COCHLEAR IMPLANT CANDIDATE EVALUATION
The cochlear implant is an electronic device that provides electrical stimulation to the damaged hearing
nerve and is designed to assist oral communication. In order to determine if you or your family member is a
candidate for a cochlear implant, certain requirements must be met. Hearing tests or audiograms are the
basic criteria for candidacy, but we also consider other factors such as consistency in: hearing aid use,
treatment and/or educational program, parental involvement, parental or family support and responsibility,
and other physical/mental challenges. To assess these areas, it is your responsibility to have your child’s
teacher complete the enclosed teacher’s questionnaire for our file, and to see that we receive records from
the necessary professionals (see “Additional Information”).
There are several audiological tests that are required to determine the benefit you are receiving from your
hearing aids. All testing with hearing aids should be done with well-fitting earmolds and aids that are in
good working order and appropriate for your hearing loss. It may be necessary for you to obtain new
earmolds, send aids for repair, or get newer and stronger aids before these tests are done. Behind-the-ear
aids are required for testing.
For children, the required testing may performed at the Dubard School in Hattiesburg or the Magnolia
Speech School in Clinton. In Hattiesburg contact Virginia Berry at 601-266-5216. For Magnolia Speech
School, please contact Alicia Swann or Kathy Irving at 601-922-5530.
Please have the following tests sent to our office for our review:
1. Complete hearing evaluation without hearing aids.
Individual ears air and bone conduction, speech reception, and word recognition.
2. Tympanogram
3. Monaural aided audiograms
Individual ears with word recognition
4. Binaural aided audiogram with word recognition
5. Assessment of hearing aids with sentence material
(HINT or HINT-C without noise, CID, CUNY)
NOTE: All testing should be recent, i.e., within the past six months. In addition, aided testing should
include hearing aid make, model, settings (volume and internal controls), as well as a copy of electoacoustic
analysis of hearing aid function at the time of the test.
Once your file is completed with the necessary information, you will meet with one of our audiologists to
discuss the test results and answer any questions that you may have. Additional testing in our office may be
required, and several visits are usually required to make a determination. It is important that you come for
all scheduled appointments at your scheduled time.
COCHLEAR IMPLANT POST IMPLANT PROCEDURES
A cochlear implant is a prosthetic device that restores auditory sensation to adults and children with a
severe to profound sensorineural hearing loss. A critical component to the success of the procedure is
postoperative training and rehabilitation, without which the implant cannot be used, nor will any benefit be
obtained. Realistic expectations and commitment to the necessary follow up is very important to the success
of the implant.
1. Post-Op Visit
One week after the surgery you will come in to see Dr. House to have your stitches removed. At that time,
we will schedule your appointment with the audiologist to activate the device. Your visit for the initial
stimulation will be approximately one month after surgery, to allow the area around the implant to heal. At
your office visit with Dr. House, you will be given the external equipment for the implant (processor,
headpiece, battery charger, and accessories) so that you can familiarize yourself with these items before the
stimulation.
2. Initial Stimulation
Also called hook-up, the device will be turned on and programmed (mapped) at this visit. Measurements
will be made to find the softest sounds that you can detect with the implant, and where the sounds are most
comfortable. We will place several different programs in the processor for you to listen with until your next
visit. Use and care of the device will be reviewed at this time. Most patients can detect sound after this
visit, which will last about 3 hours.
3. Follow-Up Mapping
Because changes occur within the ear itself, it will take some time for the ear to adjust to the electrical
stimulation. Follow up programming is required every two weeks for the first two months after the initial
stimulation. These sessions are similar to the first visit, where electrical levels are measured and the
programs are adjusted. After this period, the you will be followed once a month for 3 months, then once
every 3-6 months depending on the stability of your program and the measured benefit. Testing of benefit
and progress with the implant will be done periodically during the first year, and then annually.
In general, the number of visits will total 12-14 visits the first year, and twice a year thereafter.
Follow up appointments cost $250 and may or may not be covered by insurance.
COCHLEAR IMPLANT EXPECTATIONS
One of the most important considerations with a cochlear implant is having appropriate expectations in
regards to what the implant will be able to do for you. THE SOUND FROM THE IMPLANT WILL
SOUND DIFFERENT FROM HOW YOU AND OTHERS HEAR SOUND. We cannot predict exactly
how well or what you will hear with the implant once it is turned on, and the sound is different for everyone.
Learning to listen with a cochlear implant is learning a whole new language, as what your brain "hears" will
be different from what it has been hearing. Familiar sounds will be altogether different, and you will have
to relearn the sound of the telephone, a knock on a door, the sound of your name. Some patients may be
able to understand others speaking without lipreading, others may be able to follow well with lipreading,
and for some the implant may only bring in better awareness of sound in the environment. There are some
factors which will influence how well you will do with the implant:

Hearing Aid Use
The longer and more consistently that you have been wearing your hearing aids, the better the
implant will work for you. The more stimulation your hearing nerve and your brain receives, the
better they will be able to utilize the cochlear implant's electrical stimuation to turn it into sound
that you can use.

