Auditory rehabilitation; prelingual hearing loss
CPT4 code
Name of the Procedure:
Auditory Rehabilitation for Prelingual Hearing Loss
Common names: Auditory Therapy, Hearing Rehabilitation
Summary
Auditory rehabilitation for prelingual hearing loss is a series of therapies and interventions designed to help individuals who were born with significant hearing loss develop communication skills. This can include the use of hearing aids, cochlear implants, and speech therapy to enhance the ability to hear and speak.
Purpose
This procedure addresses prelingual hearing loss, which occurs when a child is born deaf or loses hearing before they have developed language skills.
Goals: Improve auditory perception, enhance speech and language development, and facilitate communication skills in affected individuals.
Indications
Indicated for children and infants diagnosed with significant congenital or early-onset hearing loss.
Criteria: Early diagnosis through newborn hearing screening or pediatric evaluations, and a confirmed lack of adequate hearing for normal speech and language development.
Preparation
Parents or guardians should ensure that the child undergoes a comprehensive auditory evaluation, including audiometry tests and imaging studies if necessary.
No specific fasting or medication adjustments are needed for the initial evaluations. However, specific preparations may be required for certain procedures like cochlear implant surgery.
Procedure Description
- Initial Assessment: Comprehensive hearing tests using otoacoustic emissions (OAE) and auditory brainstem response (ABR).
- Hearing Aids: Fitting and tuning of hearing aids to amplify sounds.
- Cochlear Implants: Surgically implanted devices that directly stimulate the auditory nerve (performed under general anesthesia).
- Speech Therapy: Regular sessions with a speech-language pathologist to develop speech and language skills.
- Auditory Training: Exercises to improve sound discrimination and listening skills.
Duration
The duration varies depending on each intervention. Hearing aid fitting and initial training may take a few sessions, while cochlear implant surgery is a multi-hour procedure followed by months or years of therapy.
Setting
Evaluation and therapy typically occur in an outpatient clinic or a specialized auditory center. Cochlear implant surgery is performed in a hospital or surgical center.
Personnel
- Audiologists
- Otolaryngologists (ENT specialists)
- Speech-language pathologists
- Surgeons (for cochlear implants)
- Nurses and anesthesiologists (for surgical procedures)
Risks and Complications
- Hearing aids: Ear discomfort, feedback noise, or less than expected improvement.
- Cochlear implants: Surgical risks such as infection, device malfunction, and rarely, facial nerve damage.
- Speech therapy: No significant risks but requires long-term commitment.
Benefits
- Enhanced ability to hear and interpret sounds.
- Improved speech and language development.
- Better communication skills leading to improved social integration.
- Benefits are often realized over several months to years with consistent use and therapy.
Recovery
- Hearing aids: Immediate use with adjustment over days to weeks.
- Cochlear implants: Initial recovery from surgery takes a few weeks, followed by a period of device tuning and extensive therapy.
- Regular follow-ups with audiologists and speech therapists are crucial for ongoing improvement.
Alternatives
- Manual communication methods: Sign language.
- Tactile communication devices: For patients who do not benefit from auditory interventions.
- Pros and cons: Non-electronic methods like sign language are effective but do not provide auditory experience; tactile devices are less effective than cochlear implants in providing clear communication but are good alternatives.
Patient Experience
Patients may experience initial discomfort with hearing aids or implants, but these devices greatly improve over time with proper adjustments and ongoing therapy. Pain management after surgery includes standard post-operative care, and both patients and families should receive guidance and support throughout the rehabilitation process.