Cochlear Implant Surgery in Children

Cochlear Implant Surgery in Children

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For many children with severe or profound hearing loss, a cochlear implant can improve or restore hearing. Early implantation is key to minimizing delays in language and speech development. Our team makes every effort to ensure that children who will benefit from cochlear implantation, in one or both ears, have that opportunity as soon as possible. For many children, this may be as early as 12 months of age.

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How Do Cochlear Implants Work?

Hearing loss is often caused by problems in the cochlea, snail-shaped tubes inside the inner ears that hold thousands of hearing receptors called hair cells. Healthy hair cells send sound signals to the brain through the auditory nerve. When hair cells are missing at birth or damaged by an illness, injury, or medications, it affects our ability to hear.

A cochlear implant works by bypassing the damaged cochlea. It has two parts. The external part -- called a speech processor -- picks up speech and other sounds and turns them into an electrical signal. The speech processor sends the signal to the internal part, which is implanted in the bone right behind the ear. The internal part then sends the signal directly to the auditory nerve, which delivers sound information to the brain.

Is Your Child a Candidate for a Cochlear Implant?
Children must meet FDA eligibility criteria to receive a cochlear implant. They must:

  • Be 12 months of age or older (earlier implantation is possible under certain conditions)
  • Have severe or profound hearing loss in both ears caused by a problem with the cochlea
  • Receive little or no benefit from hearing aids
  • Be healthy enough to have surgery
Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

What to Expect from the Cochlear Implant Process

Our team will help you understand what to expect before, during, and after your child’s cochlear implant surgery.

Comprehensive Evaluation

Team members from multiple specialties participate in a thorough evaluation of your child. Audiologists measure your child’s ability to hear and understand speech with and without hearing aids. Speech and language experts determine whether your child is meeting communication milestones. An otolaryngologist will determine whether implantation is medically and surgically appropriate.

CT or MRI Scans

These imaging scans look for problems in the ear or brain. For example, children born without auditory nerves are not candidates for cochlear implant surgery. Findings from CT or MRI scans can also help determine whether to implant devices in one or both ears.

Family Support

Our clinical social workers provide information on financial and other support services available to your child and family. And our child life specialists help your child understand, at a developmentally appropriate level, what will happen on the day of surgery.

Cochlear Implant Surgery

For most children, cochlear implant surgery is an outpatient procedure. It’s performed using general anesthesia and takes about 90 minutes per ear. There is a three- to four-week healing period before the external part of the device (the speech processor) is turned on and your child begins to hear.

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After Cochlear Implant Surgery

Programming the Device

After the speech processor has been turned on, you can expect six to eight follow-up appointments with your child’s audiologist in the first year. During this time, we fine-tune the implant to help your child gradually become accustomed to sound without being overstimulated. 

Speech and Language Therapy

After surgery, your child will also undergo intense therapy with our pediatric speech-language pathologists. Our goal is to help your child interpret new sounds, understand language, and build their speaking skills. Therapy plans are tailored to match your family’s goals and preferences and can help improve your child’s school performance. We use a parent coaching model that teaches you how to develop your child's language and speech throughout your daily family routines. We also work with the other helpers in your child's life to further support your family's goals.

Long-Term Support

Our specialists will continue to provide your child personalized care to manage and optimize the speech processor’s performance. Although the internal part of the implant is generally considered permanent, manufacturers continue to design new speech processors compatible with the internal implant. This allows your child to take advantage of technological advances.

Consistently Ranked Among the Nation’s Best Hospitals
In addition, Duke University Hospital is proud to be named the best hospital in North Carolina, and nationally ranked in 10 adult and 9 pediatric specialties by U.S. News & World Report for 2019–2020.

Why Choose Duke

A Collaborative Approach
Our comprehensive hearing center brings together several pediatric specialists who contribute their expertise to your child’s care plan. All team members -- including specialists in neurotology, ENT surgery, audiology, speech-language pathology, psychology, and social work -- have extensive experience in providing support services to children who are deaf or hard of hearing.

Coordination with Local Specialists
Our goal is to make it easy for families who travel to Duke for cochlear implant surgery to continue receiving follow-up care closer to home. No matter where you live, our team will work closely with speech-language pathologists and audiologists in your own community. 

Cochlear Implant Pioneers and Researchers
A Duke scientist helped invent many of the speech processing strategies that paved the way for advances in cochlear implants. In 1984, we created one of the world’s first cochlear implant programs. Today, members of the Duke community lead and participate in research that aims to eliminate deafness and hearing impairments. We’re studying the impact of hearing loss on the development of auditory function in children, investigating the use of cochlear implant signals to prevent or reverse degenerative changes in the inner ear, and testing emerging therapies for sensorineural hearing loss.  

Reviewed: 02/19/2019