Cochlear Implantation: Phoniatric perspective
- Executive Summary
The goals of cochlear implantation in children are acquiring normal speech and language development, achieving higher levels academically, enrolling in main streaming and developing better sense of security and better quality of life (Strong recommendation).
As for adult recipients of CI, main goals are improved social and work quality of life, with less stressful events (Strong recommendation).
- Duration of deafness, hearing aid use prior to implantation, and age at implantation, can affect candidacy and predict post-operative outcomes (Strong recommendation).
- Pre lingually deafened adolescents and adults may benefit from cochlear implantation and should not be excluded from candidacy (Conditional recommendation).
- Children with disabilities in addition to deafness may benefit from cochlear implantation in quality-of-life outcomes and environmental awareness. These groups should not be excluded from candidacy. Families should be counseled regarding realistic expectations (Strong recommendation).
- A speech and language evaluation may be recommended in adult candidacy evaluations and could be considered critical in pediatric candidacy evaluations (Strong recommendation).
- High performance in children who use a cochlear implant has been linked to full-time use of the cochlear implant in home and school environments (Strong recommendation).
- The amount and quality of language used by parents/caregivers of children who use cochlear implants has a strong influence on these children’s linguistic development. (Strong recommendation).
- Bilateral stimulation should be considered for all individuals who use a cochlear implant, if not otherwise contraindicated.
Clinicians should be able to:
-Work in a multidisciplinary team of related specialties to ensure proper candidate selection and successful outcomes post implantation.
- Acquire full history from the patient/caregiver.
- Perform evaluation of the preimplant auditory skills, speech, language and voice evaluation.
- Implement different strategies of auditory training to enhance auditory skills development in order to acquire normal spoken receptive and expressive language development (Strong recommendation).
All clinicians should be aware and informed to consider the following:
• Red Flags that need any referral for Assessment/ Management must be taken into consideration.
• Why and when to refer to other specialties .
• Management should be targeted towards implementation of proper auditory training for acquisition of spoken language skills, aiming to decrease the gap between the chronological age and the language age (Strong recommendation).