Cochlear Implant Speech Therapy: Licensed Speech and Language Therapists

Christina Gonzales-Sanders, MS

Cochlear Implant Patient Coordinator

Patients who are interested in learning more about cochlear implants should contact our dedicated cochlear implant coordinator, Kendra Kendall. She will talk to you about your hearing loss and help you get started down the right path to improved hearing. With the UK Cochlear Implant Center as your partner in your hearing-loss journey, we will connect with experts in this field and will arrange the necessary tests and appointments.

Kendra Kendall
Patient Services Coordinator
If you’d like to schedule an appointment for an assessment, please call 859-218-2183.

Sound is transmitted through the air in waves. As sound enters the ear, these waves contact and vibrate the eardrum. These vibrations travel from the eardrum through three little bones of hearing to an opening into the inner ear. The inner ear is filled with fluid and contains special sensory hair cells that send nerve impulses to the brain when triggered. As the vibrations enter the inner ear, the fluid within the inner ear begins to move like an ocean wave. As the fluid moves along the inner ear, the special sensory cells are triggered to send impulses to a nerve within the inner ear. This nerve carries the impulses to the brain, where impulses are processed. The brain attaches meaning to these impulses to help us detect, recognize and distinguish sounds and speech.

As one of the five special senses, hearing is vital to so many aspects of life. Hearing helps us engage with our environment and learn spoken language. This enables us to socialize, enjoy music, learn in school and communicate in the workplace. Hearing also alerts us to danger, allows us to locate where sounds are coming from and keeps us connected with the outside world. People with hearing loss may have difficulty communicating with those around them, including their family and friends. Sometimes, people with hearing loss feel isolated and avoid social situations because they have difficulty understanding what’s being said. This can lead to depression and potentially to a loss of mental sharpness and awareness. At UK HealthCare, our mission is to help patients maximize the function and quality of their hearing so they can enjoy life to the fullest.

People with inner ear hearing loss have difficulty detecting sounds because they have damaged or lost some of the special sensory cells of the inner ear. Hearing aids are used to help patients with hearing loss by increasing the volume of sounds, thereby helping parts of the inner ear with damaged or lost cells. As more cells are damaged or lost, hearing loss worsens and patients may have difficulty with understanding words. Hearing aids can help to a degree but may not provide enough clarity or understanding of words for patients with more severe forms of hearing loss. A cochlear implant works differently than a hearing aid and can help people who have difficulty detecting sounds and understanding words. The cochlear implant is a two-piece electric device that restores hearing for a person with hearing loss. It has an external piece and an internal piece.

The external piece, or the processor, resembles a hearing aid in appearance with some additional components. A small microphone and a speech processor are packaged together into a hook-shaped component that is worn on the ear. The ear processor connects to a disc-shaped transmitter that is worn behind the ear and contains a magnet.

The internal piece is secured during an operation and is not visible outside the skin. This part of the implant is thin and encased in silicone. It has a magnet, which allows for wireless connection with the external piece transmitter. It also has electrical circuits that lead to a long, thin and narrow electrode, which contains electrical wires. This electrode is placed into the fluid-filled inner ear where direct electrical stimulation of the hearing nerve can occur.

When the external microphone picks up a sound, it converts the sound into electrical impulses. The transmitter sends the electrical impulses wirelessly through the skin to the internal piece, which then sends the impulses through the electrode down into the inner ear. This electrode then directly stimulates the auditory nerve in the inner ear, which sends the impulses to the brain, where sounds can be heard and understood. In spite of the damaged or lost cells in the inner ear, a cochlear implant can restore the ability to get sound information to the brain.

Anyone 12 months or older with moderate to profound hearing loss with difficulty understanding words can be considered for cochlear implants. We routinely care for babies and young children who are born with hearing loss and others – including teenagers, adults and elderly patients who have decreased, distorted or a complete loss of hearing. Cochlear implants can help younger patients learn how to communicate through spoken language and develop language skills. Cochlear implants also empower patients to function well at school, at work and in social situations. By improving understanding of words, cochlear implants help people engage with their family and friends and get back into the conversation.

If you are a candidate for a cochlear implant and decide to proceed, you will undergo cochlear implantation surgery. This operation typically lasts two to three hours. Patients are greeted by and cared for by an experienced team of nurses, anesthesia doctors and surgeons who have extensive experience in cochlear implant surgery. Before, during and after the operation, patient comfort and safety are our highest priorities. Patients undergo general anesthesia before the surgery and typically go home on the same day as the surgery. During the operation, the surgeon shaves a small amount of hair at the hairline behind the ear. A small incision is made behind the ear and the organ of hearing is exposed. Our expert surgeons then insert the implant into the organ of hearing using a delicate hearing-preserving technique.

After surgery:

• Patients have a small dressing on the ear that can be removed easily at home the next day.
• Some patients experience temporary mild pain or dizziness.
• Patients frequently return to work or school five to seven days after the surgery.
• Other than keeping the incision dry for a few days, there is little to no wound care.
• The small amount of hair that was shaved during surgery grows back normally.
• Patients typically revisit their surgeon for a follow-up appointment a few weeks after surgery.

The rehabilitation with the audiology team after surgery is crucial to the success of the cochlear implant. Approximately three to four weeks after surgery, an audiologist will place the external piece of the cochlear implant and turn on the device. Patients will notice sounds immediately through the implant, and the brain will gradually begin to use the cochlear implant to distinguish different sounds and words. The time for the brain to adapt to the sound information coming from the cochlear implant varies among patients. Patients meet with their audiologist several times in the first few months to adjust the settings of the implant as the brain continues to acclimate to new sounds. Patients should then expect to meet with their audiologist at three, six and 12 months after surgery and then usually once a year thereafter.

Our experienced team of audiologists will work diligently to maximize hearing and understanding through the cochlear implant, and they may use a variety of resources and home exercise to get the most out of the implant for their patients. We also work very closely with experienced speech therapists to provide comprehensive and intensive therapy for pediatric patients to expedite and expand their speech development.

• American Cochlear Implant Alliance
• MED-EL (Hearing implants)
• Cochlear.com
• Advanced Bionics