Serving Children & Adults With Hearing Disorders

Contact Us

To make appointment for an evaluation, please contact us:
Phone: 801-587-8368

The Utah Cochlear Implant Program has implanted more than 1,000 patients, both adults and children. Our typical volume is 60 to 100 implants per year. We implant devices from the three available manufacturers, and perform surgeries at University of Utah Hospital, Primary Children's Hospital, and LDS Hospital, depending on insurance and the age of the patient.

We use the latest surgical techniques, including soft insertion, minimal or standard access, and bilateral simultaneous implantation. We also use facial nerve monitoring, which is standard.

Utah Cochlear Implant Team

The Utah Cochlear Implant Team is a multidisciplinary group of professionals, who are dedicated to providing the finest care to severely hearing impaired patients. This team includes implant audiologists, surgeons, deaf educators, members of the parent/infant program, and speech pathologists. The team meets monthly to discuss potential cochlear implant candidates and make recommendations for the best possible treatment. Our surgeons are fellowship-trained and board-certified or board-eligible in neurotology.

What Is a Cochlear Implant?

A cochlear implant is an electronic device manufactured and designed to assist severely to profoundly hearing-impaired adults and children who have gained little to no benefit from hearing aids.

How does a cochlear implant work?

There are two main components to a cochlear implant:

  • The receiver/stimulator (implant), which is surgically implanted
  • The speech processor (headpiece) which is worn externally.

Sound is picked up by the microphone (part of the externally worn speech processor) and is converted into an electrical signal. The signal is then coded or converted to specific patterns or pulses. This coded signal is sent by the transmitting coil of the speech processor to the receiving coil of the internal receiver/stimulator (the implant). The signal is sent across the skin inductively; there is no direct connection with the implant, since it is implanted beneath the skin.

The implant now sends the coded electrical signal to the electrode array, which is implanted into the cochlea (inner ear). Multiple channels and points of stimulation now fire in a pattern that the cochlea can recognize stimulating the acoustic nerve ending in the cochlea. The auditory nerve picks up these signals and transmits them to the brain (auditory cortex) where they are perceived as sound.

What are the potential benefits of cochlear implants?

The benefits of cochlear implants can vary from individual to individual depending on a variety of factors, which include length of hearing loss and degree of rehabilitation following surgery. For most good candidates, the benefits are significant. Benefits may range from improved sound awareness to hearing and understanding speech in noise:

  • Sound awareness
  • Hearing everyday sounds
  • Improved lip reading
  • Hearing and understanding speech
  • Improvement of the user’s own speech
  • Listening in background noise
  • Use of a telephone

Your surgeon and audiologist can discuss what would be reasonable expectations for performance for you or your child as the level of performance depends on certain variables including length of hearing loss, motivation, and available rehabilitative services among others.

What are some cochlear implant device types?

The University of Utah physicians implant cochlear implant devices from all three FDA-approved device manufacturers. The center has experience with the surgical procedure and the rehabilitative process involved with all of the manufacturers device types. The center enjoys a strong relationship with the individual manufacturers and receives significant clinical support in programming, rehabilitative, and surgical issues with the respective implants.

For more information, we recommend you visit the manufacturer’s sites:

www.medel.com
www.cochlear.com
www.advancedbionics.com

 

Cochlear Implant Candidacy

Who is a candidate for a cochlear implant?

Essentially any adult or child, who is severely hearing impaired and does not receive adequate benefit from a hearing aid, is a candidate for a cochlear implant. Children as young as six months can be implanted. Adults in their eighties and nineties can and have been implanted, as long as there are no medical reasons which would impact the implant surgery.

