Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com

Adult Otology Pediatric Otology Cochlear Implant Program Implanted Hearing Devices Hearing Aid Program Audiology Services

Cochlear Implant International Program

Our cochlear implant center has implanted patients from many different countries, therefore it is our desire to provide this rewarding technology to as many individuals as possible. However, it is important to keep in mind cochlear implants require frequent, periodic life-long programming to optimize their performance, especially during the first year. Additionally, Auditory-Verbal therapy, preferably performed by someone who has experience with cochlear implants, is essential to teaching children to understand what they hear and to talk during the years that follow receiving a cochlear implant. This therapy is an ongoing process that the parents are taught to perform themselves during all waking hours. There are 3 options with respect to how long you stay in Dallas.

Recommended Therapy

Ideally patients should remain in the Dallas area for a minimum of 6 months. This allows for evaluation, surgery, and 5 months of programming and therapy. The implant programming can be advanced to a higher level than with option 2. Parents can be more thoroughly trained in home-delivery of speech and hearing therapy. We understand that it is an expensive proposition to be living away from home and to be away from work for 6 months. However, if possible it gives the most rapid results and better prepares the family for long-term management.

Minimum Therapy

When there are no programming or therapy services available near the patients home he/she must remain in the Dallas area for a minimum of 3 months. This allows for evaluation, surgery, and 2 months of programming and therapy. This is not enough time to optimally program the implant or educate the parents in hearing and speech development. The patient may have to travel to an implant center for programming a few months after returning home. A greater burden is placed on the parents or adult patient to provide some form of speech and hearing therapy. This option saves money on the cost of housing and therapy in Dallas. Understand that if there is no place in your country to program the implant you may have to fly back to Dallas 6 to 12 months after surgery for a short period of programming and therapy.

Surgery Only

This is an option only if you have a center near your home capable of programming cochlear implants and performing the post implant speech and hearing therapy. The surgery would take place soon after your arrival in Dallas. The implant is activated 3 weeks after surgery. The patient can return home 5 to 6 weeks after surgery, once we are assured that the device is working properly and that the ear has healed well enough to permit air travel. Auditory-verbal therapy is performed twice weekly starting 1 week after surgery and continuing until the patient leaves for home.

Cochlear implants are very expensive. The expense is increased when the patient and family are traveling to the US from another country and must pay for living expenses in addition to the evaluation and treatment. In order to make this as economical as possible we have developed the following steps.

All Information and correspondence can be emailed or faxed to us at 972.566.6560.

Step 1
Assuring the patient is a good candidate for a cochlear implant

For infants and children less than 3 years old send the results of Auditory Brainstem Response (ABR) testing. This is also sometimes called Brainstem Evoked Response (BSER) or Brainstem Auditory Evoked Response (BAER).

For children 3 years and older send results of prior ABR testing as well as results of sound booth hearing tests performed by a certified audiologist. The hearing tests should be performed both with appropriately fitted hearing aids and without hearing aids. For patients who have developed speech ability, word understanding tests should also be performed with and without hearing aids.

For older children and adults send results of sound booth tests performed by a certified audiologist. The tests should be performed with and without appropriately fitted hearing aids and should include tests of speech understanding

Answer the following questions. Please explain answers as necessary

  • How old was the patient when the hearing loss was first diagnosed?
  • Is the cause of the hearing loss known?
  • Is it from birth, injury, infection?
  • Has the patient worn hearing aids?
  • If so for how long?
  • Do they seem to help?
  • What environmental sounds does the patient hear?
  • Can the patient understand people talking?
  • Does the patient have any other health problems other than hearing loss?
  • Seizures, paralysis, heart problems, meningitis (brain infection), malformed ears or malformed face?
  • Does the patient have any other developmental or mental function problems other than hearing loss?
  • Autism, delayed motor development, mental retardation, cerebral palsy, inability to walk, inability or poor ability to eat and drink by mouth.
  • Does the patient speak at all?
  • Who can understand the patient?
  • Does the patient speak in words or sentences?
  • What is the native language?
  • Has the patient been receiving speech therapy?
  • If so, how often and for how long?
  • Can a PAL or VHS videotape be sent to us showing the patient interacting with family members?

Once it has been determined that the patient can benefit from a cochlear implant you will be asked to proceed with step 2.

