Toddler Receives Implants Thanks to Early Detection
Born profoundly deaf, Alexis Simmons is now able to hear with her new cochlear implants. As a newborn at Children’s Hospital of Georgia in 2007, Alexis underwent standard screening tests to determine any hearing problems. She did not pass the diagnostic testing provided through the Early Detection of Hearing and Intervention (EDHI) screening program. EDHI identifies early onset and congenital hearing loss, providing an initial infant screening for both ears, then retesting if a patient fails. After a second fail, an outpatient audiologist provides further testing for the child.
“Through the EDHI, we provide complete diagnostic evaluations and, when appropriate, fit these children with hearing aids within the first six months of life,” explains audiologist Dr. Becky Hopkins of Augusta Hearing and Balance, which works closely with Georgia Regents Medical Center (Georgia Regents Medical Center) and the Children's Hospital of Georgia. Many infants who are severely to profoundly hearing impaired may then become candidates for cochlear implants at the age of one year. Diagnostic testing indicated that Alexis was profoundly hearing impaired in both ears. Dr. Hopkins fitted her with hearing aids before six months of age.
“She wasn’t responding to the hearing aids. I feared they weren’t working,” recalls her mom, Donna. “Alexis is profoundly hearing impaired, so the hearing aids provided only minimal benefit — not unusual with her degree of hearing loss,” explains Dr. Hopkins.
Her parents, Donna Simmons and Macanthony Williams, met with Dr. Brian McKinnon, a neurotologist, to discuss implant surgery. During the cochlear implant procedure, a surgeon makes an incision behind the ear, then creates a small opening into the inner ear, placing a tiny electrode. A week later, the surgery is duplicated in the opposite ear. Manually controlled by a device the patient wears outside the ear and places much like a hearing aid, the implant aids in hearing by sending signals to the brain.
“In the last few years, evidence has determined that a bilateral cochlear implant is best, so it has become the standard of care for children who have severe hearing loss,” says Dr. McKinnon. The ideal age to receive the surgery is one, but Alexis didn’t have access to the program until she was two, when Dr. McKinnon and his team reopened the cochlear implant program at the children’s hospital.
“I was very nervous, because she was so young, and because of the risk that she could lose the little bit of hearing she did have, if the surgery wasn’t successful,” recalls Donna. “Everybody at the hospital answered all of my questions and didn’t beat around the bush with anything. Dr. McKinnon explained everything that would happen in detail.”
During the surgery, Donna paced the floor. “Nan, Dr. McKinnon’s nurse, was so great. She kept us posted and gave us updates to tell us how the surgery was going.”
The surgery was a success; within three weeks, Alexis and her mom were able to “turn on” her implants with the help of senior audiologist Dr. Miranda Pritcher, who specializes in cochlear implant programming. It was an introduction to the world of sound.
“At first she was scared; it surprised her,” says her mom. Three months later, the little girl is adjusting well. “She loves to go to the hospital to do the mapping,” says Donna about the implant tune-ups. “She sits still, so I know she understands what they’re for.” The mapping process allows the audiologist to make adjustments to sound levels and establish the necessary thresholds for comfort. Pitch, loudness and tempo are all measured and coded over a series of regular meetings in an effort to fine-tune the implant and ensure the child has a normal hearing range.
Alexis reads lips and signs a bit, too. “She’s got a long way to go, but she’s vocalizing a lot more, especially since she started pre-school,” says Donna. “She won’t ever hear like we do – she’ll always hear differently — with a sort of echo, and limitations — but she’ll adjust so that she understands just about everything,” she continues. “I’m so grateful she had the surgery.”
Brian J. McKinnon, MD, MBA
Department of Otolaryngology-Head & Neck Surgery
Becky Hopkins, AuD
Augusta Hearing and Balance