Cochlear Implants

3.6.1 What is a cochlear implant and how does it work?

3.6.2 How does the patient with a cochlear implant perceive sound?

3.6.3 Name the components of a cochlear implant. What are the 3 current systems in use? What does Dr. (your otologist) use and why? Describe some of the different electrode arrays that are available and their indications for implantation?

3.6.4 Who can benefit from a cochlear implant? How would you assess someone for implant candidacy? Describe AzBio, HINT, and CNC testing and their role in the assessment of potential cochlear implant patient.

3.6.5 Discuss post-operative rehabilitation of cochlear implant patients.

3.6.6 List the complications of cochlear implants.

Luetje CM, Jackson K. Cochlear implants in children: what constitutes a complication? Otolaryngol Head Neck Surg. 1997 Sep;117(3 Pt 1):243-7. PMID:9334772

3.6.7 Are there any contraindications for cochlear implant?

Luntz M, Balkany T, Hodges AV, Telischi FF. Cochlear implants in children with congenital inner ear malformations. Arch Otolaryngol Head Neck Surg. 1997 Sep;123(9):974-7. PMID:9305249 Rauch SD, Herrmann BS, Davis LA, Nadol JB Jr. Nucleus 22 cochlear implantation results in postmeningitic deafness. Laryngoscope. 1997 Dec;107(12 Pt 1):1606-9. PMID:9396672

3.6.8 Describe the surgical procedure for cochlear implantation.

3.6.9 How much does cochlear implantation cost?

Cheng AK, Niparko JK. Cost-utility of the cochlear implant in adults: a meta-analysis. Arch Otolaryngol Head Neck Surg. 1999 Nov;125(11):1214-8. PMID:10555692

Balkany T, Hodges AV, Goodman KW. Ethics of cochlear implantation in young children. Otolaryngol Head Neck Surg. 1996 Jun;114(6):748-55. PMID:8643298

Lane H, Bahan B. Ethics of cochlear implantation in young children: a review and reply from a Deaf-World perspective. Otolaryngol Head Neck Surg. 1998 Oct;119(4):297-313. PMID:9781982

3.6.10 Assess the benefits of cochlear implantation in adults and children.

3.6.11 What are the advantages and disadvantages of MRI and CT in evaluating a potential cochlear implant candidate? Describe the difference between the two presented MRI images? 

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Cochlear%20Implants/Cochlear-Impants-Q11.jpg

3.6.12 A 5 year old male patient is 3 years out from a left cochlear implant. His parents have noted a significant decline in his receptive and expressive language in the past 3 months despite normal integrity testing on the implant. What would you do next? Define hard and soft cochlear implant failure. What is the incidence of cochlear reimplantation? How do patients who require reimplantation perform?

3.6.13 What is the incidence of meningitis in cochlear implant patients? Discuss the CDC recommended vaccination schedule for cochlear implant recipients?