What is a cochlear implant?

The cochlear implant is an electronic device that provides sound sensation to a person with severe hearing loss or deafness. An implant does not cure hearing loss; instead, it bypasses the damaged part of the ear, stimulates the auditory nerve directly, and sends signals directly to the brain.

The cochlear implant consists of two parts — one is surgically implanted, the other is externally worn. With a cochlear implant, your child may be able to hear and speak better. Outcomes vary, however, based on the individual.

Who is a candidate for cochlear implant?

Cochlear implants are not appropriate for all children with hearing loss, but can have significant benefits for some children.

Your child may be considered for a cochlear implant at The Children’s Hospital of Philadelphia if:

• Your child has severe to profound sensorineural hearing loss in both ears
• Your child is receiving limited benefit from hearing aids
• There is a strong family commitment to continuing care and follow up for your child
• Your child has an educational plan that emphasizes development of auditory skills

Testing and evaluation

Evaluating your child for a cochlear implant is a multi-step process.  When you schedule your child’s first appointment, we will ask you some general questions about your child and his condition, including:

• Your child’s age
• How long your child has had hearing loss
• When your child’s hearing loss was detected
• If your child uses any type of hearing aid
• Your child’s educational placement
• Your child’s mode of communication, such as spoken language, sign language, or total communication
• Your goals and expectations for your child if he gets a cochlear implant

During your child’s first appointment with the Cochlear Implant Program team, we will examine your child and gather more information about his condition.

If appropriate, we will schedule appointments for your child to see specialists including an audiologist, otolaryngologist, child and family therapist, teacher of the deaf and a speech-language pathologist. Additionally, our educational consultant will review your child's Individualized Family Service Plan (IFSP) or Individualized Education Plan (IEP).

After we have learned as much information as possible about your child’s condition, your child’s team will meet to determine if he is a good candidate for a cochlear implant.

The cochlear implant team may:

• Recommend your child receive cochlear implant surgery
• Delay making a final decision about your child’s treatment until any concerns are resolved
• Decide your child is not a candidate for implantation

If implantation is recommended, a surgery date will be scheduled, and pre-implant auditory training may be recommended.

Cochlear implant surgery

Cochlear implant surgery may be performed as an inpatient or outpatient procedure depending on your child’s medical and general health.

While your child is under general anesthesia (asleep), a surgeon will make an incision behind your child’s ear to open the mastoid bone leading to the middle ear space. Then, the surgeon will create an opening in the cochlea (inner ear) and insert the implant electrodes.

The electronic device (receiver/simulator) at the base of the electrode array is then put under the skin behind your child’s ear. Finally, all incisions are closed. When the procedure is finished, the surgeon will place a removable pressure dressing behind the ear.

Follow-up care

About two to three weeks after your child’s surgery, your child will return to the hospital and an audiologist will activate the cochlear implant. Your child will also be seen by an ENT provider for post-surgery follow-up at the time of the initial visit.

After the activation, your child will return for a series of follow up appointments over the next year.  Post-surgery appointments include:

• 1 week: Audiology
• 1 month: Audiology and speech therapy
• 2 months: Audiology and child and family therapy
• 3 months: Audiology and speech therapy
• 6 months: Audiology and speech therapy
• 9 months: Audiology and speech therapy
• 12 months: Audiology and speech therapy

These are just general guidelines for follow-up care. How often your child is reassessed — and what additional services she may need — are customized for your child. 

Regular and on-going speech-language therapy is recommended for every child who has received a cochlear implant. Therapy may take place by both our team of therapists and by other professionals in your child’s school or community.

Annual evaluations with the audiologist, speech language pathologist and child and family therapist document the child's progress and allow any concerns to be addressed.
Learn more about post-operative cochlear implant care.