This is a short review of new opportunities for children with hearing loss aimed at primary care doctors. Parents can learn from it as well. Presented at the Swedish Pediatric education 1/21/11.

1. Current Opportunities in Pediatric Hearing Loss Douglas D. Backous, MD, FACS Otology, Neurotology, Skull Base Surgery Medical Director, Swedish Center for Hearing and Skull Base Surgery Seventh Annual Pediatric Specialty Update for the Primary Care Physician Swedish Medical Center January 21, 2011

6. Severe to Profound Hearing Loss on Reading Comprehension Schildroth and Karchmer 1986

7. Educational Impact of Unilateral Loss Hearing Loss White K. (2004) Am J Med Genetics

8. Severe to Profound Hearing Loss on Income Project Hope, 2001 proportion (%)

13. Left bone Right air Left air 100% 100% Right bone Understanding the Audiogram Normal Mild Hearing Loss Moderate Hearing Loss Severe Hearing Loss Profound Hearing Loss < > O X

14. Hearing Aids

16. Baha

17. Left air CNE CNE Right air Severe to Profound Hearing Loss 49 year old white male with progressive hearing loss < >

18. Candidacy Criteria Adults Adults/children 2+ Adults/children 1+ Speech recognition criteria Adults : < 50% sentences in ear to be implanted < 60% bilaterally (best aided condition) Children: <30% MLNT or LNT best aided Frequency (Hz)

19. Tonotopic Organization

20. Cochlear Implant System An internal implant placed just under the skin, behind the ear 1 And an external sound processor 2

21. Hearing loss in the U.S. 1.Kochkin, S. The Hearing Review,(2005); July. 2.Blanchfield, B.B.. JAAA. (2001);12: 183-189. 3.Available Mkt- National Institute on Deafness & Communication Disorders (NIDCD) 2004 4. Recipients– Internal Cochlear data Total hearing loss 1 1.6% annual growth rate 32m Potential device candidates 2,3 1 - 1.2 million severe-profound and profound 1 million SSD, mixed and conductive ~2m Total implanted population 4 10% Cochlear Implant /1% Baha <200k

26. Thank you