.The Medical Field

.The Medical Field

Medical provision for hearing impairment

From the first moment of a suspected issue, the diagnosis, first paths towards medical facilities to the eventually required operation – you can find useful medical information for your child here, together with Austria-wide institutions that can ensure a fast and safe diagnosis or give your child the best support:

Hearing and Hearing Loss

Information about how hearing works and how hearing losses can occur can be found in detail on MED-EL’s website. Amongst other things, you can find a graphic representation which shows the individual steps in hearing. The different types of hearing loss are also explained.

Decision to have a hearing implant

From suspected issue to diagnosis

The paediatrician is for years the first point of contact for parents in matters of their child’s health. Your child is regularly checked, inoculated and supported there up until teenage years. If a hearing loss should manifest over time, the pediatrician is also an important contact with who you should discuss the issue because the earlier a childhood hearing loss is discovered, the better it is for the child.

Further steps to the expert

Hearing losses, especially on one side, unless they arise from illness or accident, develop slowly, so that they are often recognized and treated very late. Intact hearing is very important, especially in school time, so that your child can follow the lesson, communicate with classmates and can interact. A consequence of hearing impairment could be isolation as well as falling behind in lessons.

A prudent pediatrician will refer you to an ENT specialist who will arrange further important examinations to get a final diagnosis.

Hearing implant systems

If it should transpire that various medical measures have no prospect of success, or the degree or type of hearing loss of your child is not, or no longer, suitable for a conventional hearing aid, you should consider the possibility of an implanted hearing system for your child. The decades of experience of the implant developers and their satisfied users might make the decision to take this important step easier.

The hearing solutions to treat hearing losses are as varied as the types of those hearing losses. You can get a good insight into the most modern hearing solutions here:

Information on the reliability of MED-EL implant systems here:

Bilateral hearing provision

In the decision for a cochlear implant system you will probably ask the next question: “Should my child be fitted with a hearing implant system on both sides?“

Specialists explain conclusively to us why nature gives us two ears, that it is not a coincidence and what we lose by having only one ear.

Bilateral (both sides) implants or implanting the deaf ear where there is one-sided deafness or as a supplement to the hearing aid on the other ear enables localization, equally good hearing and understanding from all directions and thus a balanced and three-dimensional hearing impression and consequently an improved understanding of language in noisy surroundings. As everything is heard from both sides, your child can also perceive the sound more loudly. This effect brings about “easier” hearing and your child will not tire so easily in everyday life. For example, hearing provision on both sides will have a positive effect on school performance. Studies have shown that children who are deaf on one side have significantly higher deficits in their school performance.

Apart from that, the central hearing (brain) of both sides is stimulated, and last but not least, the implant on the second side offers a back-up system in case batteries run out or a wire in the audio processor breaks.

All in all, it can be said that bilateral implants offer – as, analogously, does an implant on the deaf side – the possibility for optimal hearing and language development and greater security in everyday situations.

The website Switch-On-Life uses hearing simulations to show visually the difference between perception with one and with two ears in special everyday situations. So for you as parents, in the case of a unilateral hearing loss in your child, his or hear hearing situation will be made more understandable, and you also get interesting insights into the science and technology behind hearing implants.

Kontakt zu Experten

The service center ZENTRUM HÖREN in Vienna offers the counseling services for people with hearing loss, advises on the different types of hearing implants and provides long-term care for users after the surgery.

You can find the direct contact to the experts, in order to take further steps and book an appointment for a professional counseling.

About the operation

Required preliminary examinations

After a consultation meeting and various audiological examinations in your implant clinic, and if these all indicate a decision to have a cochlear implant, an X-ray or CT scan follow and a special test of the auditory nerve is made, as correct function of this is a fundamental requirement for a successful implant.

Actions before the operation

Cochlear implants are carried out across Austria in many ENT-clinics . You will get optimal surgical and therapeutic support in all of these institutions so you can choose the clinic you trust near you with reassurance.

A cold might lead to the operation date being postponed. As these dates are most set far in advance, you should protect your child for one to two weeks before, and if possible avoid situations where a cold might be caught.

Please check together with your pediatrician the list of medicines that your child might take regularly. Some medicines might be a problem in respect of an operation due to their ingredients and must be discontinued or adjusted in good time.

A comprehensive internal medical examination is standard before any operation and ensures a complication-free operation and recovery procedure.

In the event that you child has already been fitted on one side with a CI or hearing aid, it is helpful to hand the device to the responsible care staff shortly before the operation, so that you child can hear again immediately after the operation in the recovery room. Usually, the staff in CI clinics are tuned and trained to work together perfectly.

Support person in the hospital

For most parents, it is a given that they do not want to leave their child alone in the hospital in any circumstances. For this reason, one parent or grandparent often stays overnight in the hospital as well. Fortunately, that is usually no problem in Austria’s hospitals. Most public hospitals allow accompanying persons to stay overnight with a child below the age of 18. But whilst accompanying an infant is free, there are fees for accommodation and board for the accompanying person after the infant age.

The costs vary from hospital to hospital and from state to state. The daily rates are usually graduated according to the age of the child. Find out in advance from your hospital of choice about any costs or think about taking out a so-called companion cost insurance.