Good candidates for the cochlear implant have/had the following:

  • Minimal to no benefit from the use of conventional hearing aids
  • Severe to profound sensorineural hearing loss (SNHL)
  • An environment at home or in school where oral communication is encouraged
  • Realistic goals concerning the implant
  • Realistic understanding of the surgery, the risks, and inherent benefits to cochlear implantation
  • No significant medical issues that would make the risks of implant surgery greater than the benefit
  • *For children* Failure to develop good oral language skills despite intensive speech and language rehabilitation and an adequate period of hearing aid use

How do I determine if I am a cochlear implant candidate?

You will need several appointments before getting a CI. It is important to come to all of them. If you need to reschedule, please contact the clinic as early as possible. Please send all past records related to hearing, medical and educational records (if appropriate). We need these before the first visit to help us serve you best. You may either mail or fax records to us at:

University of Utah Health
Otolaryngology & Hearing Aid Services
50 N Medical Dr. E11
Salt Lake City, UT 84132
Fax: 801-585-2500

Consult with an Audiologist

  • A full hearing test with and without hearing aids
  • An exam with our clinic hearing aids if needed
  • A discussion of candidacy
  • An explanation of the CI device, including what it is and how it works
  • A discussion of expected outcomes considering hearing and health history
  • A discussion about CI resources and assistive technology

Consult with a Neurotologist/Ear Surgeon

  • Medical history and physical exam
  • An MRI scan of the temporal bones will be ordered. You may do this test at our facility. If you live far from Salt Lake City, you can get the test at a radiology center close to home. If done elsewhere, you need to bring or send a report and the films to us before we can complete surgery.
  • A meningitis vaccination is advised for all CI recipients. See the vaccination instruction sheet given at your medical consultation for more information. Once you have this, please give us a copy of the records for our files.
  • Detailed information about the surgery and medical care after surgery will be discussed. The surgeon will also answer any questions or concerns at this time.
  • CI surgery is usually an outpatient procedure and does not require an overnight stay at the hospital. If you live far from Salt Lake City, consider spending the nights before and after the surgery near the hospital.

What is involved in the surgery for cochlear implantation?

Cochlear implant surgery is usually performed as an outpatient procedure and takes one to three hours. Patients of any age can be implanted, (we have implanted patients in their nineties!) but it is unusual to implant a child before age six months. Children less than 24 months old are observed in the hospital overnight. Recovery is typically three to five days. Post-operative activation with the speech processor generally occurs two to four weeks after surgery.

Surgery

Depending on the make and model of implant chosen, a minimal access approach may be used. Once the incision is made, the bone behind the ear is exposed for insertion and securing of the implant. The aerated bone behind the ear is removed (mastoidectomy). The ear canal and eardrum are not disturbed during the procedure. The cochlear implant is placed in its position under the skin and muscle and secured. A small opening is made in the cochlea (cochleostomy). The electrode is inserted into the cochlea via the cochleostomy.

A soft technique is routinely used in an attempt to preserve any residual hearing and cause the least amount of disturbance to the balance system. The skin is closed and a dressing is applied. The dressing is removed the next day at home.

Follow-up and Rehabilitation

Two to four weeks after surgery, you will see both your surgeon and audiologist. Your surgeon will check the surgical site to make sure that you are healing properly. Your audiologist will activate the CI.

Device activation takes place during a 2-hour appoinment:

  • The initial programs will be made
  • You will have a full orientation to the device
  • You will learn how to effectively troubleshoot equipment

Reprogramming and Testing

As the recipient is getting used to hearing with the CI, the programming will need adjusting. Reprogramming happens at specific intervals after the device is activated:

            1 week             1 month           2 months         3 months

            6 months         9 months         1 year

Hearing tests, both with and without the CI on, will be conducted at most visits. Testing helps to measure progress and determine needed programming changes.

After the first year, the recipient will be evaluated and a new schedule for testing and mapping will be set up based on individual needs. In general, children continue to be seen every 3 months and adults are seen every 6 to 12 months.

*Please remember that each person’s program is specific and developed to meet their individual needs. Progress will continually be evaluated and the number of appointments changed as needed. Please feel free to contact any of our team at any time with questions or concerns.