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Audiology and ENT Yr2 > Cochlear Implant > Flashcards

Cochlear Implant Flashcards

1
Q

A cochlear implant is a ______ aid.

A

Sensory.

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2
Q

What is a cochlear implant not?

A

It is not a cure for hearing impairment.

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3
Q

Who is a cochlear implant suitable for?

A

Those with a bilateral severe-to-profound sensory hearing loss who receive little or no benefit from conventional hearing aids.

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4
Q

What is the main aim of a cochlear implant?

A

To provide access to spoken language through hearing.

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5
Q

A cochlear implant is a ______ hearing aid but doesn’t work as an ______.

A

Sophisticated

Amplifier.

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6
Q

What does a cochlear implant stimulate?

A

It directly stimulates nerve cells.

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7
Q

Having access to spoken language enables…

A

Development of spoken language (in kids) or retaining it (adults).

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8
Q

What does congenitally deaf mean?

A

Born Deaf.

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9
Q

Over 90% of deaf children are born to ______ and ______ parents. what do they want to do?

A

Hearing and Speaking

To speak to their kids.

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10
Q

Language centers in the brain develop in the first _____ years of life. Implantation needs to happen within this _____________ _____________.

A

three.

Critical Time Frame.

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11
Q

Why is it important to get an implant as early as possible?

A

To maximise language acquisition - time is precious! Need to be immersed in language to develop spoken language.

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12
Q

What are the consequences of profound deafness?

A

Stops auditory cortex and auditory pathways from developing.

Prevents Language centres in brain from developing.

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13
Q

Name the process of early intervention.

A

UNHS
Diagnostic Tests
Hearing Aids & Rehabilitation support
Monitoring Progress & Surveillance.

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14
Q

Before a cochlear implant what is always tried first?

A

A hearing aid is always tried first.

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15
Q

What do hearing aids do?

A

They selectively amplify sounds across the frequency range.

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16
Q

Hearing Aids are non-_____.

A

Invasive.

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17
Q

What do hearing aids use?

A

They make use of the natural hearing mechanisms.

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18
Q

When conventional hearing aids are not providing enough benefit, this is when a _____ _____ is considered.

A

Cochlear Implant

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19
Q

A cochlear implant consists of ____ parts.

A

2.

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20
Q

name the 2 parts of a cochlear implant.

A 
External component (sound processor)
Internal Component.
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21
Q

What part of a cochlear implant looks a bit like a hearing aid?

A

The external component.

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22
Q

A cochlear implant needs ____ components in order to work.

A

Both.

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23
Q

Describe the internal Component of a cochlear implant.

A

-Consists of receiver/stimulator package and electrode.
-Passive device (no batteries)
Designed to last a lifetime.

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24
Q

After 4 weeks the implant becomes ____ in the ear, bony fibrous tissue forms over it.

A

Embedded.

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25
Q

What component is replaced every 5 years?

A

External component.

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26
Q

Describe the external component of a cochlear implant.

A
  • Sound processor
  • It’s an active device (powered by batteries)
  • Easily worn
  • Removable- taken off at nights
  • Needs to be programmed, maintained & replaced
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27
Q

How does the cochlear implant work?

A
  1. Picks up signal
  2. Converts signal
  3. Electrical signal passed along cable
  4. Magnet holds stimulator in place
  5. The signal then wires into the cochlea
  6. Then passed onto auditory nerve.
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28
Q

The cochlear implant process is not a _____ ____ procedure.

A

1 off

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29
Q

Describe the cochlear implant process.

A
  • Assessment
  • Surgery
  • Device Programming
  • Rehabilitation
  • Equipment Maintenance
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30
Q

Who is in the MDT?

A
  • Clinical scientists
  • Clinical psychologists
  • ENT Surgeons
  • Rehab specialists
  • Support Staff.
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31
Q

In the assessment process, the maximum wait is 12 weeks, but typically seen ___-____ weeks.

A

5, 6.

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32
Q

In what cases would there be no wait for? Why?

A

Sudden onset or post-meningitis cases.
They had hearing before the event so find it very traumatic.
In meningitis, bone starts to grow in the cochlea (ossification of cochlea).

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33
Q

For young children ABR and CT/MRI is carried out under ___________.

A

General anaesthetic.

34
Q

The duration of assessment is typically _____ to _____ months. but can be reduced or extended.

A

3 to 6.

35
Q

Patients are assessed to establish ______.

A

Candidature.

36
Q

To establish whether they are a candidate for a cochlear implant there is set ______ based on ____ guidlines.

A

Criteria, NICE.

37
Q

For adults cochlear implant criteria is _____.

A

Stricter.

38
Q

What is the audiometric selection criteria for a cochlear implant?

A

Profound Sensory Hearing Loss in both ears at 2 and 4 kHz.

39
Q

Really low audiometric thresholds, indicates what?

A

There is not enough hair cells, therefore even with a hearing aid these people won’t access speech sounds.

40
Q

ABR stands for…

A

Auditory Brainstem Responses.

41
Q

In ABR it measures an ____ response. A tone is presented using ________, usually it would show a flat line.