Step 2
Further Testing and Assessment of Local Resources

Please have a CAT scan of the temporal bones performed on the patient if not performed in the past. The radiologists' interpretation should be sent to us, preferably in English. If CAT scan facilities are not present in the patient's geographic area this test can be performed once he/she is in Dallas but this will increase the costs by $900

Answer the following questions. This may require research on your part to find the answers

  • Are there any centers in your country that are capable of programming cochlear implants? If so, how far away is the closest center from where the patient lives?
  • Which cochlear implant devices are they capable of programming: Nucleus, Advanced Bionics, or Med-El?
  • Are there speech therapy services available in your area? If so, do they have any experience working with cochlear implant patients?

Step 3
Scheduling and Preparing for the Cochlear Implant Surgery and Treatment

  • A visa will be required. Our office will send a letter to the US Consulate in your country stating the reason for travel is medical treatment
  • A date will be set for your arrival and evaluation. The patient and family are responsible for all travel arrangements. Our center can make the necessary arrangements for your housing, transportation from the airport and transportation to and from our center while you are in Dallas. There may be a charge for some local transportation (see expense section below). The cost of housing and food is the responsibility of the patient and or family
  • If you arrive early in the morning on a business day you may come directly to our center to begin testing. You will be asked to pay the evaluation fee in US dollars before we begin. If you arrive late in the day, the evaluation will begin the next business day
  • You must bring the CAT scan films (not just the radiologist’s report) to avoid repeating this test. Also bring the patient’s hearing aids in working condition and with properly fitted ear molds.
  • Once the patient is a confirmed implant candidate the surgery will usually occur within 2 to 3 days. The entire costs of the surgery and device must be paid before surgery. The money should be in a financial institution in the patient’s home country capable of performing a wire transfer. This avoids the patient or family carrying such a large sum of money and helps to avoid delays related to conventional transfers.

Step 4
Surgery, Programming, and Therapy

  • The surgery will occur as soon as all financial arrangements are completed
  • Three weeks after surgery the device will be activated. An expedited programming schedule is followed in order to be the most efficient with the patient’s time in Dallas
  • Auditory-verbal therapy will begin 2 to 3 times per week either immediately after surgery or after activation

Expenses



The following list is as complete a list of costs as we are capable of providing. The costs of housing and local transportation may change slightly and are not in our control. Some expenses may be encountered that we are unable to predict. The patient and/or family are responsible for all expenses.

 

 

Evaluation Fees (Due upfront)

  • Medical Examination $150
  • Audiometric Testing $150
  • Auditory-verbal Evaluation $100
  • Psychological Evaluation $150
  • TOTAL $550

Surgery (Due upfront)

  • Cochlear Implant Device: includes implant and 2 speech processors $30,000
  • Surgeons fee $3,500
  • Anesthesia Fee $1,000
  • Operating Room Fee $3,500
  • TOTAL $38,000

Programming and Auditory Verbal Therapy

These services are billed at $100 per hour. There will be 2 to 3 sessions per week during the stay in Dallas after surgery. We require payment for 3 months of programming and therapy before implant activation. Depending on the option selected for the program, the costs can range from $1,000 for the Surgery Only option to $5,000 for the Recommended Therapy option. Keep in mind, the total cost of the services will factor in the duration of treatment in Dallas.

Other Therapy

Many children with deafness have other disorders that effect their learning and communication development. Following the Auditory-Verbal evaluation, the therapist may recommend that the patient see other specialists for additional evaluations. In addition to the ongoing sessions of Auditory-Verbal speech and hearing therapy, the child may need additional sessions of other therapies. These other evaluations and therapies can add a minimum of $1000 dollars to the costs

Housing

Special rates have been established with the Homestead Village, which is with in walking distance from our center. The room includes a kitchen with full size refrigerator, microwave oven, cooking utensils, and either a queen size bed or two full size beds. The rate is $975 for the first month and $850 for each month after the first month, or $28 per day

Transportation

You will be met at the airport by a member of our implant team and transported to Homestead Village. Our center is within walking distance for most of the testing and treatment. There may be a need to travel short distances to other therapy sessions. We cannot always guarantee transportation. On occasion a taxi may be needed to attend some therapy. If you desire transportation for your own leisure a rent car may be appropriate for you

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Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com