The Medical City Launches Cochlear Implant Program

Premier health institution The Medical City (TMC) announces the formal launch of its Cochlear Implant Program (CIP), an innovative treatment option available for children with severe to profound deafness or hearing loss.

Cochlear implantation has become a standard rehabilitative approach for hearing impaired patients who do not benefit significantly from hearing aids. TMC-CIP is the first private, hospital-based comprehensive program for rehabilitation of hearing impaired children.

A cochlear implant is a small, complex electronic device that provides direct electrical stimulation to the auditory nerve in the inner ear. There is an external part that is worn behind the ear with a microphone that picks up sounds from the environment, a speech processor and a transmitter that gets signals from the processor and turns them into electric impulses. It is attached to a receiver and electrode system which is surgically implanted into the inner ear.

Sometimes called a bionic ear, a cochlear implant does not restore normal hearing and is very different from a hearing aid. Hearing aids amplify sound so that damaged ears can hear them. Implants bypass the damage and directly stimulate the auditory nerve which then sends the signals to the brain.

Children as young as 12 months of age can be candidates for this surgery. They may have been born deaf or become deaf after learning to speak. The earlier a child is identified with hearing loss, the better hearing and speech potential that child will have. Adults can also undergo cochlear implant. Criteria for adults and children are slightly different but they are based on similar guidelines.

The patient, whether a child or an adult, should have severe to profound hearing loss in both ears, and get almost no improvement with hearing aids. He needs to be highly motivated to be part of the hearing world and to communicate through listening, speaking and speech reading.  Children need to be enrolled in programs that would help them learn how to process sound.

The Medical City Cochlear Implant Surgery team is currently composed of Dr. Nathaniel Yang, Neurotologist; Dr. Rina Reyes-Quintos, Pediatric Otolaryngologist and Audiologist; Amadona Luistro, Audiologist and Prof. Joanne Rabang-Mata, Speech Pathologist and Auditory Verbal Therapist.

Dr. Yang started performing cochlear implant surgery in 1998, as this was part of his clinical fellowship training in Otology & Neurotology at the University of Miami / Jackson Memorial Hospital. At TMC, he has been doing cochlear implantation in children since 2008.

Dr. Yang said TMC-CIP involves the entire process of identifying patients with hearing loss, providing appropriate hearing aid amplification and auditory-verbal speech therapy, evaluating the patient for audiologic and surgical candidacy for cochlear implantation, the surgical procedure itself, and the post-implant cochlear implant mapping and continuing post-implant auditory-verbal speech therapy.

“We are doing this in order to provide patients with a guiding hand in the entire process of dealing with a hearing-impaired child. Anecdotally, I have been told by patients that when their child was diagnosed to have hearing loss, they were at a loss as to what to do,” added Dr. Yang.

Dr. Yang also said these patients apparently got only bits and pieces of information from different health care professionals and not the big picture. They essentially had to find out things by themselves by seeing a lot of different doctors on their own volition, and by going through information on the internet.

“Many times, this involved a long process that took so much time that their child was finally provided with appropriate treatment at an inappropriately late time,” said Dr. Yang.

The Medical City has a complete multi-disciplinary team of health professionals dedicated to the timely evaluation and treatment of individuals who are deaf or who may be hearing-impaired.

“Our goal is to provide a complete range of services to successfully rehabilitate the hearing-impaired individual - from the initial hearing evaluation, medical assessment, hearing aid fitting and auditory-verbal speech rehabilitation, to cochlear implantation, implant switch-on and mapping, and post-operative speech therapy rehabilitation,” said Dr. Clarissa Fortuna, head of the Department of Otolaryngology.

To become a candidate for CIP, a child is assessed by TMC’s multi-disciplinary group of health professionals. Tests include high resolution scans to examine the structure of the ear, extensive hearing evaluations, and evaluation by a variety of other specialists such as a psychologist, geneticist, speech-language pathologist and surgeon.

Initial rehabilitation with hearing aid amplification coupled with intensive auditory-verbal speech therapy is performed. If subsequent evaluation suggests that this form of rehabilitation is inadequate, then the patient is offered the choice of cochlear implantation.

If the evaluation suggests cochlear implantation surgery for the child, TMC’s specialists led by Dr. Yang handle the surgery and the activation of the cochlear implant device as well as supervise a thorough follow-up program of support for the patient and family.

The surgery is performed under general anesthesia and normally takes from one and a half to three hours.  Patients usually leave the hospital within 24 hours after the surgery is completed. Pain is mild-to-moderate for one to two days and can usually be controlled with oral pain medications. Patients are seen one week after surgery to check the incision. Initial activation of the device and placement of the external equipment is performed three to four weeks after surgery.

For more information, contact The Medical City ENT Center at tel. nos. 988-1000 or 988-7000 ext. 6465