Length of Deafness
The shorter the period of severe to profound deafness, the better the outcome. Those who have
lost their hearing rapidly (for example, due to infection) or have had a recent decrease in an
established hearing loss have more memory for sound, and the brain is better able to organize the
implant's signal.

Age
The younger the candidate, the shorter the time it takes to become accustomed to the signal from
the implant: the brain is not yet completely "wired" for sound and is able to adjust faster.

Rehabilitation after Implantation
Auditory training will help your brain transition to the new language better and faster. For
children this is especially important as they are trying to learn their first language, and the more,
the better. Children need the benefit of an auditory/oral school where they will work on auditory
training every day. Think about it! It is easier to learn Russian if you have a teacher, helper,
and guide, than if you were dropped off alone in the middle of Moscow.
The cochlear implant is designed to give your brain a more consistent auditory signal, and we aim for a
certain range of hearing on the audiogram--to hear or detect sound better. What we don't know is how well
your brain will be able to use that information to understand what is heard. The better auditory signal does
not necessarily carry over to improve speech and language development, and if you or your child already
has auditory processing disorders (how your brain organizes and uses sound), the implant will not improve
this difficulty.
FINANCIAL ASPECTS OF COCHLEAR IMPLANTATION

THE IMPLANT AND SURGERY
The complete cost of receiving a cochlear implant is approximately $50,000. The majority of this cost is
covered by most insurances. The internal device carries a 10 year warranty against device failure. When
you come for your appointment, please be sure and bring your insurance card and a copy of your benefits
booklet if you have private insurance. We will obtain pre-authorization from your insurance company
before surgery is scheduled. To expedite this process, both implant companies have reimbursement
specialists who will help you obtain pre-authorization. Once you decide which device you would like to
pursue, there are forms that will need to be filled out and sent in to the company in order for them to assist
you. We will file the cost of the surgery with your insurance.

OFFICE VISITS
The cost of office visits prior to surgery range from $90 to $175. The cost of your programming visits after
surgery is $250. Your insurance may or may not cover these visits. Please contact our billing office to
determine if we will file your insurance for you, and whether you will be responsible for the total cost of the
visit each time.

REPLACEMENT OF EXTERNAL PROCESSOR PARTS
The external processor and headset comes with a three year warranty from the manufacturer. If you should
have any problems with your hardware during that time, the part will be replaced. This does not include
replacement if you lose any of these parts. Currently, the cost to replace the external speech processor is
approximately $6,500, and the headset about $400. Usually your medical insurance will not cover these, so
we will provide you with forms to fill out for implant replacement insurance. This insurance will cost $200
per year per processor.

CORDS AND BATTERIES
There will be an ongoing expense for cords and batteries. Cords may need to be replaced yearly or sooner,
depending on wear and tear. Cost of cords range from $12 to $28, depending on the manufacturer, and are
not covered by insurance. Batteries range from $90 for rechargeable batteries from Advanced Bionics
which need to be replaced yearly, to $5 per package for disposable batteries that last 2-3 days from
Cochlear Corporation. In most cases, the cost of replacing these items are your responsibility, and may be
obtained from us, or directly from your manufacturer.

OTHER MISCELLANEOUS SUPPLIES
In order to keep your processor in good working condition, it is necessary to protect it from moisture. This
requires the use of a Dri-Aid Kit ($20.00), similar to those used for hearing aids, and which needs to be
replaced yearly. Other accessories are available: extra belt pouches ($30), earhooks ($10) are the most
common.
PRECAUTIONS WITH COCHLEAR IMPLANTS

Meningitis
The vaccine called Prevnar has been recommended since 2000 by the American Academy of Pediatrics for
a form of bacterial meningitis call pneumococcal meningitis. It is strongly suggested that all persons
receive this vaccine prior to implantation.

MRI
Magnetic Resonance Imaging (MRI) is not allowed with most current cochlear implants. The magnetic
field of the scanner can jar the positioning of the internal device and cause it to malfunction. If this is a
concern, this may be discussed with Dr. House. If MRI is required, it may be necessary to undergo surgery
to have your implant deviced removed so that the scan can be done, then reinserted. It may also be possible
to have an implant with a removeable magnet: this would still require surgery, but only the magnet be
removed, not the complete device.

Diathermy
No diathermy that utilizes microwaves or inductive heat may be used on cochlear implant recipients.
Ultrasound diathermy may be used, but only below the head and neck area.

Static Electricity
Patients with cochlear implants must be aware of static electricity and should not discharge the static to the
processor or headpiece. Specifically, this means that children should not play on plastic slides or in the
plastic ball playrooms with their processors on. Also this means no folding clothes out of the dryer or
touching TV or computer screens with your external processor on. A handout is available on this topic.

