From the first suspicion to the diagnosis, the first steps to medical facilities and any necessary and appropriate surgery - here you can find valuable medical information that will ensure a quick and reliable diagnosis and provide your child with the best possible medical support:

Information on how hearing works and how hearing loss occurs can be found in detail on the MED-EL website. Among other things, you will find a graphic representation that illustrates the individual steps of hearing. The different types of hearing loss are also explained.

Initial detection in the first days of life

It is up to the parents themselves to decide where their baby is born - whether in a maternity clinic or at home. Immediately after the birth, however, the conditions for important examinations and checks should always be guaranteed. One of these examinations is the newborn hearing screening (NGHS). This uncomplicated and gentle method of testing the newborn's hearing provides quick initial information on any abnormalities. In order to detect possible unilateral deafness in good time, this examination should, of course, be carried out on both ears since 2018.

Further steps for the experts

After discharge from the maternity clinic, pediatricians are the first point of contact for parents. Your baby will be regularly checked, vaccinated and followed up for years. If the newborn hearing screening at the maternity clinic was abnormal and you were not automatically referred to an ENT clinic, pediatricians are also an important contact with whom you should discuss the issue.

After all, how early a child's hearing impairment is discovered is crucial for the development of the auditory pathway and therefore for early childhood speech development.
The pediatrician may then refer you to an ENT specialist at the latest, who will order further important examinations for a final diagnosis.

As the newborn hearing screening only provides an initial indication of a possible hearing impairment, further important examinations are required, such as brainstem audiometry, the so-called ABR, which provides very precise information about your child's hearing status.

Hearing implant systems

In case your child's degree or type of hearing impairment does not allow for the use of a conventional hearing aid, you should consider the option of an implantable hearing system for your child. The decades of experience of implant developers and their satisfied users may make the decision to take this important step easier.

The hearing solutions used to treat hearing loss are as varied as the types of hearing loss. You can find a good insight into the latest hearing solutions here:

Information on the reliability of MED-EL implant systems can be found here:
https://www.medel.com/de-at/hearing-solutions/cochlear-implants/reliability

Hearing care on both sides

When deciding on a cochlear implant system, you will probably ask the next question: "Should my child be fitted with a hearing implant system in both ears?"
Experts explain to us conclusively why nature gives us two ears, that this is no coincidence and what we miss out on with just one ear.
Bilateral CI implantation or implantation of the deaf ear in unilaterally deaf babies enables localization, equally good hearing and comprehension from all directions and thus a balanced and three-dimensional auditory impression as well as improved speech comprehension in noisy environments. As everything is heard from two sides, your child can also perceive the sound louder. These effects make hearing "easier" and your child will not tire so quickly in everyday life. In addition, the central auditory system (brain) is stimulated on both sides. Last but not least, the implant on the second side provides a backup system in case the batteries run out or a cable of the audio processor breaks.

All in all, it can be said that bilateral implantation - and, by analogy, implantation of the deaf side - offers the opportunity for optimal hearing and speech development as well as greater safety in everyday situations.

The Switch-On-Life website uses hearing simulations to clearly demonstrate the difference you can perceive in specific everyday situations with one or two ears. As parents, in the event of your child's unilateral deafness, this should make it easier for you to understand their hearing situation and also give you interesting insights into the science and technology behind hearing implants.

Necessary preliminary examinations

After a consultation and various audiological examinations at your Implantation clinicprovided they all contribute to the decision for a Cochlear implant This is followed by an X-ray and/or computer tomography as well as a special examination of the function of the auditory nerve, which is a basic prerequisite for successful implantation.

If your child is an infant, the operation will ideally be scheduled around their 1st birthday due to the general constitution and anatomical conditions.

