Cochlear Implants

It’s important to remember that cochlear implants can help your child hear sounds and understand speech, but to get the most out of the technology, they’ll need rehabilitation with audiology, speech-language pathology and additional related services providers on a long-term basis. At their first visit, we’ll take time to talk with you about your child’s hearing loss.

We might ask questions like:

• Is there significant hearing loss in just one or both of their ears?
• Does your child use hearing aids but would like to hear better?
• Does your child have any health conditions that might make surgery risky?

Then we may do some tests like:

• Hearing tests: An audiologist will check to see how well your child hears sounds and understands what people are saying with and without hearing aids. Older children will repeat words back to the provider. Younger children may point to pictures.
• Auditory brainstem response (ABR): This test estimates hearing sensitivity by assessing the auditory nerve. Very young children and children who are unable to participate in a behavioral hearing test may need this.
• Vestibular test battery: These tests check for balance problems, which can sometimes happen if your child’s inner ear is damaged.
• Speech-language evaluation: Your child will meet with a speech-language pathologist (SLP) who will determine if they’re meeting certain developmental milestones.
• CT scan or an MRI: These imaging tests take detailed pictures of your child’s inner ear to determine if they’re a good candidate for surgery.
• Surgery evaluation: An otolaryngologist (ear, nose and throat specialist) will make sure your child is a good medical candidate for cochlear implantation and can safely have cochlear implant surgery.

Meet Our Cochlear Implant in Children Team

When hearing aids aren’t helping enough with their hearing loss, your child’s care team can help determine whether cochlear implants may be a good option for them. These providers work closely together to plan the best care for your child. And they’ll always keep you in the loop throughout the decision-making process. Your child’s care team could include:

• Otolaryngologists
• Pediatric audiologists
• Pediatric speech-language pathologists
• Pediatric nurse practitioners
• Pediatric geneticists

There are two parts to a cochlear implant — the actual implant that’s placed in your child’s inner ear during surgery, and a device called a sound processor that they wear on, or near, the outside of their ear. A magnet connects the two parts. The processor picks up sounds and sends them to the implant, where they become electric signals that travel up the hearing nerve to their brain. Their brain interprets these signals as sounds.

What to expect during cochlear implant surgery

Before surgery, we’ll give your child general anesthesia so they’ll be asleep and won’t feel any pain or know what’s happening.

During surgery, the surgeon will:

• Make an incision (cut) behind your child’s ear.
• Open the bone behind your child’s ear (mastoid).
• Implant the receiver that picks up sounds and a wire with electrodes into the hollow, snail-shaped bone (cochlea) in your child’s inner ear.
• Stitch the incision closed.

After surgery, your child will go to a recovery area where we’ll keep a close eye on them until they wake up from anesthesia. Sometimes, we keep your child overnight after surgery, and sometimes you can take your child home the same day.

Important things to know about cochlear implant surgery

Here are a few things to understand before your child gets cochlear implants:

• Your child can get an implant in just one ear or in both ears. Sometimes, they may need one implant but can use a hearing aid for the other ear. If your child’s hearing gets worse in the hearing aid ear, you might decide for them to have implant surgery for that ear, too.
• If your child can still hear a little bit in the ear to be implanted, the surgeon will make every effort to make sure that hearing is preserved after surgery.
• Your child will have the cochlear implant for the rest of their life. So, they’ll need to have regular appointments to make sure their device is working well. Their providers will also make sure that their skin near the device doesn’t become irritated.
• Your child’s providers will explain everything you need to know and will help your child learn how to live safely with cochlear implants.

After cochlear implant surgery

After healing from the surgery (about two to four weeks), your child will have several appointments with their audiologist. At the first appointment, their audiologist will:

• Place the sound processor and adjust it to fit.
• Make sure the transmitter and electrodes are working.
• Turn on the device and fine-tune it for your child.
• Adjust the device if needed.

Living With Cochlear Implants

It may take some time for your child to get used to hearing with the cochlear implant. Their speech-language pathologist can help them adjust to the device and teach you how to track your child’s progress. It’s important to be patient. Your child’s brain needs to learn to hear again with the cochlear implant. That’s natural and expected. Wearing their device consistently will help your child adjust to it quicker.

Taking the Next Step

A cochlear implant can open up your child’s world. Cochlear implants can help your child access so many sounds and communicate much easier. We understand that deciding on surgery for your child is a big step, and we know you probably have many questions. At Cleveland Clinic Children’s, our hearing specialists will give you the information you need to decide if cochlear implants are right for your child and guide your family through the entire process.