Kapi'olani Offers New Hope for Children with Severe Hearing Loss

May 2005

Cochlear implants, the latest treatment for children and adults with severe to profound hearing loss, are now available at Kapi'olani Medical Center for Women & Children. Until now, children had but two choices: continue to live in a world of silence, or seek treatment on the mainland.

Now, thanks to Kapi'olani's newly organized Cochlear Implant Team, these children can enter the world of sound without ever leaving Hawai‘i.

"It can make a big difference in a child's life to go from having no hearing and using sign language to hearing and communicating verbally," says Lenh Anh Tran, M.D., an ear, nose and throat specialist at Kapi'olani who performs this state-of-the-art procedure.

Cochlear implants are not hearing aids, which just amplify sound. The implants, which are surgically placed under the skin behind the ear, employ exciting new technology. By converting sound to electrical current, the implant performs the function of the child's damaged or missing auditory hair cells, which transmit sound from the ear to the brain.

Each implant has four basic parts:

• A microphone, which picks up sound from the environment
• A speech processor, which selects and arranges the sounds
• A transmitter and receiver/stimulator, which receives signals from the speech processor and converts them into electric impulses
• Electrodes, which collect the impulses from the stimulator and send them to the brain

To be a candidate for a cochlear implant, a child must meet the following criteria:

• Severe to profound hearing loss in both ears
• Little or no benefit from hearing aids
• Lack of progress in developing auditory skills
• Poor test results on age-appropriate materials

For children with significant hearing problems, Dr. Tran first tries hearing aids for three to six months. If that fails to improve hearing, the child might be a candidate for a cochlear implant. Each member of Kapi'olani's cochlear implant team evaluates the child to make sure he or she is an appropriate candidate — physically and psychologically — for the procedure. In addition to Dr. Tran, the team comprises an audiologist, a speech/language pathologist, a clinical psychologist, a social worker, a physical and occupational therapist and, depending on the child's age, a liaison with the child's school.

And that's just the beginning of the team's involvement. After the surgery, the child undergoes several weeks or months of rehabilitation with team members to make sure the implant is programmed correctly and the child is adapting appropriately. "We want to get to the point where the child is hearing sounds without having any discomfort," says Dr. Tran.

"Thanks to our newborn hearing screening program, we are identifying children with hearing impairments earlier," she adds. "If hearing aids aren't sufficient, having a team right here at Kapi'olani that can provide cochlear implant services locally — instead of having to go to the mainland — represents a huge emotional and financial uplift for patients and parents, as well as the community and insurers."

For more information on cochlear implants, please call 983-8235.