USF Cochlear Implant Center
- K. Paul Boyev, MD, Director
Who we are
The Cochlear Implant Center at the University of South Florida was established in 2000 as a collaborative effort between the USF Department of Otolaryngology-Head and Neck Surgery and the USF Department of Communication Sciences & Disorders. In 2004 the Center was expanded and the James A. Haley Veterans Administration Hospital was added.
Our philosophy is based around the idea that patients benefit most if the human talents of a modern university can be focused towards the provision of patient care, education, and research. Surgeons, audiologists, speech therapists, and nurses are all dedicated to the successful empowerment of individuals who have lost the ability to hear or who are deaf from birth.
What is a Cochlear Implant?
Cochlear implant technology is the most successful interface between micro-electronics and the human senses - in this case, the sense of hearing. Because most deafness results from a lack of nerve endings of hearing - the hair cells of the cochlea - the cochlear implant electronically stimulates surviving components of the pathway "further upstream".
The cochlear implant, in basic terms, consists of an external processor, and two surgically implanted components: a receiver and an electrode. The external processor receives soundwaves from the external environment, and the software of the processor converts these into electrical signals detected by the receiver under the scalp. The receiver in turn relays these signals into the electrode which has been inserted into the cochlea, enabling it to substitute for the missing cochlear hair cells.
Who Benefits from Cochlear Implantation?
There are two main groups who stand to benefit from this life-changing technology: infants and young children who were born deaf, and adults who have been able to hear in childhood but who have subsequently lost hearing later in life. A third group, patients who were born deaf but did not seek cochlear implantation until their late teens or later, sometimes may benefit but not nearly as much as those in the other two groups. And, unfortunately, there are some individuals for whom cochlear implants are not recommended.
The general rules for infants and children born deaf is "the earlier the better" and "two are better than one". Children who were implanted early and on both sides are essentially indistinguishable from children born with normal hearing - you couldn't pick them out of a crowd.
Adult hearing loss can occur very gradually, where a patient experiences years of decreasing benefit from more and more powerful hearing aids, until finally even the most powerful hearing aid won't help. There are some disorders however, where adults can go through a more devastating experience and lose the hearing in both ears over a period of weeks. Cochlear implants can restore the ability to hear speech in these patients. Although the sound quality might not be as "Hi Fi" as it once may have been, these patients can communicate without lip-reading and even use telephones and cellphones.
Candidates, Surgery and Beyond
At your appointment with us, you and/or your child will be interviewed and examined by Dr. Boyev. If it seems that you would benefit from cochlear implantation, a CT scan of your ears and an MRI of your brain will be ordered. Additionally - and this is very important - you will need the vaccine for the pneumonia bacteria streptococcus pneumoniae, to minimize your risk for meningitis. We will also arrange special audiologic testing by Dr. Muscato at the USF Department of Communications Sciences & Disorders. For children, it is necessary to assess speech therapy and educational needs, as well as counseling support services. These needs are addressed at our Cochlear Implant Multi-disciplinary Conference.
Surgery takes place at Tampa General Hospital, which has received an award from U.S. News & World Report as one of the top hospitals for ear, nose, and throat surgery in the U.S. Patients remain overnight with a surgical drain which is removed the next morning, at discharge. Follow up appointment takes place on the following week.
The exciting part comes after the incisions have fully healed in about three to four weeks after surgery: the device is switched on! That day consists of an appointment with Dr. Boyev to check the surgical site, followed by an appointment with Dr. Muscato for "mapping". Mapping balances the quietest and loudest range of the implant for optimal comfort and function. Mapping sessions can occur several times before the implant is tuned up optimally for your or your child's needs.
After a child has had the initial mapping session, the real rehabilitation work begins. Although the child may be hearing sounds, he or she needs to learn how to hear and to produce speech. This depends on teamwork between motivated parents, educators, and therapists.