HAC Cochlear Implant Basics & Referral 3 — Questions and Answers
Question 1: Cochlear implants are designed to bypass which damaged structure to restore hearing?
- Ossicles
- Tympanic membrane
- Outer hair cells of the organ of Corti (Correct answer)
- Semicircular canals
Correct answer: Outer hair cells of the organ of Corti
Cochlear implants electrically stimulate the auditory nerve directly, bypassing damaged or absent outer (and inner) hair cells.
Question 2: A parent asks whether their 10-month-old child with bilateral profound SNHL is too young for a cochlear implant. What is the correct response?
- Yes, children must be at least 2 years old per FDA guidelines
- No, the FDA approved cochlear implants for children as young as 12 months, and early implantation is encouraged (Correct answer)
- Children should wait until 5 years old for language development assessment
- Age is irrelevant; only hearing thresholds matter
Correct answer: No, the FDA approved cochlear implants for children as young as 12 months, and early implantation is encouraged
The FDA has approved cochlear implants for children as young as 12 months, and earlier implantation is associated with better language outcomes.
Question 3: Which professional is typically NOT part of the core cochlear implant team?
- Audiologist
- Otolaryngologist (ENT surgeon)
- Optometrist (Correct answer)
- Speech-language pathologist
Correct answer: Optometrist
Cochlear implant teams consist of audiologists, ENT surgeons, and speech-language pathologists; vision specialists are not routinely part of the core team.
Question 4: Post-cochlear implant, what is the term for the process of programming the device to set comfortable and threshold stimulation levels?
- Calibration
- Mapping (MApping) (Correct answer)
- Tuning
- Binaural fitting
Correct answer: Mapping (MApping)
Mapping (also called programming or MAPping) establishes the threshold (T-level) and comfort (C-level or M-level) for each electrode channel.
Question 5: A cochlear implant candidate has otosclerosis causing profound SNHL. What preoperative concern is most relevant?
- Risk of facial nerve damage due to enlarged fallopian canal
- Cochlear ossification that may impede full electrode insertion (Correct answer)
- Incompatibility of titanium implants with the stapedial reflex
- Increased risk of perilymph gusher
Correct answer: Cochlear ossification that may impede full electrode insertion
Otosclerosis can lead to cochlear ossification, which may prevent full insertion of the electrode array and reduce outcomes.
Question 6: In bilateral cochlear implantation, what is the primary benefit over unilateral implantation?
- Reduced risk of device failure
- Improved sound localization and speech understanding in noise (Correct answer)
- Lower cost of long-term maintenance
- Elimination of the need for auditory therapy
Correct answer: Improved sound localization and speech understanding in noise
Bilateral implantation provides binaural hearing cues, improving the ability to localize sound and understand speech in background noise.
Question 7: Which statement about cochlear implant use and residual hearing is correct?
- Cochlear implantation always destroys all residual low-frequency hearing
- Hearing-preservation cochlear implant techniques attempt to maintain residual acoustic hearing in the implanted ear (Correct answer)
- Patients must have no residual hearing to qualify for a cochlear implant
- Residual hearing automatically improves after implantation
Correct answer: Hearing-preservation cochlear implant techniques attempt to maintain residual acoustic hearing in the implanted ear
Modern hearing-preservation surgical techniques and hybrid implants aim to maintain low-frequency acoustic hearing alongside electric stimulation.
HAC Cochlear Implant Basics & Referral 3
Cochlear implants are designed to bypass which damaged structure to restore hearing?