Pediatric Cochlear Implant Program in Costa Rica

First, Dr. Vega discusses her workup on infants with hearing loss. Every infant is first screened with the otoacoustic emission (OAE) test. If they fail the test twice, they are sent to complete the auditory brainstem response (ABR) test. NICU babies go through ABR testing directly. Dr. Vega’s aim is to diagnose hearing loss at 3 months so infants can trial bilateral hearing aids for at least 6 months. If the parents and audiologists note no improvement with hearing aids, they will discuss cochlear implantation as a treatment option. She emphasizes that speech pathology, audiology, genetics, pediatrics, and psychology are integral parts of the care team during the workup of an infant with hearing loss as well.

She then transitions into how she educates families about the importance of speech therapy and audiology follow up after implantation. Some families may not have adequate financial resources to access these services, so she works through the social security system in Costa Rica to help parents with the cost of follow-up. Additionally, she notes that she does implant older patients who are prelingual, as verbal language is not the only goal of cochlear implantation. She believes that hearing can markedly improve an older patient’s quality of life by improving their social interactions. Before placing an implant in any child, she presents the patient case and workup results to an independent cochlear implant commission which decides if the patient is a good candidate for cochlear implants. During this time, the commission also assesses socioeconomic barriers and advocates for social security coverage of expenses.

Finally, the doctors end the discussion by talking about an upcoming cochlear implantation conference in Costa Rica in December.