Otolaryngology: Cochlear Implants in Children

FOR APPOINTMENTS, PLEASE CALL 314- 454-2201 (Voice or TTY)

Patients may be referred by pediatricians, otologists, audiologists or hearing instrument specialists. Self-referral is also accepted. Patients are seen at several convenient locations.

PEDIATRIC COCHLEAR IMPLANT TEAM :

Richard A. Chole, MD, PhD Medical Director
Timothy Hullar, MD
Keiko Hirose, MD
Anita Jeyakumar, MD, MS
Jamie H. Cadieux MA, CCC-A, Audiologist
Jerrica L. Kettel, AuD, CCC-A, Audiologist
Julie Jackson, Administrative Assistant
Veronica Heinz, Administrative Assistant
Mary Lucido, Social Work
St. Louis Children's Hospital Department of Psychology

• Your child may be eligible for a cochlear implant if:
• If your child has bilateral severe or profound hearing loss
• If your child has a progressive hearing loss
• If your child has received little or no benefit from the hearing aids

Each child is considered on a case-by-case basis and may be considered a candidate while not strictly meeting the above criteria. 

What is the evaluation Process?
The Pediatric Cochlear Implant Team evaluates each child carefully to optimize a positive result. It is important to realize that when working with young children the process may take several appointments to complete the evaluation process.

What does the surgery involve? 
Cochlear implant surgery usually takes from three to five hours. The surgeon places the internal device under the skin and the electrodes are then inserted through an opening in the cochlea. Once the skin heals, the only visible evidence is a slight bump behind the ear. The hospital stay is usually overnight. One family member may stay overnight in the child's room and other family members are welcome to stay in the lounge area where cots are furnished. Throughout the recovery period in the hospital, your child will be cared for by the experienced nurses and staff at St Louis Children's Hospital.

How safe is the surgery?
Cochlear implants are recognized by the American Medical Association (AMA) and the American Academy of Otolaryngology - Head and Neck Surgery (AAO- HNS) as an approved medical procedure for children as young as 12 months of age. They are approved by the Food and Drug Administration (FDA).

In general, the surgical procedure is not considered dangerous or particularly painful. As with any surgical procedure, parents should be aware that there are risks associated with anesthesia. A very small percentage of patients may experience some post operative effects such as inflammation or bleeding at the surgical site, numbness or stiffness around the ear, injury to or stimulation of the facial nerve, taste disturbance, dizziness, ringing in the ear (tinnitus), or neck pain and fluid leak from the cochlea which could result in meningitis. The greatest concerns are trauma to the facial nerve which occurs in less than 1% of cases and a partial insertion of the electrode.

How do I prepare my child for surgery?
St. Louis Children's Hospital/ Department of Otolaryngology, Washington University School of Medicine wants you and your child to feel as relaxed as possible on the day of your child's surgery. To ease any anxiety, you and your child may take a tour of the same-day surgery area on the 6th floor at St. Louis Children’s Hospital. During the tour a nurse will walk you through the pre-operation area, show a video of the operating room and show you the parents' waiting area. You can also see the area where your child will stay overnight. At the end of the tour, the nurse will let your child play with toys that are similar to instruments used by the surgeon.

Will I be notified of my child's status during surgery?
You will be given periodic updates during the surgery by the nurses in the operating room so that you will know how the surgery is proceeding. After surgery, the physician will inform you of all aspects of your child's operation. The team audiologist will notify you whether all electrodes were able to be inserted and if they are making proper contact with the auditory nerve.

How will my child look after surgery?
The internal part of the implant is not visible after surgery. The bandage that is placed over the incision at the end of surgery will remain on his/her head for a few days. Your child will not need to have any sutures removed after surgery.

What follow-up services are offered?
Click on this link for a comprehensive list and explanation of follow-up services offered by the Department of Otolaryngology at Washington University.

What About Costs?
We only can estimate of the total cost of cochlear implant services for which you and/or your insurance company will be responsible. These costs are estimated because individuals differ in the services they require.

A cochlear implant is covered by most insurance policies as well as Medicaid. Our insurance specialist will work to secure written confirmation that your plan covers the device and procedures. You may be responsible for a portion of the costs. Depending on your benefit plan, you may need to pay a deductible. If you have questions about insurance coverage, please allow our specialist to contact your company.

The Washington University Advantage

What are the benefits of cochlear implants in children?
A young child learns oral communication skills very early in life by repeatedly hearing the spoken speech of his/her family and others around him/her. Over time she/he begins to imitate and reproduce what she/he hears. Severe hearing loss can a have significant effect on the child's ability to develop speech and oral language. The child's ability to be aware of and respond to environmental sounds is also affected.

Generally, the greater the hearing loss, the greater the delay in speech and language development. Research studies have demonstrated that children with cochlear implants who have participated in an intensive speech and language training program administered by qualified professionals can have excellent progress in developing oral communication skills. In general, children who receive a cochlear implant early in life use the implant more effectively.