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The Ottawa Cochlear Implant Program for Adults is part of the Audiology Department, located in the Parkdale Clinic of The Ottawa Hospital’s Civic Campus. This program was created in 1993 and individuals have travelled from many parts of Canada to have their surgery done here. The surgeon who heads the medical and surgical aspects of the program is Dr. David Schramm.

Dr. Schramm is an otolaryngologist / otologist / neurotologist who has been with the program since its inception. The team is also comprised of three audiologists: Shelly Armstrong, who is the Program Coordinator, Chantal Gauthier-Hotte and Sylvie Lalonde-Couturier. Other professionals may be involved in the pre- and post-cochlear implantation stages. To date, more than 1,000 cochlear implant surgeries have been performed in Ottawa.

About Cochlear Implants

What is a cochlear implant?

A cochlear implant is an electronic device that replaces damaged or absent hair cells located in the inner ear, also known as the cochlea. These hair cells normally transmit stimulation to the hearing nerve fibres. When there is significant damage to these hair cells, a cochlear implant may be inserted to artificially replace the hair cell function.
How does a cochlear implant work?

Briefly, a cochlear implant operates as follows:

  1. Sound waves enter the cochlear implant system through an external microphone. The sound waves are converted into electrical signals.
  2. The electrical signals are then sent to the speech processor.
  3. The speech processor converts the electrical signals into codes developed for sound and speech understanding.
  4. The coded signals are sent to the headpiece and transmitted across the skin to the cochlear implant (in the skull) via radio waves.
  5. The cochlear implant decodes the signals and delivers them to the electrodes located inside the cochlea.
  6. The electrodes stimulate the hearing nerve fibres within the cochlea, which in turn send electrical impulses to the brain. The brain then interprets the stimulation as sound and speech.

This may appear like a slow process, but it occurs so rapidly that sounds are actually perceived as they happen. The new sound perception allows a deaf person to improve his or her ability to communicate.

Determining Cochlear Implant Candidacy

What is is the process?

The first contact with the Cochlear Implant Program at The Ottawa Hospital is with the audiologist. The audiologist will measure the patient’s hearing loss and determine the amount of benefit that the person receives from their hearing aids. Then, the patient will undergo a few medical tests, and meet with the surgeon, Dr. Schramm.

Who is a candidate for a cochlear implant?

The following checklist is only a guideline for adult patients. Most cochlear implant candidates meet the following criteria. However, patients who are close to the criteria may also be referred and considered as candidates. Patients who are bordering candidacy are welcome as well, so that they gain information on cochlear implants, and at least consider it as a future option.

  • Severe to profound hearing loss in both ears.
  • Limited benefit from hearing aids.
  • Poor speech recognition ability.
  • Difficult, impossible or limited use of the telephone.
  • Speech-reading or note writing required to understand speech.
  • Distressed by the inability to communicate efficiently on a daily basis.

Expectations and Benefits of Cochlear Implants

Why have a cochlear implant?

The range of potential benefits with a cochlear implant varies across users and may include the following:

  • Environmental awareness and responsiveness.
  • Reconnection with the world of sound.
  • Better speech understanding compared to the use of a hearing aid.
  • Less dependence on family members and friends for day-to-day living.
  • Facilitation of communication with family and loved ones.
  • Ability to talk on the phone.
  • Better appreciation of music.

What are the factors to consider before making the decision to get a cochlear implant?

An implant does not cure deafness. People with cochlear implants do not have normal hearing. They often continue to struggle to hear in difficult listening situations, such as when distance and background noise are present. When the cochlear implant system is turned off, there is no sound.

It takes time, motivation and patience to learn to use a cochlear implant and to achieve its full benefits. Rehabilitation is often required to help the person make use of the new sound. Regular follow-up appointments in audiology can be expected to optimally adjust the cochlear implant system.

Although there are many positive aspects to receiving a cochlear implant, there are also some drawbacks. Cochlear implants are electronic devices. Similar to a hearing aid, at times, the external pieces malfunction and require replacement.

Your expectations of the cochlear implant should be thoroughly discussed with your audiologist to ensure that you truly understand what it can and cannot accomplish for you.

In conclusion, there are basically four different stages of cochlear implantation: assessment, surgery, rehabilitation and yearly follow-ups. Choosing to get a cochlear implant is a very personal decision. It is a process that needs to be examined with the person considering getting an implant and the entire Cochlear Implant Program team.

If you would like more information on cochlear implants, or if you wish to refer a patient, please contact:

Shelly Armstrong, Cochlear Implant Program Coordinator
Audiology Services
The Ottawa Hospital – Civic Campus
737 Parkdale Avenue
Ottawa ON K1Y 1J8
Tel.: 613-798-5555 ext. 18003
Fax: 613-761-4312
Email: sarmstrong@toh.ca