The operation

As a parent you will of course be excited and worried. However, you can be reassured by the decades of experience of the clinicians and technicians. The intervention is, by contrast to a tonsillectomy (removal of the tonsils) in a comparatively harmless area and is a routine intervention in ENT surgery.

The operation is generally minimally invasive (a small incision behind the ear), lasts between one and two hours and requires an in-patient stay in the clinic of only a few days, even with fitting on both sides at the same time, as is usual today.

In the implantation, a reception coil is attached to the skull behind the ear and an electrode is fed into the cochlea through a small opening called the oval window.

An intra-operative test by the technician in attendance identifies whether your child responds positively to the first stimulation of the implant.

After the operation

The medical staff in the recovery room look after your child immediately after the operation. To be safe, you should inform them that your child cannot hear at this point, and that will make interaction between the staff and the little patient.

The pain from the wound will not be too great or last for too long as it is now only a small incision. Children also recover much more quickly now, as the duration of the anesthetic has been shortened considerably over the decades of development of the operation technique. Parents can usually stay with their child through the night and be at their side.

In rare cases, there can be a feeling of dizziness, but this usually applies more to older patients. In itself, this is harmless but is possible because the intervention is in the region of the balance organs.

In the course of discharge from the clinic, the medical and care staff will give you some information to take home that must be followed. This includes:

  • Regularly taking any medicines required (antibiotics, painkillers etc.)
  • The hair may not be washed until the stitched are removed (stitches must remain dry)
  • General protection in the first weeks up to initial programming.

Carer’s leave

As your child will need more intensive care around and immediately after the operation than normally, you can normally claim carer’s leave. Basically, you can have one week of carer’s leave for each year of employment – to the extent of your weekly working time. You can take the carer’s leave weekly, daily, or hourly. Moreover, there is a second carer’s leave week within a working year (again to the extent of the weekly working time) if your child is not yet twelve years old.

After all continued remuneration payments from the entitlement within carer’s leave have been exhausted, you can take holiday to care for your sick child under 12 years old without prior agreement with your employer, and this counts as part of your annual holiday. If there is not sufficient holiday entitlement left, you can still take holiday, but this will be unpaid.

First hearing impressions with the implant system

At the earliest after the stitches are removed (around ten days after the operation) but at the latest four weeks after the operation, the fitting and programming takes place. In this, the young patient receives the external part of the implant, the “audio processor” which is worn behind the earlobe or as a button processor (a little above). The system can only be activated buy this. Up until this day, the ear is still deaf after the operation. The audio processor is switched on and programmed. Audio signals can immediately be transmitted to the implant and perceived. A great and unforgettable moment for parents and child!

A world is opened up via the implant that would otherwise have remained closed.

Dominique, mother of CI-user Mariella

A world is opened up via the implant that would otherwise have remained closed.

Dominique S.,
mother of CI-user Mariella

Additional disabilities

On average, a third of all children with a hearing loss have an additional disability. This is because along with a genetic predisposition, the causes of a hearing impairment are often the reason for a further disability. Causes are, for example, premature birth, oxygen deficiency during birth, meningitis, measles, jaundice, vaccination damage, effects of medication etc.

The additional disabilities include, for example, functional faults of the limbs, inner organs, weight problems, cerebral faults, mental limitations, vision impairment or only a specific learning difficulty.

Unfortunately, some of these additional disabilities are sometimes not immediately identified, often only by the first nursery teacher or teacher so it is even more important to investigate this as well immediately after the diagnosis of a hearing loss. This sometimes requires additional medical examinations or clarification by a developmental psychologist. Genetic tests can also help to be prepared for further disabilities or to be able to exclude them.

Observe the right of all human beings to choose their own path and surprise themselves.

Hans Jonas, Philosopher

Radiological examination with hearing implants

If a radiological examination is required for any reason following the fitting of the implant, this is not a cause for concern for users of MED-EL systems.

Whilst X-ray imaging, Computer tomography (CT), sonography (ultrasound) or scintigraphy can be carried out without special preparation and with no concerns, you must be aware of the field strength (Tesla) used in magnetic resonance tomography (MRT, MRI). In the clinical range, field strengths of 1.0 or 1.5 Tesla are usual, and recently up to 3.0 Tesla. Machines with higher magnetic force are only used in research.

With the exception of the previously used middle-ear implants VORP 502, all MED-EL hearing implants are MR compatible up to 1.5 Tesla, the SYNCHRONY-implant with the special magnetic assembly even to 3.0 Tesla.
Users of MED-EL implants report an unpleasant sensation in MR only in rare cases, and no serious complications for MED-EL users have yet arisen through MR.

In any MR-examination, the doctor carrying out the examination should be informed about the implant when the appointment is made so that there is enough time before the appointment for any enquiries to be made with the manufacturer of the implant. Detailed and current specifications of the compatibility of its implants with medical procedures are provided by MED-EL at http://www.medel.com/isi/.


Kontakt zu Experten

The service center ZENTRUM HÖREN in Vienna offers the counseling services for people with hearing loss, advises on the different types of hearing implants and provides long-term care for users after the surgery.

You can find the direct contact to the experts, in order to take further steps and book an appointment for a professional counseling.

Registered doctors

The lists of all registered pediatric and ENT doctors can be found here!

ENT clinics

A list of all ENT clinics dealing with hearing implants can be found here!