Factors Impacting Successful Cochlear Implantation

Question

Answer

There are a seemingly endless number of factors that can affect success with a cochlear implant. This list of factors includes, but is not limited to: age at onset of deafness, duration of deafness, etiology of deafness, status of the cochlea and auditory nerve, age at implantation, mode of communication, (re)habilitation services, educational environment, motivation and commitment by the patient, and motivation and commitment by the patient's support system (family and friends). Based on the number of influential factors and the endless number of ways in which these factors can be combined for any given patient, cochlear implant candidacy must be considered on a case-by-case basis. For this reason, it can be very difficult, if not impossible to make generalized statements regarding candidacy.

With respect to the aforementioned factors, consider the following:

• A pre-lingual onset of deafness poses more challenges than a post-lingual onset


• A longer duration of deafness poses more challenges than a short duration


• An etiology affecting the auditory nerve or neural pathways offers a poorer prognosis for implantation than a strictly sensory loss


• A malformed or ossified cochlea poses more challenges than a normally formed and patent cochlea


• A sufficient number of healthy nerve cells is critical to success following implantation


• Patients relying on manual modes of communication will face more challenges than those that communicate orally


• Patients receiving appropriate auditory based (re)habilitation services have a greater opportunity for success


• Children in a classroom setting offering an auditory enriched environment and peers that can serve as models for normal speech and language are more likely to experience success, particularly if a strong and supportive team approach is in place


• Patients must be motivated to learn to listen with the implant and must be committed to a lifelong follow-up program to succeed


• Patients also need the support and assistance from others that are motivated and committed to the patient's success



 
• Thus, a teenage or adult patient that was born deaf, has communicated using American Sign Language, has never worn hearing aids, and does not have access to appropriate resources or support would have a poor prognosis for success following implantation. Such a patient could only expect to gain an improved awareness of environmental sounds and an aid to speech reading from a cochlear implant.
  
  
  Aimee Gross, M.S., CCC-A
  Clinical Specialist
  MED-EL Corporation
  
  Aimee Gross serves as Clinical Specialist with MED-EL Corporation. She is based at MED-EL's North American Headquarters in Research Triangle Park, Durham, NC and is largely responsible for clinical education and training. Mrs. Gross is a member of both the Clinical Support and Patient Support teams at MED-EL Corporation. Before joining MED-EL, she worked with the cochlear implant team at the University of North Carolina Hospitals. Mrs. Gross holds a Master of Science degree in audiology from the University of North Carolina School of Medicine and certification in audiology from the American Speech-Language-Hearing Association.
  
  
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