Measures before the surgery

• Cochlear implants are performed throughout Austria in numerous ENT clinics performed. You will receive optimal surgical and therapeutic care in all of these facilities, so you can choose the clinic you trust and which is closest to you.
• A cold could lead to a postponement of the surgery date. As most of these appointments are scheduled well in advance, please make sure that your child is given a week or two of rest and avoid situations that could lead to a cold as much as possible.
• Please check with your pediatrician the list of medications that your child may take on a regular basis. Some preparations are problematic in connection with an operation due to their ingredients and must be discontinued or adjusted well in advance.
• A comprehensive internal examination is a standard procedure before every operation and ensures a complication-free operation as well as recovery.
• If your child is already fitted with a CI or hearing aid on the other side, it is helpful to hand the device to the responsible nursing staff shortly before the operation so that the child can hear again in the recovery room immediately after the operation. Nonetheless, the staff in CI clinics are usually perfectly coordinated and trained.

Accompanying person in the hospital

Most parents do not want to leave their child alone in the hospital under any circumstances. For this reason, a parent or grandparent often stays overnight in the hospital as well. Fortunately, this is not usually a problem in Austrian hospitals. Most public hospitals allow accompanying people to stay overnight up to the child's 18th birthday.

However, while accompanying infants is still free of charge, after infancy (up to the age of 3) there are costs for accommodation and meals for the accompanying person. The costs vary from hospital to hospital and from state to state. The daily rates are usually staggered according to the age of the child. Find out about any costs in advance from your trusted hospital or consider taking out so-called accompanying person insurance.

The surgery

As parents, you will naturally be excited and worried. However, the decades of experience of the clinicians and technicians can allay your fears. In contrast to a tonsillectomy (removal of the tonsils), the procedure is carried out in a comparatively harmless area of the skull and is now a routine procedure in ENT surgery.

Today, the operation is usually minimally invasive (a small incision directly behind the ear), takes between one and two hours and requires a hospital stay for just a few days, even if both ears are treated at the same time, which is common nowadays.

During implantation, a receiver coil is fixed in the skull bone behind the ear and an electrode array is inserted into the cochlea through a small opening, the so-called round window.

An intraoperative test by the technician present will ensure that your child reacts positively to the initial stimulation of the implant.

After the surgery

The medical staff in the recovery room will take care of your child immediately after the operation. To avoid any inconvenience, please let them know that your child cannot hear at this point, as this will help to ease the interaction between the staff and the young patient.

Thanks to the now very small incision, the soreness after the operation will neither last long nor be too extreme. The little ones also recover much faster today, as the duration of anesthesia has been significantly shortened through years of further development in surgical technology. Parents can usually stay with their children and support them, even overnight.

Although dizziness may occasionally occur, this tends to be an issue amongst older patients. This is harmless in itself but might happen as the procedure is carried out close to the vestibular system.
When you are discharged from the clinic, the medical and nursing staff will give you a few tips to follow at home. These include:

• Regular intake of any necessary medication (antibiotics, painkillers, etc.)
• No hair wash until the suture is removed (the suture must remain dry)
• General rest in the first few weeks until the initial fitting

Care leave

As your child needs even more intensive care around the operation and afterwards than in everyday life, you are usually entitled to care leave. In principle, you can take one week of care leave per working year - to the extent of your weekly working hours. You can take care leave by the week, by the day or by the hour. In addition, there is a second week of care leave within a working year (again to the extent of your weekly working hours) if your child is under the age of 12.

Once you have exhausted all entitlements to continued remuneration under the title of care leave, you can take leave to care for your sick child under the age of 12 without prior agreement with the employer, whereby this will be deducted from the annual leave. If you do not have sufficient leave credit, you can still take leave, but it will be unpaid.

First hearing impressions with the implant system

The so-called initial fitting takes place at the earliest after the sutures have been removed (around ten days after the operation), but no later than the fourth postoperative week. The young patient receives the outer part of the implant, the so-called "audio processor", which is fitted to the ear. behind the auricle or as Button processor (slightly above) is worn. The system cannot be activated without it. Up to this day, the ear is still deaf after the operation. The audio processor is switched on and adjusted. From now on, audio signals can be transmitted to the implant and heard. A great and unforgettable moment for parents and children!