Criteria of Cochlear Implant

Candidacy
Total of near total sensorineural hearing loss as
characterized by pure tones averages of >90 dB
(Niparko, 2000)
Amplified threshold that failed to reach 60 dB
(Niparko, 2000)
Obtain little or no benefit from acoustic amplification
in the best aided condition.
absences of open set speech recognition despite the use of
powerful, best-fit hearing aids (Niparko, 2000)
optimally fitted hearing aids for a minimum of 3-6 months
before decision
Failure to develop good oral language skills despite
intensive speech and language rehabilitation and an
adequate period of hearing aid use

Criteria of Cochlear Implant

Candidacy
An environment at home or in school where oral
communication is encouraged
Patients with no psychiatric illness or multiply
handicapped
No medical and or radiological issues that
contraindication to cochlear implantation.
No significant medical issues that would make the
risks of implant surgery greater than the benefit.
Candidates and parents should be motivated, realistic
about the benefits of cochlear implantation, and
educated about participation in regular audio
processor programming, assessment and audioverbal
training (AVT)

Pre- Surgical
History taking - To know about subjective
information
age of onset
Duration of hearing loss
E.g for profound deafness- duration of hearing loss is
correlated with post-implant speech recognition
It seems that the effectiveness of cochlear implant
commonly declines as the duration of deafness increases
(UKCISG, 2004).
Recent onset of deafness give the best chance of a
successful outcome
Long duration of deafness gives the poorest prognosis
success.

(Fielden, 2006)

Conts
Aetiology
Certain aetiologies can have an effect on
performance outcome of decision to implant
if unidentified.
For examples, the ossification of cochlear
due to meningitis can hinder successful
implantation, so in such cases, it is essential
to consider implantation as soon as possible
following recovery from the diseases (Dodds
et al, 1997)

And current benefit obtained from

hearing aids.

Audiological Procedure

Pure Tone Audiometry

Speech Perception Test
Aided Soundfield Testing
Otoacoustic Emissions
Evoked Auditory Brainstem Response
Accessing the Benefits of Hearing
Aids to the Patient

SURGICAL PROCEDURE
Patient is setting under general anesthesia.
The procedure usually takes from 2.5 to 3
hours.
A small incision is made in the region behind
the ear. Minimal hair shaving is needed.
Once the incision is made the bone behind
the ear is exposed anteriorly to the level of
the ear canal and posteriorly to allow for
insertion and securing of the implant.
Mastoidectomy are performed. The ear canal
and ear drum are not disturbed during the
procedure.

SURGICAL PROCEDURE
The cochlear implant is placed in its posterior
position under the skin and muscle, superior and
posterior to the ear and secured.
Cochleostomy is made into the basal turn of the
scala tympani.
The electrode is inserted into scala tympani.
Ground electrode is attached to the receiver, it is
then placed under the temporalis muscle
Receiver-simulator is placed into the well behind the
mastoid
The skin is closed and a dressing is applied.

Post- Surgical
Initial programming ( switch on) are done on
several days to weeks after the operation.
The waiting period provides time for the operative
incision to heal completely.
After the swelling is gone, audiologist can do the
first fitting and programming (CI MAPping)
Mapping (or MAPping) is the term for programming
a cochlear implant to the specifications and needs
of its user.
MAPs are programs that help to optimize the
cochlear implant users access to sound by
adjusting the input to the electrodes on the array
that is implanted into the cochlea.

SIMILARITIES
They act for the same purpose, that
is to serve the people with hearing
loss to be able to hear/ hear better.
Both of them do not restore our
hearing.

References.
ASHA (n.d). Cochlear Implant Frequently Asked Questions. Retrieved from
http://www.asha.org/public/hearing/Cochlear-Implant-Frequently-Asked-Questions/ at 27 th April
2016.
Dodds A, Tsyzkiewicz E.,& Ramsden R.(1997). Cochlear Implantation After Bacterial Meningitis:
The Danger of Delay. Archives of Diseases in Childhood 76(2): 139-40.
Elizabeth (2011). Mapping a Cochlear Implant. Cochlear Implant Online. Retrieved from
http://cochlearimplantonline.com/site/mapping-a-cochlear-implant/ on 27 th April 2016.
Fielden C.A (2006). Assessment of Adult Patient.In Cooper & Craddock(2 nd ed.).Cochlear Implant:
A Practical Guide(pp 80-90). England: Whurr Publishers Limited.
Niparko John K. (2000). Assessment of Cochlear Implant Candidancy. In Niparko J.K, Kirk K. I,
Tucci D. l., Wilson B. S., & Robbins A.M (1 st ed.) Cochlear Implant: Principle and Practices. USA:
Lippicott Williams & Wilkins.
UKCISG (UK Cochlear Implant Study Group)(2004). Criteria of Candidature for Unilateral
Cochlear Implantation in Post-Lingually Deafness Adult I: Theory and Measures of Effectiveness.
Ear and Hearing 23(2): 98-105
Vanderbilt Health(n.d). Cochlear Implant Surgical Procedure. Retrieved from
http://www.vanderbilthealth.com/billwilkerson/28094 at 27 th April 2016.
Vanderbilt Health(n.d). Paediatric Cochlear Implant Criteria. Retrieved from
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevic
es/MedicalDevicesAdvisoryCommittee/EarNoseandThroatDevicesPanel/UCM445483.pdf at 27 th
April 2016.