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What You Will Learn Today. How the ear works. How to interpret the audiogram. Treatment Options for Hearing Loss. Steps to determine cochlear implant candidacy. Management of a child with a cochlear implant. How the Ear Works. The ear consists of four main parts:. Brian. Inner Ear.

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What You Will Learn Today

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What You Will Learn Today

  • How the ear works.

  • How to interpret the audiogram.

  • Treatment Options for Hearing Loss.

  • Steps to determine cochlear implant candidacy.

  • Management of a child with a cochlear implant.


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How the Ear Works

The ear consists of four main parts:

Brian

Inner Ear

Outer Ear

Auditory Nerve

Middle Ear


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How the Ear Works

Outer and Middle Ear

Bones of the Middle Ear

Ear Drum


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How the Ear Works

Cochlea

Brain

Cochlea

Auditory Nerve


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What You Will Learn Today

  • How the ear works.

  • How to interpret the audiogram.

  • Treatment options for hearing loss.

  • Steps to determine cochlear implant candidacy.

  • Management of a child with a cochlear implant.


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The Audiogram

Audiogram: A graph that shows an individuals type and degree of hearing loss.


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The Audiogram

Frequency Low Pitch to High Pitch

Loudness

Soft to Loud


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The Audiogram

Normal Hearing

Mild Loss

Moderate Loss

Moderate Severe Loss

Severe Loss

Profound Loss


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The Audiogram

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The Audiogram

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The Audiogram

Three Types of Hearing Loss

Sensorineural

Conductive

Mixed


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The Audiogram

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The Audiogram

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The Audiogram

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Hearing Loss

Brain

Without functioning hair cells sound information cannot reach the brain for processing.

Damaged Hair Cells in Cochlea


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What You Will Learn Today

  • How the ear works.

  • How to interpret the audiogram.

  • Treatment Options for Hearing Loss.

    • Hearing Aids

    • Cochlear Implants

  • Steps to determine cochlear implant candidacy.

  • Management of a child with a cochlear implant.


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Treatment Options for

Hearing Loss

Cochlear Implants

Hearing Aids


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Treatment Options for

Hearing Loss

Hearing Aids

Behind-the-ear

In-the-Canal

In-the-Ear


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How is a Cochlear Implant

Different From a Hearing Aid?

  • Hearing Aids—acoustically amplify speech.

  • Cochlear Implants—convert speech information into electrical signals.

  • Hearing Aids—rely on the responsiveness of healthy, inner ear sensory cells.

  • Cochlear Implants—bypass the inner ear sensory cells and stimulate the hearing nerve directly.


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How Does a Cochlear Implant Work?

A Cochlear Implant consists of two main parts:

Internal Equipment

External Equipment

or


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Internal Equipment

HiRes™ 90K

Internal Electronics

Electrode Array

3 turn gold wire coil

Removable Magnet


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External Equipment

For a Cochlear Implant

Speech Processors

Battery Supply

Headpiece

Microphone

Cable


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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 internal portion of the device.

  • The internal device delivers the sound to the electrodes.

  • The electrodes stimulate the hearing nerve.

  • The hearing nerve sends the signal to the brain for processing.


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What You Will Learn Today

  • How the ear works.

  • How to interpret the audiogram.

  • Treatment Options for Hearing Loss.

    • Hearing Aids

    • Cochlear Implants

  • Steps to determine cochlear implant candidacy.

  • Management of a child with a cochlear implant.


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Steps to Determine Pediatric

Cochlear Implant Candidacy

  • Audiologic Evaluation.

  • Medical Evaluation.

  • Speech Language Evaluation.

  • Psychological Evaluation.

  • Educational Evaluation.

  • Evaluation of parent expectations.


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Who is a Candidate

for a Cochlear Implant?

  • Adults (18 years+)

  • 70dB thresholds

    Less than 50% speech recognition with hearing aids.

    Children (18 mos+)

  •  70dB thresholds

  • General plateau in auditory development.

  • Children (12mos-18mos)

    >90dB thresholds

    General plateau in auditory development.


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Candidate Profile

Age 2

Speech recognition with Hearing Aids:

Able to detect the pattern differences in words.

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Candidate Profile

A

Age 6

Speech recognition with Hearing Aids:

40%

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What You Will Learn Today

  • How the ear works.

  • The Audiogram

  • Hearing Loss

  • How a cochlear implant works

  • Steps to determine cochlear implant candidacy.

  • Management of a cochlear implant.


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Management of a Child

with a Cochlear Implant

  • Audiologic management.

  • Rehabilitation.

  • Parent commitment.

  • School Support.


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Audiologic Management

“Initial Stimulation” or “Hook Up”


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Audiologic Management

  • T level—electrical current necessary to just detect the presence of sound.

  • M Level—electrical current necessary to hear the incoming sound as loud but comfortable.

  • Sound Coding Strategy—Methodology or “formula” used to transcribe acoustic sound into an electrical code.


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Audiologic Management

Mapping very young children:

  • Clinical Experience

  • Objective Measures


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Audiologic Management

Follow Up Mapping


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Rehabilitation

Rehabilitation is KEY

A cochlear implant is NOT a “cure” for hearing loss.


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Parent Commitment


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School Support

  • Understand what a cochlear implant is and how it functions.

  • Understand the external equipment and how to complete troubleshooting.

  • Know where to find support and resource materials.

  • Openly communicate with the student’s cochlear implant center.


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Advanced Bionics

Bionic Ear Association (BEA)

Do you want to learn more about cochlear implants?

  • The BEA provides support, information, education, and guidance for cochlear implant candidates, cochlear implant users, hearing health care professionals, and school personnel.

  • Join the BEA today. You can join by visiting www.bionicear.com. Click on support for details.


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Bionic Buddy

Questions and Discussion….


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