From the first moments of suspicion, the diagnosis, the first routes to medical facilities through to any necessary surgery - here you will find valuable medical information for your child as well as Austria-wide institutions that guarantee a rapid and reliable diagnosis and provide your child with the best possible 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.

From suspicion to diagnosis

Pediatricians are the first point of contact for you as parents when it comes to your child's health. They will regularly check your child, vaccinate them and follow them through to their teenage years. If a hearing impairment becomes apparent over time, the pediatricians are also an important contact with whom you should discuss the issue. After all, the earlier a child's hearing impairment is discovered, the better it is for your child.

Further steps for the experts

Hearing disorders, especially one-sided ones, unless they occur acutely due to illness or an accident, develop gradually and are often only recognized and treated very late. Especially during school hours, intact hearing is extremely important so that your child can follow lessons, communicate with classmates and exchange ideas. In addition to falling behind in school lessons, hearing impairment can also lead to isolation.

A prudent pediatrician will refer you to one of the ENT specialists who will order further important tests for a final diagnosis.

Hearing implant systems

If it turns out that various medical measures do not promise success or the degree or nature of your child's hearing impairment does not allow or no longer allows the use of a conventional hearing aid, you should consider the possibility 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 with only one ear.

Bilateral CI implantation or implantation of the deaf ear in the case of unilateral deafness or as a supplement to the hearing aid in the other ear 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. For example, hearing aids on both sides will have a positive effect on school performance. This is because studies show that children who are deaf on one side have significantly higher rates of deficits in their school performance.

In addition, the central hearing (brain) of both sides is also stimulated and, last but not least, the implant on the second side offers 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. For you as parents, in the event of your child becoming deaf on one side, the aim is to make their hearing situation easier to understand and also to give you interesting insights into the science and technology behind hearing implants.

Necessary preliminary examinations

After a consultation and various audiological examinations in your implantation clinic, if they all lead to the decision for a cochlear implant, an X-ray or computer tomography and a special examination of the function of the auditory nerve follow, which is a basic prerequisite for a successful implantation.

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, you should make sure that your child is given some rest a week or two beforehand and that situations that could lead to a cold are avoided 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 are certain that they do not want to leave their child alone in hospital under any circumstances. For this reason, a parent or grandparent often stays overnight in hospital too. Fortunately, this is not usually a problem in Austrian hospitals. Most public hospitals allow accompanying persons to stay overnight until the child to be cared for has reached the age of 18. However, while accompanying infants is still free of charge, after infancy (from 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 costs 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 performed in a comparatively harmless area and is now a routine procedure in ENT surgery.

The operation is usually minimally invasive (small incision directly behind the ear), takes between one and two hours and requires an inpatient hospital stay of only a few days, even with simultaneous treatment on both sides, which is common today.

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 technical staff 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 be on the safe side, you should let them know that your child cannot hear at this time, which will make it easier for staff and the young patient to communicate.

Thanks to the now very small incision, the wound pain after the operation will not last long or be too great. Children also recover much faster nowadays, as the duration of anesthesia has been significantly shortened thanks to years of further development in surgical technology. Parents can usually stay with their children and support them, even during the night.

In rare cases, dizziness may occur, but this is usually more of an issue in older patients. This is harmless in itself but is possible because the procedure is performed close to the vestibular system.

When you are discharged from hospital, the medical and nursing staff will give you a few tips to take home with you, which should always be followed. 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. Here, 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!

On average, a third of all hearing-impaired children have an additional disability. This is due to the fact that, in addition to a genetic predisposition, the causes of hearing impairment are often also the reason for a further disability. Causes include premature birth, lack of oxygen during birth, meningitis, rubella, jaundice, vaccination damage, the effects of medication, etc.

Additional impairments include, for example, functional disorders of the limbs, internal organs, balance problems, cerebral disorders, mental limitations, visual impairment or even just a partial performance disorder.

Unfortunately, some of these additional handicaps are sometimes not recognized immediately, often only by the kindergarten pedagogical or teaching staff, but it is all the more important to have this clarified immediately after the diagnosis of hearing impairment. This may require further medical examinations or clarification by developmental psychologists. Genetic tests can also be helpful in order to be prepared for further impairments or to be able to rule them out.

If a radiological examination is necessary after the hearing implant fitting for various reasons, this is nothing to worry about for MED-EL system users.

While X-ray examinations, computer tomography (CT), sonography (ultrasound) or scintigraphy can be carried out without special preparation and without hesitation, the field strength (Tesla) used for magnetic resonance imaging (MRI) must be taken into account. In clinical applications, field strengths of 1.0 or 1.5 Tesla are common, sometimes even 3.0 Tesla. Only in research are devices with even higher magnetic forces used.

With the exception of the previously used VORP 502 middle ear implants, all MED-EL hearing implants are MR-compatible up to 1.5 Tesla, the current SYNCHRONY implants with the special magnet insert even up to 3.0 Tesla.
Users of MED-EL implants have only reported an unpleasant feeling in the MR in rare cases, and MED-EL users have not yet experienced any serious complications as a result of MR.

In the event of an MR examination, the examining specialist should be informed about the implant when the appointment is made so that there is enough time before the examination appointment for any queries with the manufacturer of the implant. MED-EL provides detailed and up-to-date information on the compatibility of its implants with medical procedures at http://www.medel.com/isi/.