How is hearing tested?
Hearing tests are divided into subjective methods, which require patient cooperation (and therefore cannot be used with very young children), and objective methods, where patient cooperation is not necessary. Subjective methods include the traditional hearing test using spoken and whispered speech, as well as audiometric testing. Objective methods are based on capturing responses from various levels of the brain to sound stimuli. These include BERA, CERA, and SSEP. These tests are usually performed either in natural sleep, sleep induced by medication, or under general anesthesia.
At what age can a child's hearing be tested?
Hearing can be tested in a child just a few days after birth using objective audiometric methods. Our facility is staffed and equipped to test the hearing of newborns, young children, older children, and adult patients.
Is the hearing test using objective methods reliable?
In a group of children we tested using objective methods and later verified with standard audiometric tests, it was shown that the hearing thresholds measured by objective methods correspond to the thresholds the children reported during audiometry.
Caution is required with prematurely born children or patients with neurological impairments, as they experience slower maturation of hearing pathways. Therefore, objective audiometry may show slightly worse results than the actual hearing. In such cases, it is necessary to repeat the test, use multiple methods, and closely monitor the overall development of the child and their response to sounds.
What are the risk factors for congenital hearing impairment?
Congenital hearing loss can result from genetic causes (the child inherits the predisposition for hearing impairment from their parents, who may have normal hearing but be carriers of faulty genetic information) or from environmental influences acting on the developing fetus (e.g., maternal diseases such as diabetes, cytomegalovirus, rubella, or medications the mother takes, such as antibiotics or chemotherapy).
What conditions must a child meet to receive a cochlear implant?
A candidate for cochlear implantation must meet audiological, speech therapy, and psychological criteria. The child's hearing loss must be severe enough that even the most powerful hearing aids cannot compensate for it. The child must have the potential to develop spoken language and must be willing and able to cooperate at least partially during rehabilitation. Parents must consent to the surgery, be adequately informed, and have realistic expectations regarding the potential of the cochlear implant and the child's progress. They must also be willing to cooperate with the ongoing long-term rehabilitation process. The child’s overall health and any other disabilities are also considered (the child must be able to undergo surgery under general anesthesia; we currently also perform surgery on children with combined disabilities such as deaf-blindness, cerebral palsy, autism, mental retardation, etc.).
How is the cochlear implantation surgery performed?
The surgery is performed under general anesthesia and lasts about 2-3 hours. The standard surgical procedure used in implantation centers worldwide is generally the same, differing only in some details.
First, an incision is made near the ear, and a pocket for the implant body is created in the bone behind the ear. Then, the electrode bundle is inserted into the cochlea. During the surgery, the auditory nerve responses are monitored. Finally, the implant is fixed in place, and the incisions are closed. The wound is covered with a bandage, and the child is transferred to the postoperative department. About a week after the procedure, the stitches are removed, and the child is discharged for home recovery.
Are unilateral or bilateral cochlear implants performed in the Czech Republic?
In the past, unilateral cochlear implantation was the standard. Currently, we also perform bilateral cochlear implants. More information is available at our facility.
Can a user of one cochlear implant wear a hearing aid on the other ear?
In some cases, a hearing aid on the other ear may allow for directional hearing or improve speech comprehension in noisy environments. The benefit of the hearing aid is individual and depends on the amount of residual hearing in the non-implanted ear and the user’s prior experience with hearing aids. For information about the possibility of using a cochlear implant on one ear and a hearing aid on the other, please consult your doctor at the Cochlear Implant Center.
How long after surgery does it take for a child to hear?
After the surgical wound has healed (about 4-6 weeks post-implantation), the first programming of the sound processor is done at our department. This means the child receives the external components of the implant, and the initial setting is made. From this point, the child can start perceiving sounds. Initially, they learn to hear sounds, then to recognize and distinguish them, and in the next phase, they learn to listen to and understand speech. Parents typically observe the first progress in speech comprehension several weeks to months after implantation. It depends on the child’s age, abilities, and how actively parents work with the child.
Can a child with a cochlear implant participate in sports?
A child with a cochlear implant can participate in sports and can take physical education classes at school.
However, the user of a cochlear implant should avoid activities and sports where there is an increased risk of head injury (such as blows to the head or falls), as this could damage the internal components of the device. We do not recommend contact sports (e.g., boxing, wrestling), team sports (e.g., collisions with teammates), or activities involving jumps or impacts with the ground.
Sports should always be assessed individually, taking into account the nature of the sport, the conditions of its practice, and the abilities of the cochlear implant user. When participating in sports, increased caution is required, safety rules should be followed, and protective equipment (e.g., helmets) should be used. It should also be considered that a cochlear implant user may experience difficulties with directional hearing and speech comprehension in noisy environments (e.g., gyms, sports halls). For water sports, the external components of the cochlear implant should be removed and stored safely (protected from water, damage, or loss).
The decision to engage in a specific sport is entirely at the discretion of the user.