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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.


How the Ear Works

The ear consists of four main parts:

Brian

Inner Ear

Outer Ear

Auditory Nerve

Middle Ear


How the Ear Works

Outer and Middle Ear

Bones of the Middle Ear

Ear Drum


How the Ear Works

Cochlea

Brain

Cochlea

Auditory Nerve


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.


The Audiogram

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


The Audiogram

Frequency Low Pitch to High Pitch

Loudness

Soft to Loud


The Audiogram

Normal Hearing

Mild Loss

Moderate Loss

Moderate Severe Loss

Severe Loss

Profound Loss


The Audiogram

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The Audiogram

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The Audiogram

Three Types of Hearing Loss

Sensorineural

Conductive

Mixed


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


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.


Treatment Options for

Hearing Loss

Cochlear Implants

Hearing Aids


Treatment Options for

Hearing Loss

Hearing Aids

Behind-the-ear

In-the-Canal

In-the-Ear


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.


How Does a Cochlear Implant Work?

A Cochlear Implant consists of two main parts:

Internal Equipment

External Equipment

or


Internal Equipment

HiRes™ 90K

Internal Electronics

Electrode Array

3 turn gold wire coil

Removable Magnet


External Equipment

For a Cochlear Implant

Speech Processors

Battery Supply

Headpiece

Microphone

Cable


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.


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.


Steps to Determine Pediatric

Cochlear Implant Candidacy

  • Audiologic Evaluation.

  • Medical Evaluation.

  • Speech Language Evaluation.

  • Psychological Evaluation.

  • Educational Evaluation.

  • Evaluation of parent expectations.


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.


Candidate Profile

Age 2

Speech recognition with Hearing Aids:

Able to detect the pattern differences in words.

A

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Candidate Profile

A

Age 6

Speech recognition with Hearing Aids:

40%

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x


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.


Management of a Child

with a Cochlear Implant

  • Audiologic management.

  • Rehabilitation.

  • Parent commitment.

  • School Support.


Audiologic Management

“Initial Stimulation” or “Hook Up”


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.


Audiologic Management

Mapping very young children:

  • Clinical Experience

  • Objective Measures


Audiologic Management

Follow Up Mapping


Rehabilitation

Rehabilitation is KEY

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


Parent Commitment


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.


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.


Bionic Buddy

Questions and Discussion….


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