Deafness: Cochlear Implants for Children

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Guest: Dr. Paul R. Lambert - Otolaryngology - Head and Neck Surgery (ENT)

Host: Dr. Linda Austin – Psychiatrist

Dr. Linda Austin: I am Dr. Linda Austin interviewing Dr. Paul Lambert, who is Professor and Chairman of the Department of Otolaryngology ? Head and Neck Surgery. Welcome to our show.

Dr. Paul R. Lambert: Thank you.

Dr. Linda Austin: Dr. Lambert, you have national expertise and reputation in the area of cochlear implants and one of the exciting applications of the surgery is for children, what is the youngest child you have ever done such a surgery?

Dr. Paul R. Lambert: The youngest child is about 10 months of age and this was a child, who was born deaf. We are dealing younger and younger children all the time. When I first started with this, the FDA allowed us to implant down to about age 2 and that has been creeping younger and younger over the last five to six years, and we think that the as soonest or -- if we can implant earlier in a child’s development, their ultimate ability to hear and develop speech and language increases.

Dr. Linda Austin: So, these are children, who just congenitally are born without properly functioning cochlea that were bones essential for hearing, is that right?

Dr. Paul R. Lambert: That’s correct. So, they are either born deaf or in many cases, they will develop deafness as a result of meningitis, so a large percentage of our children have contracted meningitis and in a small percentage of those, deafness will be certain.

Dr. Linda Austin: That’s what happened to Helen Keller, isn’t it? Did she have meningitis or some sort of illness as a child?

Dr. Paul R. Lambert: I think, she didn’t and I think you are right.

Dr. Linda Austin: Are there side effects or adverse reactions to this surgery?

Dr. Paul R. Lambert: Well, I think any surgery carries some risk. Fortunately the risks with this surgery are very small. Meningitis is actually a risk. Personally, I have never seen that develop over many years of doing surgery, but that’s one of the risks. The downside, however, of not performing an implant and allowing a child to never develop speech or language certainly carries a lifelong risk to it.

Dr. Linda Austin: Now, I know as a psychiatrist that as a baby’s brain develops, certain nerve cells have to be recruited in order to have a child to hear properly. It’s not just having an ear’s function right it’s the brain development that goes along with that. If a child is too old, are there problems that you see with the child’s brain learning, how to adapt to the atmosphere, a startling or even jarring sensation for 02:35?

Dr. Paul R. Lambert: That’s an excellent point. Actually, if we are unable to provide sounds to a child before age 10 or 12, then an implant really does not have much effect thereafter because there are parts of the brain that need to be stimulated, pathways as well as cells need to be stimulated or they just simply lose the ability if you try to stimulate them later on in life, it’s to no effect. There are critical learning periods for a child perhaps of age 2 to 3 and then may be again at age 5 or 6 where it is absolutely critical to have auditory input and if you miss those critical learning periods and you never really completely recover and this is will set an adolescent. We probably would not consider them for an implant if that never 03:31.

Dr. Linda Austin: How many centers in the US are currently doing this surgery?

Dr. Paul R. Lambert: I would guess that most major medical centers throughout the country are doing cochlear implants. I know them personally. I did my first cochlear implant in 1984, so it’s probably 20 years ago, but most major medical centers are currently involved in either adults or children or both.

Dr. Linda Austin: Dr. Paul Lambert, thank you so much for talking with us today.

Dr. Paul R. Lambert: Thank you.

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