Your Visit

When a child first visits the Nemours Interdisciplinary Center for Ear Reconstruction (NICEAR), they will meet with many different specialists, including a:

• Plastic surgeon
• ENT provider
• Ophthalmologist
• Developmental pediatrician
• Audiologist
• Geneticist
• Speech pathologist
• Social worker

Please expect to be at Nemours Children’s Hospital for up to 4 hours and bring diapers, formula, snacks, activities, and a list of your questions.

Here’s What Happens

• Your child will remain in one exam room, and the specialists will come in separately to perform their evaluations.
• After all evaluations are complete, your family will receive a summary of the visit, and you’ll be free to go.
• Our team will then meet to discuss your child’s needs and put together a personalized treatment plan and follow-up visits will be scheduled. A copy of the treatment plan will be sent to your child’s pediatrician.

Learn More from Nemours KidsHealth

Microtia

Aural Astresia

Ear Anomalies

Nemours Children’s Hearing Enhancement, Augmentation, and Restoration (NHEAR) Program specializes in cochlear implant surgery.

A cochlear implant is a small electronic device that can help your child hear and understand speech better. It’s made up of a processor that’s worn behind the ear and an electrode array, magnet, and computer chip that are placed inside your child’s inner ear.

Cochlear implant surgery is not painful. Your child will receive general anesthesia, so they will be in a deep sleep during the procedure and will not feel anything.

The surgery usually takes 2 to 3 hours. Most children go home the same day and are able to return to school in about a week.

Here’s What Happens

• The surgeon will cut the skin behind the ear and make a hole in the bone.
• The internal part of the device is inserted into the cochlea (inner ear) and the surgeon closes the skin.
• Your child’s head will be wrapped with a pressure bandage to reduce swelling. This bandage will be removed the next day.
• About 3 weeks after surgery, your child will have a follow up with the audiologist where they will be fitted for the external cochlear implant processor and magnet. Your child will be able to wear the cochlear implant home from this appointment.

Your child will need auditory verbal therapy for at least a year after surgery to learn to hear and speak with the cochlear implant. We will discuss this with you ahead of surgery.

Learn more about cochlear implants from Nemours KidsHealth.

Receiving a cochlear implant requires consistent and frequent follow-up appointments to help your child reach their full potential.

Here’s What Happens

• 2 weeks after surgery, you and your child will meet with a representative from your child’s cochlear implant manufacturer to review the equipment, how it works, and how to take care of it. This appointment can be done virtually or in-person.
• 3 weeks after surgery, your child will have a follow up with their audiologist where their cochlear implant will be activated. Your child will be fitted for the external cochlear implant processor and magnet, the implant will be turned on with a computer, and we’ll set the loudness levels by seeing how your child reacts to sound.
• 2 weeks after activation, your child will have a follow-up to ensure everything is working properly. This appointment can be done virtually or in-person.
• 1 month after activation, your child will have a second follow-up. After this, your child will have regularly scheduled visits every 3 months for the first year, then every 6 months, until tapering down to annual follow-ups. These appointments may be done virtually or in-person.

Learn more about cochlear implants from Nemours KidsHealth.

After receiving a cochlear implant, your child will require Auditory Verbal Therapy for at least a year. This intensive, long-term rehabilitation program helps your child develop listening, language, speech production, and communication skills. It’s vital to ensuring your child’s success with their cochlear implant.

Here’s What Happens

• Prior to cochlear implant surgery, your child will complete a listening and spoken language evaluation. Communication modalities, realistic expectations, and required follow-ups will be discussed at this session.
• Weekly therapy sessions will begin after cochlear implant surgery is complete. While the implant provides your child the ability to access sound, this therapy is necessary to teach them to listen and understand the sound.
• Every 5-6 months after surgery, a re-evaluation will be completed to assess current levels of listening and spoken language skills. We’ll adjust your child’s care plan accordingly. These appointments may be done virtually or in-person.
• 6 months after discharge from therapy, we recommend your child completes a listening and spoken language evaluation to monitor development and determine if any further services are needed.

Learn more about cochlear implants from Nemours KidsHealth.