implant system is a surgical option which restores partial hearing to
individuals with severe to profound sensorineural hearing loss who do not benefit
from conventional hearing aids. It is comprised of 2 main components:
2. External (sound processor): This is externally worn behind the ear or on the
head. It consists of a speech processor, microphone, and battery pack.
Cochlear implant systems convert everyday sounds into coded electrical signals.
These stimulate the hearing nerve which then relays the information to the
hearing center of the brain. A cochlear implant will not restore hearing to normal
levels. However, the implant can provide the necessary stimulation to restore
sound awareness and improve speech understanding.
Candidacy
In addition to this, a full clinical evaluation and CT scan (sometimes a MRI scan)
of the ears is necessary to evaluate the condition of the inner ear and
surrounding bone.
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Cochlear Implant Systems (Devices)
There are currently 3 FDA approved multichannel cochlear implant systems
available in the United States. Although there are unique differences among the
cochlear implant systems, they all function in a similar manner.
Cochlear Americas
http://www.cochlear.com/wps/wcm/connect/us/home
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Cochlear Implant Surgery
Cochlear implant surgery is performed at Lahey Hospital & Medical Center in
Burlington, MA. You will undergo general anesthesia for the surgery. An incision
will be made behind your ear. The bone behind your ear will be removed to
access the inner ear where the cochlear implant electrode will be placed. The
internal receiver will be implanted above and behind the ear, under the skin. The
average duration of surgery is 1.5-2 hours. The average recovery time in the
hospital after surgery is 2 hours. You will leave the hospital and return home on
the day of surgery unless you have serious health conditions or side effects from
the anesthesia which require overnight hospitalization for observation.
• The incision behind your ear will be covered by strips of tape which
will be removed at your post-operative visit. The stitches are buried
under your skin and do not require removal.
• It is important to keep the ear incision dry after surgery until the
first follow-up visit. You can use a crumpled wash cloth to protect the
ear and incision line from water exposure. Some patients wash their
hair in a sink for several days after surgery.
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You may experience any of the symptoms below. These are
normal and expected to resolve over time.
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Cochlear Implants and Meningitis
Patient who receive a cochlear implant are considered to be at a slightly higher
risk for contracting a certain type of bacterial meningitis caused by Streptococcus
pneumoniae (Pneumococcus). The Center for Disease Control and Prevention
(CDC) in conjunction with the Advisory Committee on Immunization Practices
(ACIP) recommend that all cochlear implant recipients be vaccinated to reduce
the risk of meningitis.
They recommend that adults 19 years of age or older who are to receive a
cochlear implant should receive an initial dose of Prevnar 13 (pneumococcal
conjugate vaccine - PCV13), followed by a dose of Pneumovax 23
(pneumococcal polysaccharide vaccine - PPSV23) at least 8 weeks later.
http://www.cdc.gov/vaccines/vpd-vac/pneumo/vac-PCV13-adults.htm
Both of these vaccinations are offered in our clinic upon request. Alternatively,
you may wish to have these vaccinations administered by your primary care
physician (bring a copy of this advisory with you).
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Using the Cochlear Implant Device
Your ear will be allowed to heal for approximately 3 weeks before your implant is
activated (turned on). If you wore a hearing aid in the implanted ear before
surgery, you will not likely notice any hearing with the hearing aid in this ear
during these 3 weeks.
Once your wound has healed and surgical swelling over the implant has
subsided, your implant will be activated by one of our implant audiologists. You
will learn and adjust with the cochlear implant more quickly in the beginning. For
this reason, numerous programming changes are needed in the first year after
surgery.
We will see you for multiple follow-up testing and programming sessions in the
first year.
- Initial activation
- 1 week after initial activation
- 4 weeks after initial activation
- 3 months after initial activation
- 6 months after initial activation
- 12 months after initial activation
After the first year, patients are normally seen once a year. These yearly
appointments are very important. We want to make sure you continue to do well
with the cochlear implant.
About 3 weeks after surgery, you will be fit with the outside part of the cochlear
implant. This time allows your ear to heal. The main outside piece is called the
sound processor. It has to be programmed for you to hear sound through the
implant. Reprogramming is done multiple times thereafter. As your understanding
with the cochlear implant gets better, less reprogramming visits are needed.
To begin, the speech processor is put behind your ear. The outside magnet (coil)
is put on your head. The outside magnet and inside magnet connect to one
another. The coil is connected to the speech processor through a transmitting
cable.
