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HeadWay - With Cochlear Implants, the Sooner the Better

HeadLines Summer 2010

With Cochlear Implants, the Sooner the Better

Date: June 14, 2010

When they heard him pronounce his first words—Dada, Mama—Michael Kade Fotta’s parents were thrilled. But that excitement gradually turned to fear when his vocabulary, instead of rapidly growing, began to decline. Soon, he was saying nothing at all.

The 15-month-old boy wasn’t responding to sound, either. Not to loud noises, not to his parents’ voices, not even to his own name. He began crying every time his parents left the room. “He’d have to run and find us,” recalls his mother, Kerri. “We could not be out of his sight.”

Now, she says, they know it was because he was afraid. “He was losing his hearing so drastically and in such a small period of time, there was no way for him to understand where we were going or that we were coming back.” A series of doctors’ visits finally revealed that Michael Kade was bilaterally deaf. By that time he was 17 months old, and his parents faced a difficult decision. Should their son receive a cochlear implant so he could hear?

For young children with acute hearing loss, the length of sound deprivation can be critical in their ability to develop voice and hearing skills later. Children with prolonged early deafness are at a disadvantage as they try to make sense of speech and sound with a cochlear device. The sooner they can get cochlear implants, the better.

After meeting with Johns Hopkins otologist Howard Francis, Michael and Kerri Fotta gave their approval for their son to undergo the procedure. The technology has in recent years reached tried-and-true status and become the go-to solution for eligible patients, especially young children. Even so, Michael Kade’s case is different.

In the past, physicians and families hesitated to provide children with cochlear devices in both ears. Surgeons worried that if the procedure disrupted the hearing or vestibular function of one ear, it would be too risky to jeopardize the other ear with the same surgery. They also thought it wiser to save the second ear in case better technology emerged. “There were potential drawbacks,” Francis says, “that turn out to be uncommon.”

For the first six years of his life, Michael Kade had a single implant, and, his mother says, once his hearing was restored, he made rapid progress, including starting preschool at the normally scheduled age of 3 years.

In the end, though, the benefits of bilateral implantation—including improved understanding of speech in noisy environments and better sound localization—outweighed the risks.

“It was a hard decision for us,” Kerri says, “but as parents we wanted to better his quality of life, and we felt that included bilateral hearing.”

But it isn’t a decision a family can ponder for a long time. The opportunity for cochlear implant surgery to provide optimal benefits does have something of a shelf life. “Kids need this early on because it’s a prime opportunity for language development,” Francis explains. “It’s not going to be as helpful to them once that window of opportunity closes.”

For Michael Kade, whose second implant was placed in 2009, six years after the first, this theory—along with the decision to implant devices in both ears—turns out to be correct. Today, Kerri says, her son is just a normal kid who’s completely adapted to a hearing world. “He’s hearing crickets for the first time. He plays basketball, baseball. He just made honor roll. He’s perfect.”

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