Cochlear Implants in Children
The pediatric cochlear implant program at the University of Chicago Medicine Comer Children’s Hospital has the tools to bring clear spoken language and enjoyable musical sounds to a deaf child’s silent world. A safe, proven medical treatment, the cochlear implant enables your child to hear by transmitting sound beyond the damaged portion of the ear.
Dana Suskind, MD, leads our expert and dedicated cochlear implant team. Our highly trained is made up of surgeons, audiologists, speech pathologists, child life specialists, a social worker, a geneticist, a developmental pediatrician and a psychologist. Working together, we make sure each step of the process is executed well and successfully.
Our goal first — and always — is the best interest of your child. We are experts in determining if a cochlear implant is the best choice or if another alternative would serve your child better. To make this determination, we thoroughly evaluate your child’s health and hearing.
Initial evaluation is done on an outpatient basis. It is noninvasive and usually takes several hours.
The medical evaluation is accomplished with the use of advanced imaging technology, which enables our surgeons to view and evaluate the structure of your child’s inner ears. The two types of imaging technologies typically used for this assessment are MRI (magnetic resonance imaging) and CT (computed tomography).
Conducted by our team of audiologists, the hearing evaluation is multifaceted. Your child undergoes a series of tests individually tailored to him/her — every child is different. Types of assessments used during a hearing evaluation include the following:
- Behavioral audiometric evaluation, with and without hearing aids
- Speech perception testing to determine the functional benefit of hearing aids
- Immitance measurements to determine if the child has or may have a tendency toward middle ear fluid
- Electrophysiologic testing to gather information about inner ear and auditory nerve function
Parents are asked to complete questionnaires to help determine functional hearing and hearing aid benefit.
Speech and language evaluation and educational plan assessment are ongoing components of the process involved in helping your child attain appropriate developmental levels.
If cochlear implant is deemed the best option for your child by the multidisciplinary team (which includes you), the next step is to schedule surgery. The surgery is a routine, outpatient procedure, which usually takes one to three hours. It involves a small incision, which allows the surgeon to properly place the implant within the inner ear.
At Comer Children’s, you may wait in the operating room until the anesthesia takes effect and your child is asleep — one of many extra steps the cochlear implant team takes to assure the best experience for your child and for you. For your comfort, we can also arrange an overnight stay for your child and family.
Three to four weeks after surgery, your child returns to have the implanted device activated. This involves linking the implanted internal receiver to the external speech processor. The audiologist creates the initial MAP or program, which allows your child to hear sound for the first time with the cochlear implant.
This is a truly momentous occasion — the moment at which your child moves from a world of silence into a world of sound. Our surgeon and staff celebrate this major turning point in your child’s life with you at a "Hearing Birthday" party, which marks a totally new beginning for your child and family.
Once the cochlear implant is activated, your child returns to the multidisciplinary team for check-ups and therapy on a regular basis. Typically there are evaluations at the two-week, one-month, three-month, six-month and nine-month marks. At each evaluation, your child’s speech processor is remapped, and additional testing is provided as needed. Each child hears differently, and our audiologists excel at matching programs to each child’s unique style of hearing.
After the first year, audiograms and speech perception tests are given every six months for two to three years, after which they are given annually. Programming is done at the same intervals, and speech and language evaluation is done once a year. If necessary, your child may require more frequent follow-up visits.
If you live far away and/or it is not convenient for you to come here on a regular basis, we work with you to find health care professionals in your area who can provide care that is both appropriate and convenient.
We have a support team you can join if your child has a cochlear implant here. The team will put you in touch with other families whose children have also received cochlear implants at Comer Children’s as well as with the professionals dedicated to helping you and your child.
Frequently Asked Questions
A cochlear implant is a safe, FDA-approved medical device that transmits sound past the damaged hair cells of the ear, enabling deaf children to hear electronically. The internal portion — the implant — is positioned in the cochlea of the ear. The external portion — the processor — is positioned close to the child’s outer ear. The processor picks up sounds with microphones and sends them to the implant, which stimulates the hearing nerve directly.
How natural hearing works
How cochlear implant hearing works
Ear canal: Sound moves through the ear canal and strikes the ear drum
Sound processor: External sound processor captures sound and converts it into digital signals
Eardrum and bones: Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion
Digital signals: Processor sends digital signals to internal implant
Inner ear: The motion causes the fluid inside the inner ear (cochlea) to move the hair cells inside the inner ear
Electrode array: Internal implant converts signals into electrical energy, sending it to an electrode array inside the cochlea
Hearing nerve: Hair cells change the movement into electric impulses, which are sent to the hearing nerve in the brain, enabling the person to hear.
Hearing nerve: Electrodes stimulate the hearing nerve, bypassing damaged hair cells. The brain perceives the signals as sound, enabling the person to hear.
The cochlea is the organ of hearing. This pea-sized structure, located deep inside the ear, sends sound information to the brain where it is heard as sound. Inside the cochlea are very delicate hair cells, which enable the individual to hear different pitches and rhythms of sound. If the hair cells are damaged, the individual has severe to profound sensorineural hearing loss.
For some children, a hearing aid is simply not enough. Hearing aids only amplify sound. For children who have severe-to-profound hearing loss, making sounds louder does not make them clearer. For these children, even the most advanced hearing aids will not work effectively. While hearing aids may provide minimal benefit to some, what they hear will not be clear. They will find it difficult to understand speech and other sounds. With even the best hearing aid, children with severe to profound hearing loss are unable to interpret sounds well enough to learn to understand the spoken word and to develop the ability to speak.
In contrast to a hearing aid, a cochlear implant does not make sounds louder — instead it bypasses the damaged part of the ear, sending sounds directly to the auditory (hearing) nerve, which mirrors the intricacies of natural hearing for your child.
Cochlear implants are not for everyone. To know whether a cochlear implant may be right for your child, you first need to know the extent of the hearing loss. Children with mild to moderate hearing loss are not candidates for cochlear implants. Hearing aids and other forms of amplification can usually help them. Cochlear implants are most likely to help children who have severe to profound sensorineural hearing loss (nerve deafness). Children with this type of hearing loss get little or no benefit from hearing aids.
The earlier a child receives an implant, the greater the potential to develop listening/speaking skills at the same level as peers who have no hearing loss. The multidisciplinary cochlear implant team at the University of Chicago Medicine Comer Children’s Hospital, as well as audiologists and specially trained teachers in the educational system in your community, have the ability and resources to help your child make as much progress as possible with listening/speaking skills.
Finally, for your child to be successful with a cochlear implant, your family must have a strong commitment. You are the most important part of the process!
There are many families whose children have had cochlear implants at Comer Children’s. They would be happy to share their experiences with you to help you while you are in the decision-making process.
The cochlea is fully formed at birth, so your child will not outgrow the implant. The skull is almost fully grown by the time a child is two years old, and the electrode array is designed to accommodate this skull growth in children under two.