Next, the programming of the speech processor begins. The speech processor is
connected to the audiologist’s computer. Individual electrodes of the implant are
stimulated. You will hear a series of beeps, sounds or tones. The audiologist will
measure your response to these sounds. We are determining the levels that are
loud but comfortable. We may also measure sounds that are very soft.
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After measuring these sounds, the speech processor is turned on. This enables
you to hear the sounds that are around you, including speech. The volume will be
increased slowly. Hearing speech through your cochlear implant may sound
unnatural initially. The sound you hear on the first day of listening is different for
every patient. For some, speech may sound like “beeps”, while others it may
sound like bells, buzzing, etc. Typically if it sounds like a voice, it is not a natural
voice. Patients describe speech as sounding “mechanical”, “cartoonish” like
“Mickey Mouse” or “Donald Duck”. The quality of the sound will get better with
time and patience.
Finally your listening programs are saved to the speech processor. We will then
go over how to use, troubleshoot, care for and maintain your equipment.
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Listening Practice
With each day, with each week, you will hear and distinguish more sounds.
Learning to listen again and understand what you are hearing takes time and
effort. Be patient. Your family and friends should speak to your normally, and
should not raise your voices. Having others read books, magazines, and
newspapers while following along is a good way to practice listening. Listening to
audio books while reading along is a good way to practice on your own. Please
ask your audiologist other ways or ideas that you can learn and practice at home.
There are also some free resources available online which you can listen and
practice with at home. Some of these programs include:
The Listening Room sponsored by Advanced Bionics has free activities and
resources to support the development of speech, language and listening.
Available at: http://hearingjourney.com/Listening_Room/preview.cfm?langid=1
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Connect with Other CI Recipients
It is often helpful to connect with other cochlear implant recipients to share
information and support. The listings below are for local groups of adults with
hearing loss who use cochlear implants and other hearing technologies.
http://necisupport.org/index.html
http://hearingloss.org
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What to Do if Your Equipment Breaks
At some point your outside equipment may stop working. When this happens,
your equipment may need to be repaired or replaced. Please keep in mind that
you should have back up equipment that you can use. You received back up
equipment at your initial activation. It should be in your kit.
Call the clinic if you are still having a problem (781-337-6860). Ask for a cochlear
implant audiologist. If we are not available, please leave a message. We will
contact you as soon as possible.
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Warnings with a Cochlear Implant
- Be careful when playing sports and in certain activities (contact sports,
bicycling, rollerblading) without a helmet.
- Try not to hit your head during activity (football, soccer, hockey, etc.).
- If the inside implant stops working (rare), then you may need another
surgery. This is called a “revision surgery”.
- The US Food and Drug Administration (FDA) does not allow certain
imaging (MRI= magnetic resonance imaging) with some cochlear implants.
Check with your implant team before getting a MRI scan.
- A treatment for some types of cancer (Ionizing radiation) will hurt the
inside implant.
If you have a medical problem or question, please contact your cochlear implant
doctor.
If you plan on having any of the above procedures please inform your cochlear
implant doctor.
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Tips for Traveling
- Take extra parts (like a back-up speech processor, battery pack, coil and
cables) with you in case of emergency.
- Take plenty of batteries (disposable or rechargeable). If you use
rechargeable, do not forget your battery charger (and adapter if needed).
- Remember to take you drying jar or Dry and Store box with you so you
can put your processor in it overnight. This is important if you will be
somewhere with high humidity.
Will my implant send signals that can interfere with the plane’s navigational
instruments?
Your implant cannot get in the way of the plane’s systems. Your implant sends
out radio frequency signals. These are very short range (less than five feet from
the outside coil). Your remote control (if applicable) does send out high frequency
radio waves and should be turned off during take-off and landing. If your remote
does not have an “off” switch, do not use it.
Like other electronic devices, should I turn off my speech processor during
take-off and landing?
No. Cochlear implant patients DO NOT have to turn off their speech processors
when instructions are given to turn off cell phones, music players, or anything
with an on/off switch. The FAA views cochlear implants as within the Hearing Aid
category.
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Cochlear Implant Data Sheet
Imaging Studies Date
CT Scan
MRI Scan
(If applicable)
Vaccination Date
Date Date
Surgery Surgery
Activation Activation
Warranty
Model Serial Number Expiration
Device Internal
External
Warranty
Model Serial Number Expiration
Device Internal
External
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Cochlear Implant Teams:
Elizabeth Toh, MD
Surgeon
Phone: 781-744-8451
Email: Elizabeth.Toh@lahey.org
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