A

Elicited.

Headphones.

42
Q

When is hearing aid evaluation carried out?

A

Hearing Aid Evaluation is carried out after at least 3 months of consistent hearing aid use (immersed in spoken language).

43
Q

It is important that HAs are _____ worn.

A

Consistently.

44
Q

When are cochlear implants considered?

A

If child has no benefit (it makes no difference) from a conventional HA.

45
Q

How if functional hearing evaluated?

A
  • Speech Perception (LINGS Sounds)
  • Evidence from parents
  • Questionnaires
  • Sound detection and discrimination
  • Vocalisation (child using sounds?)
  • Communication/spoken language development.
46
Q

What do LINGS sounds test?

A

Speech Perception.

47
Q

LINGS sounds can be used at start of a _____ session or when _____ meeting the child.

A

Therapy

First.

48
Q

LINGS sounds assesses whether a child can _____ and _______ sounds.

A

Detect, Discriminate.

49
Q

List the LINGS Sounds.

A 
a
i
u
s
ʃ
m
50
Q

Speech sounds are made up of lots of different _______.

A

frequencies.

51
Q

Each speech sound has a specific _____.

A

Forma.

52
Q

Why do people with HI get mixed up with certain sounds?

A

They can’t tell the difference between them! e.g. shat and sat :(

53
Q

What is the crescent of sound used for?

A
  • Sound detection
  • Sound tracking
  • Speech perception in quiet and noise etc.
54
Q

What are other aspects of assessment?

A
  • Child’s ability to produce consistent behavioral responses
  • Child’s potential to make use of auditory information & develop spoken language
  • Commitment, motivation and appropriate expectations
  • Fitness for Surgery
  • Otology (if they have glue ear, they can’t have implant).
55
Q

Even id HA isn’t helping, why are children encouraged to wear it up until surgery?

A

It normally provides most of them with a little bit of sound
It stimulates the nerve cells
It gets the child used to wearing equipment.

56
Q

When is a cochlear implant provided to a congenitally deaf child?

A

When they are between 12 and 18 months old.

57
Q

Adults have a prompt referral once HL is in _______________-____________ range.

A

Severe-profound.

58
Q

Those with no functional spoken language or poor auditory experience cannot be considered for cochlear implant after the age of ___.

A

5 years old :(

59
Q

In the very rare occasion (apart from age) , why would a cochlear implant not be possible?

A

Inner Ear Anomalies (cochlear and/or auditory nerve)

Not fit for surgery.

60
Q

The surgery is _____ risk.

A

low.

61
Q

Most receive ______ cochlear implants.

A

Bilateral.

62
Q

Surgery takes ____ hours and they stay in the hospital _____ days.

A

3-4 hrs

2-3 days.

63
Q

What is a planar x-ray used for?

A

To check that the implant is in the right place.

64
Q

4 weeks after surgery what happens?

A

The cochlear implant is “switched on” at an appointment and external equipment is issued.

65
Q

Describe Device Activation.

A

The electrodes are activated for the first time.

Device is custom programmed.

66
Q

How many electrodes does a cochlear implant have?

A

22.

67
Q

What electrode is responsible for low frequency tone?

A

No. 22.

68
Q

What electrode is responsible for high frequency tone?

A

No. 1.

69
Q

Once implant is activated, what is important?

A

Ongoing Monitoring.

70
Q

Why does monitoring need to happen?

A

At first tolerance for some sounds can be low. Things can change!

71
Q

What is a useful set up for people in remote areas like shetland?

A

Remote programming Configuration. Video call appointment to monitor implant annually.

72
Q

What does a cochlear implant sound like?

A

Sounds electronic at first but then get used to it and it sounds normal.

73
Q

All cochlear implant users have exactly the same _____.

A

Audiogram.

74
Q

Describe the audiogram for cochlear implant users.

A
  • It’s flat across the full frequency range
  • Hearing thresholds are equivalent to mild hearing loss.
  • Hearing doesn’t deteriorate.
75
Q

What are the factors affecting the outcome of cochlear implants?

A
  • Use
  • Hearing History
  • Age at time of implant
  • Period of auditory deprivation
  • Environment (needs to be stimulating)
  • Commitment and motivation
  • Communication approach
  • Co-existing morbidity
76
Q

After programming, where do implant users visit?

A

Rehab.

77
Q

What is the role of rehabilitation?

A
  • Monitor Progress

- Give advice and support to families

78
Q

Equipment ______ is important with a cochlear implant.

A

Maintenance.

79
Q

Name important parts of equipment maintenance.

A
  • Should always carry spare batteries around with them

- Processor should be upgraded every 5 years,.

80
Q

What can be a problem for people with cochlear implants?

A

Background noise.

81
Q

Name some assistive listening devices.

A
  • Telecoil / loop
  • Streaming / Bluetooth (good for background noise)
  • FM systems (teacher has mic and kid has reciever on implants/aid)
82
Q

You can even get _____ accessories for cochlear implants!

A

swimming

Audiology and ENT Yr2 (21 decks)

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