Future Technology
Both implant manufacturers maintain that the design of the internal device will not change significantly in
the foreseeable future. It is strongly recommended that you or your child continue to wear a hearing aid on
the non-implanted ear to stimulate the nerves for that ear. The future is unknown, and the cochlear implant
in 20 years may be significantly different from the ones we know today.It is important that the currently
unimplanted ear be stimulated to better take advantage of future improvements.
ADDITIONAL INFORMATION REQUIRED
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Previous audiological tests
Any electrophysiological test results, i.e., Auditory Brainstem Response (ABR) ,
electonystagmography (ENG), or electrocochleography (ECoG)
Medical records pertaining to the ear and any overall health conditions
Educational test findings: speech/language evaluations and/or psychological testing
Previous MRI/CT scans of the head
Contact information for other involved professionals (internist, ENT, audiologist, speech
pathologist, occupational or physical therapist, deaf educator, school teacher)

If you have any questions regarding any of the information in this packet, please contact one of our
audiologists at 601-981-2825.
Teacher’s Questionnaire
Child’s Name: ________________________________________________________ Age: ___________
Family Data:
Parent(s) Name(s): ________________________________________ Education:____________________
Occupation: ____________________________ Place of Employment: ___________________________
Does the child wear the hearing aid at home? ________________________________________________
Have aids been lost? How often? __________________________________________________________
How does the child relate to siblings? ______________________________________________________
School Performance:
Days Absent ______________ Reason (if known): ____________________________________________
General Mood: ________________________________________________________________________
Interest in School: _____________________________________________________________________
Attitude: _____________________________________________________________________________
Peer Relations: ________________________________________________________________________
Personal Habits: _______________________________________________________________________
Classroom Behavior: ___________________________________________________________________
Work/Study Habits: ____________________________________________________________________
Extra-Classroom Behavior (playground, lunch) _______________________________________________
_____________________________________________________________________________________
Describe child’s degree of effort: __________________________________________________________
_____________________________________________________________________________________
Does the child wear or bring his or her hearing aids to class? Yes______________ No ______________
What problems or difficulties does the child exhibit in school? __________________________________
_____________________________________________________________________________________
Speech/language deficits: ________________________________________________________________
Auditory processing disorders: ____________________________________________________________
Impression as to suitability for cochlear implant: _____________________________________________
_____________________________________________________________________________________
Teacher Signature: ______________________________________________ Date: ________________
No. 1
Candidate
Children’s Expectations Questionnaire
(Answer True or False)
When I am using the cochlear implant… …
__________ 1. I will be able to talk on the phone right away.
__________ 2. I will usually have to see someone’s face to understand words.
__________ 3. Noise will always make hearing and understanding harder.
__________ 4. I will understand people talking on T.V.
__________ 5. I will be able to notice many everyday sounds.
__________ 6. All words will sound clear to me.
__________ 7. I will be able to understand all speech without lipreading, once I have received training.
__________ 8. At school, usually it will be very difficult to understand the teacher if I cannot see her
face.
__________ 9. I will be able to hear my own voice.
__________10. I won’t be able to hear better in school.
__________11. Music will sound good to me.
__________12. Others will not know that I have a hearing problem.
__________13. Speech will sound natural to me.
__________14. I will have to have some training so that I can learn new sounds.
__________15. I will be able to tell the difference between some, but not all, voices.
Candidate
No. 1
ADULT EXPECTATIONS QUESTIONNAIRE
(Answer True or False)
When I’m using the cochlear implant… … ..
__________ 1. Conversation over the telephone will be easy to understand.
__________ 2. Lipreading will always be a major part of my communication.
__________ 3. If there is background noise, it may always be a problem.
__________ 4. Most television programs will be easy to understand with hearing alone.
__________ 5. Sounds around me will be different than what I remember them.
__________ 6. It will be impossible for me to separate one word from another when listening to normal
conversation.
__________ 7. I will be able to understand all speech without lipreading, once I have received training.
__________ 8. I an auditorium, usually it will be very difficult to understand the speaker.
__________ 9. It will be possible to hear my own voice.
__________10. I can be assured of better job opportunities because of better hearing.
__________11. Music will sound as I remember.
__________12. Others will not know that I have a hearing disability.
__________13. Speech will sound natural to me.
__________14. It will be necessary to undergo some training in order to make use of the new sound
sensations.
__________15. I will be able to tell the difference between some, but not all, voices.
Family
No. 1
ADULT EXPECTATIONS QUESTIONNAIRE
(Answer True or False)
When my family member receives the cochlear implant…..
__________ 1. It will be possible to carry on normal conversations when there is average noise at the
dinner table.
__________ 2. Music will sound normal to him/her.
__________ 3. (S)he will need further training to make the best use of the new sounds.
__________ 4. (S)he will be able to understand all speech without lipreading.
__________ 5. We will be able to have a normal conversation over the telephone.
__________ 6. (S)he should be able to better control the loudness of his/her voice.
__________ 7. Background noise may still make communication more difficult.
__________ 8. (S)he should be able to recognize a number of environmental sounds after some use and
training.
__________ 9. Lipreading will no longer be a major part of his/her communication.
__________10. Sounds will be different than what (s)he remembers.
__________11. It will be difficult for him/her to follow a conversation when several people are talking at
once.
__________12. His/her deafness will no longer be a disability.
__________13. (S)he will be assured of better job opportunities because of improved hearing.