Becoming Familiar with Cochlear Implants

NameTitle

• Advanced Bionics• Most advanced cochlear implants

• Cutting-edge technology

• Sonova • Global market leader

• Full spectrum of hearing solutions

• Medical division

Sonova and Advanced BionicsOur Commitment to the Future of

Hearing

What you will learn today:

• How the ear works

• How to interpret the audiogram

• Cochlear implant candidacy

• Treatment options for hearing loss

• Management of a child with a cochlear implant

Outer Ear

Middle Ear

Inner Ear

Auditory Nerve

Brain

The ear consists of four main parts:

Ear Drum

Bones of the Middle Ear

The Outer and Middle Ear

Cochlea

Auditory Nerve

Brain

The Inner Ear

Without functioning sensory cells in the cochlea, sound information cannot reach the brain for processing.

Damaged Sensory Cells in Cochlea

Hearing LossBrain

What you will learn today:

• How the ear works

• How to interpret the audiogram

• Cochlear implant candidacy

• Treatment options for hearing loss

• Management of a child with a cochlear implant

Audiogram: A graph that shows an individual’s type and degree of hearing loss.

The Audiogram

Loudness

Soft toLoud

Frequency Low Pitch to High Pitch

xo ox xo ox xo

Normal Hearing

xoox

ox ox oxox

Moderate- to-

Severe Loss

xoox

ox ox oxSevere-to- Profound

Loss

Types of Hearing Loss

Sensorineural

Conductive

Mixed

xo<

xo<xo o ox x

xo< < <

Sensorineural Hearing Loss

< < < < <

xo xo xo o ox xxo

Conductive Hearing Loss

< <<

< <

xo xo xo o ox xxo

Mixed Hearing loss

What you will learn today:

• How the ear works

• How to interpret the audiogram

• Cochlear implant candidacy• Candidacy guidelines• Steps to determine candidacy

• Treatment options for hearing loss

• Management of a child with a cochlear implant

Who is a Candidate for a Cochlear Implant?

Range of hearing for a cochlear implant candidate.

Adults (18 years+)• Severe-to-profound, bilateral sensorineural hearing loss• Less than 50% speech recognition with hearing aids on

open-set sentence recognition

Children (12 months - 2 years)• Profound, bilateral sensorineural deafness (> 90 dB HL)• Little or no benefit from hearing aids

Children (2 years - 17 years)• Severe-to-profound, bilateral sensorineural deafness • Little or no benefit from hearing aids

Who is a Candidate for a Cochlear Implant?

• Audiologic Evaluation

• Medical Evaluation

• Speech Language Evaluation

• Psychological Evaluation

• Educational Evaluation

Pediatric Cochlear Implant Candidacy

Team Approach

Psychologist

SLP

Audiologist

Caregivers

Surgeon &Pediatrician

Teacher

Child

Audiological Evaluation• Determine the type and degree of hearing loss

• Air & bone conduction thresholds for each ear• ABR & OAEs

• Assess the child’s current amplification system• Aided sound field testing• Aided speech perception testing

• Counseling• Address realistic expectations• Device selection• Post-operative follow-up

Medical Evaluation

• Determine cause of hearing loss • Assess status of middle ear & cochlea• CT scan/MRI• Counseling

• Hearing loss• The surgical procedure

• Typically out-patient and performed by an otolaryngologist (ENT) or otologist (ear specialist)

• Post-surgical considerations

• Bilateral Implants• Industry trend• Simultaneous vs. sequential• Benefits:

• Improved directionality• Improved listening in noise• Clarity of speech• Developmental

Bilateral Cochlear Implants

Speech & Language Evaluation• Areas assessed

• Vocabulary - knowledge of single words• receptive • expressive

• Language - word combinations, grammar• receptive

• expressive • Articulation/Intelligibility• Reading skills

Developmental Evaluation

• Assessment of non-verbal & verbal IQ• Verbal IQ assessed when appropriate

• Counseling for family• Impact of hearing loss on the family unit

• Assessment of child’s learning style• Assessment of any other underlying

issues• Serves as a baseline evaluation

Educational Evaluation

• Areas to consider:• Communication methodology• Support services • Speech/language and

auditory skill development• Professional training

What you will learn today:

• How the ear works

• How to interpret the audiogram

• Cochlear implant candidacy

• Treatment options for hearing loss

• Management of a child with a cochlear implant

Cochlear Implants Systems

Treatment Options for Hearing Loss

Hearing Aids

Behind-the-Ear

In-the-Ear

In-the-Canal

Treatment Options for Hearing LossHearing Aids

How is a Cochlear Implant Different From a Hearing Aid?

