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Kapi'olani Offers Cochlear Implants New hope for children with severe hearing loss 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, Hawaii's 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 Hawaii. "It can make a big difference in a child's life, to go from a child who doesn't have any hearing and has to use sign language to a child who hears and communicates 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 receive 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 -- Dr. Tran, as well as 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 -- evaluates the child to make sure he is an appropriate candidate -- physically and psychologically -- for the procedure. 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. Lenh Anh Tran, M.D. "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." Says Jadie Goo, whose son Emerson had to travel to Los Angeles for his cochlear implant four years ago, "It's great that the whole package -- pre-evaluation, the surgery and follow-up therapy -- is now available in Hawaii at Kapi'olani." For more information on cochlear implants, contact Kapi'olani's Rehabilitation Department at 808-983-8235. A Miracle When he was 4 1/2 months old, an ear infection destroyed both Emerson Goo's eardrums and his hearing. Profoundly deaf in both ears, he didn't benefit from hearing aids. "It was devastating," says his mother, Jadie Goo. "Fortunately, we had a lot of support from professionals, family and friends." To regain his hearing, Emerson's only recourse was a cochlear implant. But the procedure wasn't available in Hawaii at the time, so his family had to take him to Los Angeles. He was just about a year old. There he underwent pre-screening, surgery to repair his eardrum, implant surgery, and the first programming of his implant device. Three months after the surgery, with intensive auditory and speech therapy, Emerson said his first word, "Mama." Thanks to this new technology, Emerson now has what's classified as mild to moderate hearing loss. In a quiet room, he can hear a whisper. He is a kindergartner, and a top performer in his class. His language is appropriate for his age, and he reads far above his age level. Says his mother: "He's doing great; we're very happy with where he is now." "The device is a miracle. It has re-opened the hearing world to Emerson." Kapi'olani Kids is printed by Kapi'olani Medical Center for Women & Children. This is the May 2005 issue. Kapi'olani Kids is published twice a year as a service to parents in the community served by Kapi'olani Medical Center for Women & Children, 1319 Punahou, Honolulu, HI 96826. The information is provided as education about physical, mental and psychosocial health. It is not intended as a substitute for consultation with a physician. If you have questions or concerns about specific items that appear in Kapi'olani Kids, please contact your child's doctor. To advise us of changes to your mailing address, please contact us at 808-535-7554.