The most critical period for a child’s auditory development is before the age of two. Children who lack auditory stimulation during this critical period will have difficulty learning language later in life. From the age of 2 to 7 years, the brain’s ability to learn to make sounds and form language gradually deteriorates, and with it, the difficulty of learning language increases, but there is a great deal of individual variation in children’s language development, so the critical period described above is only for most children.
0-3 months
Responds to loud sounds (wakes up, startles or stares.)
Recognizes the voice of the parent.
Responds to familiar sounds (becomes quiet, smiles)
Looks around for the source of the sound when spoken to
Makes pleasant loud noises: cooing, giggles softly
Has a special way of crying (cries when hungry)
3-6 months
Begins to develop his own “baby language” (also called babble)
Pay attention to the sound of music
Can recognize friendly or angry sounds
Can find the source of the sound and can hear his own name
Uses different crying sounds and will stop crying when spoken to
6-9 months
The “baby language” is getting richer.
Listens to music attentively and responds to his own name.
Understands simple verbal commands.
Can recognize the names of simple objects.
Indications for cochlear implants
A comprehensive assessment is made based on the patient’s age, audiological evaluation, medical evaluation, intelligence testing, parental expectations, family financial conditions and support. The details are as follows.
Bilateral severe or very severe sensorineural deafness. That is, pure tone mean hearing loss ≥ 70 dB HL; auditory brainstem evoked potentials ≥ 100 dB nHL.
There were no contraindications to surgery, cochlear development was basically normal, no cerebral palsy, no post cochlear lesions, and normal mental intellectual and behavioral development. Zheng Jun, Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital
Parents have a correct understanding of the cochlear implant and appropriate expectations.
Family has the ability (human and financial resources) to cover all costs incurred except for the cochlear implant
Cochlear implant
Contraindications to cochlear implants
The cochlear implant is a device that allows the patient to perceive sound through electrical stimulation of the auditory nerve. It is mainly suitable for cochlear deafness, but not for post cochlear deafness. The degree of hearing loss is severe and profound deafness.
1. Cochlear and auditory nerve factors: From the imaging degree, it is believed that the relative contraindications to cochlear implantation should be complete absence of the cochlea and severe narrowing of the internal auditory canal. The cochlear implantation is generally contraindicated when the internal auditory canal is less than 2 mm in diameter because of the lack of the auditory nerve and vestibular nerve.
2. Middle ear infection: In patients with purulent otitis media, implanting electrodes can bring the infection foci into the inner ear, which is very dangerous. If a cochlear implant is to be made, the head should have the otitis media disease completely removed. Therefore, the period of purulent otitis media is one of the contraindications to cochlear implantation.
3. Cochlear fracture: Cochlear fracture is likely to damage the vestibular cochlear nerve and make cochlear implantation into ineffective. Therefore, cochlear fracture leading to damage to the auditory nerve is a contraindication to cochlear implantation surgery.
4. Patients with mental illness: Electrical stimulation may stimulate the cerebral cortex, so mental illness is a contraindication to cochlear implantation surgery.
5. Other contraindications to routine surgical procedures are also not considered for cochlear implantation.