Hearing Aid Cochlear Implant

Acoustically amplify sound.

Convert sound into electrical signals.

Rely on the responsiveness of healthy inner ear sensory cells.

Bypass the inner ear sensory cells and stimulate the hearing nerve directly.

A Cochlear implant system consists of two main parts:

Internal Implant

External Equipment

How Does a Cochlear Implant Work?

or

HiRes 90K™ AdvantageHigh-Performance Hearing

• Unlimited ways to deliver stimulation• 16 independent current sources• Low-profile design• Removable magnet• Industry’s highest case impact resistance- up to 6 Joules1,2

• Industry’s fastest stimulation rates• Reliability you can count on with 99.8% CSR at one year3

HiRes 90K™ Advantage Implant HiRes 90KTM Implant

Unmatched Technology

1. Holtkamp V. Cochlear Implants Under Impact Loading. Evaluation of Accident Scenarios. Determination of Load Limits, and Development of a Standardizable Test Procedure. Dissertation accepted by the Senate of Hannover Medical School, May 19, 2004.

2. Cochlear Nucleus CI512 Cochlear Implant Technical Specifications. N33741F 1ss1 Jun09.3. Advanced Bionics Reliability Update. 2012.

Harmony™ Sound Processor

HiResolution™ Bionic Ear System

Engineered to be Reliable•Industry Standard Reliability

• 99.8% CSR at 1 year³ for the current AB HiRes 90K Implant

•Built to withstand rain, perspiration and moisture

3. Advanced Bionics Reliability Update. 2012.

The World’s First and Only Waterproof Sound Processor

• Freestyle™ Design

• Built Kid Tough™

• Stylish and Discreet

•Durable and Easy to Use

•Ideal for All Ages and Lifestyles

Neptune Features

• Waterproof• Removable Controls• Powered by 1 AAA Battery

• Cost Effective • Full day of use with a single

disposable or rechargeable battery

• Universal Headpiece (UHP) and AquaMic

• Compatible with HiRes 90K™ and CII implant devices

NeptuneBatteryCompartment

Cable

Headpiece

• …to be able to hear like everyone else does

• …to fit in

• …to realize their potential

• …to be successful in today’s world

HiResolution™ SoundWhat do parents want for their child?

• Sound waves enter through the microphone.

• The sound processor converts the sound into a distinctive digital code.

• The electrically coded signal is transmitted across the skin through the headpiece to the implant.

• The implant delivers the sound to the electrodes.

• The electrodes stimulate the hearing nerve.

• The hearing nerve sends the signal to the brain where it is perceived as sound.

How Does a Cochlear Implant Work?

How Does a Cochlear Implant Work?

What you will learn today:

• How the ear works

• How to interpret the audiogram

• Cochlear implant candidacy

• Treatment options for hearing loss

• Management of a child with a cochlear implant

• Audiologic Management

• Rehabilitation

• Family Commitment

• School Support

Pediatric Management

Audiologic Management

• Goal is to assure access to sound adequate for auditory development

• Programming or “mapping” of the cochlear implant system

• Assessments at regular intervals to track auditory development

• Age-appropriate techniques & materials

Audiologic Management

CI CI CI CI CI

Rehabilitation is KEY

Parent Commitment

School Support • Understand what a cochlear implant is & equipment

troubleshooting • Assist in the management of the device and child• Perform behavioral listening checks on a daily basis• Know where to find support and resource materials• Maintain communication between the student’s parents, teachers and cochlear implant center

Summary

• Cochlear implants are an effective treatment for severe-to-profound sensorineural hearing loss.

• A multi-disciplinary approach is necessary when determining cochlear implant candidacy in children.

• Post-operative management of a child with a cochlear implant consists of programming of the sound processor and important rehabilitation.

• Parent commitment and school support are necessary components to ensure a child’s success with a cochlear implant.

Resources & Support:For Educators, Therapists, Recipients, and Families• Online:

• Live chat• Click on icon

• AdvancedBionics.com• HearingJourney.com

• Customer Care:• Speak with an audiologist at 1-877-829-0026• Monday through Friday, 5 am to 5 pm PST• Ask questions via email:

• ToolsForSchools@AdvancedBionics.com• ListeningRoom@AdvancedBionics.com• hear@AdvancedBionics.com

Education and rehabilitation are keys to success with a

cochlear implant.

Visit Advanced Bionics online today atAdvancedBionics.com!