Transcript Slide 1
Becoming Familiar with Cochlear Implants Name Title
Sonova and Advanced Bionics
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Our Commitment to the Future of Hearing
Advanced Bionics • • Most advanced cochlear implants Cutting-edge technology • Sonova • • Global market leader Full spectrum of hearing solutions • Medical division
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
The ear consists of four main parts:
Outer Ear Brain Inner Ear Auditory Nerve Middle Ear
The Outer and Middle Ear
Ear Drum Bones of the Middle Ear
The Inner Ear
Cochlea Brain Auditory Nerve
Without functioning sensory cells in the cochlea, sound information cannot reach the brain for processing.
Hearing Loss Brain Damaged Sensory Cells in Cochlea
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
The Audiogram
Audiogram: A graph that shows an individual ’ s type and degree of hearing loss.
Loudness
Soft to Loud Frequency Low Pitch to High Pitch
Normal Hearing x o x o x o x o x o
Moderate to-Severe Loss x o x o x o x o x o x o
Severe-to Profound Loss x o x o x o x o x o
Sensorineural
Types of Hearing Loss
Conductive Mixed
Sensorineural Hearing Loss x o x o x o x o x o x o
Conductive Hearing Loss < x o x o < x o < x o < x o < x o
Mixed Hearing loss < x o x o < x o < x o < x o < x o
What you will learn today: • How the ear works • How to interpret the audiogram •
Cochlear implant candidacy
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Candidacy guidelines Steps to determine candidacy
• Treatment options for hearing loss • Management of a child with a cochlear implant
Range of hearing for a cochlear implant candidate.
Who is a Candidate for a Cochlear Implant?
Who is a Candidate for a Cochlear Implant?
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
Pediatric Cochlear Implant Candidacy
• • • • • Audiologic Evaluation Medical Evaluation Speech Language Evaluation Psychological Evaluation Educational Evaluation
Team Approach Teacher Psychologist Surgeon & Pediatrician Child SLP Caregivers Audiologist
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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 Cochlear Implants
• Bilateral Implants • Industry trend • • Simultaneous vs. sequential Benefits: • Improved directionality • Improved listening in noise • Clarity of speech • Developmental
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
Treatment Options for Hearing Loss
Hearing Aids Cochlear Implants Systems
Treatment Options for Hearing Loss Hearing Aids
Behind-the E ar In-the-Canal In-the-Ear
How is a Cochlear Implant Different From a Hearing Aid?
Hearing Aid
Acoustically amplify sound.
Cochlear Implant
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.
How Does a Cochlear Implant Work?
A Cochlear implant system consists of two main parts: Internal Implant External Equipment
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HiRes 90K ™ Advantage High-Performance Hearing
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Unmatched Technology
Unlimited ways to deliver stimulation 16 independent current sources Low-profile design Removable magnet Industry ’ s highest case impact resistance- up to 6 Joules 1,2 Industry ’ s fastest stimulation rates Reliability you can count on with 99.8% CSR at one year 3
HiRes 90K TM Implant HiRes 90K™ Advantage Implant
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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.
Cochlear Nucleus CI512 Cochlear Implant Technical Specifications. N33741F 1ss1 Jun09.
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
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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 Cable Neptune Battery Compartment
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Headpiece
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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
HiResolution™ Sound
What do parents want for their child?
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…to be able to hear like everyone else does
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…to fit in
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…to realize their potential
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…to be successful in today
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s world
How Does a Cochlear Implant Work?
• • • • • • 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?
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
Pediatric Management
• Audiologic Management • Rehabilitation • Family Commitment • School Support
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
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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.
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Resources & Support:
For Educators, Therapists, Recipients, and Families
Online:
• Live chat • Click on icon • AdvancedBionics.com
HearingJourney.com
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Customer Care:
• Speak with an audiologist at 1-877-829-0026 • • Monday through Friday, 5 am to 5 pm PST Ask questions via email: • [email protected]
Education and rehabilitation are keys to success with a cochlear implant.
Visit Advanced Bionics online today at AdvancedBionics.com
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