1 00:00:00,240 --> 00:00:02,319 This is Chris Sosa with the Becker's Healthcare 2 00:00:02,319 --> 00:00:02,819 podcast. 3 00:00:03,199 --> 00:00:04,639 I am thrilled to be joined by doctor 4 00:00:04,639 --> 00:00:07,440 Abby Meyer, medical director of ENT and facial 5 00:00:07,440 --> 00:00:10,500 plastic surgery at Children's Minnesota, and Chelsea Kimlinger, 6 00:00:10,559 --> 00:00:12,894 an audiologist at the health system. They're with 7 00:00:12,894 --> 00:00:16,015 us to discuss Children's Minnesota's pediatric cochlear implant 8 00:00:16,015 --> 00:00:18,254 program. Doctor Meyer and Chelsea, thank you for 9 00:00:18,254 --> 00:00:19,154 joining us today. 10 00:00:20,015 --> 00:00:21,394 Thank you for having us. 11 00:00:21,774 --> 00:00:22,434 Thank you. 12 00:00:22,974 --> 00:00:24,675 Wonderful. For those of us, 13 00:00:25,019 --> 00:00:26,859 for those of us in the audience rather 14 00:00:26,859 --> 00:00:29,100 who do not are not familiar with your 15 00:00:29,100 --> 00:00:31,339 work, could you please introduce yourselves and tell 16 00:00:31,339 --> 00:00:32,719 us a bit about your backgrounds? 17 00:00:33,820 --> 00:00:35,740 Happy to. So my name is Abby Meyer. 18 00:00:35,740 --> 00:00:37,120 I'm a pediatric otolaryngologist. 19 00:00:37,935 --> 00:00:39,774 I did my training at the University of 20 00:00:39,774 --> 00:00:42,575 Minnesota and at Seattle Children's Hospital, and I've 21 00:00:42,575 --> 00:00:44,734 been in practice for a little over 13 22 00:00:44,734 --> 00:00:45,554 years now. 23 00:00:46,414 --> 00:00:48,975 I am the medical director at Children's Minnesota 24 00:00:48,975 --> 00:00:50,975 for ENT for and I've done that for 25 00:00:50,975 --> 00:00:52,335 2 years. And then prior to that, I 26 00:00:52,335 --> 00:00:54,899 was the director of audiology services at Children's. 27 00:00:55,679 --> 00:00:57,920 And one of the main focuses of my 28 00:00:57,920 --> 00:01:00,320 practice is caring for children who are deaf 29 00:01:00,320 --> 00:01:01,299 or hard of hearing. 30 00:01:02,079 --> 00:01:05,680 I am Chelsea Kimlinger, pediatric audiologist at Children's 31 00:01:05,680 --> 00:01:06,180 Minnesota. 32 00:01:07,515 --> 00:01:09,935 I work with children of all ages 33 00:01:10,234 --> 00:01:11,834 and their families to help, 34 00:01:12,314 --> 00:01:13,215 reach individualized 35 00:01:13,995 --> 00:01:16,495 hearing and speech and language outcomes. 36 00:01:17,114 --> 00:01:18,989 I am one of 2 audiologists that helped 37 00:01:18,989 --> 00:01:21,629 to start the cochlear implant program here a 38 00:01:21,629 --> 00:01:23,170 little over 10 years ago. 39 00:01:23,469 --> 00:01:25,709 So I have a passion for working with 40 00:01:25,709 --> 00:01:27,090 children and their families 41 00:01:27,549 --> 00:01:29,569 entering the cochlear implant process. 42 00:01:30,349 --> 00:01:32,430 Fantastic. Thank you both so much for filling 43 00:01:32,430 --> 00:01:34,375 us in, and thank you for all the 44 00:01:34,375 --> 00:01:36,314 wonderful work that you do in this area. 45 00:01:36,694 --> 00:01:39,355 As you mentioned, Chelsea, Children of Minnesota is 46 00:01:39,734 --> 00:01:42,135 working on 10 years of this pediatric cochlear 47 00:01:42,135 --> 00:01:44,135 implant program. My question is, what do you 48 00:01:44,135 --> 00:01:46,295 see as the biggest changes in cochlear implants 49 00:01:46,295 --> 00:01:47,515 over the last 10 years? 50 00:01:48,569 --> 00:01:50,329 Yeah. I would say that one of the 51 00:01:50,329 --> 00:01:52,890 biggest changes we have seen in this first 52 00:01:52,890 --> 00:01:54,269 decade of our program 53 00:01:54,569 --> 00:01:56,810 is the expansion of who is a candidate 54 00:01:56,810 --> 00:01:58,989 for a cochlear implant, particularly 55 00:01:59,290 --> 00:02:01,390 for 2 populations of children, 56 00:02:02,064 --> 00:02:04,405 that first group being single sided deafness. 57 00:02:05,105 --> 00:02:07,984 So in this population a patient has typical 58 00:02:07,984 --> 00:02:10,944 hearing in one ear and no functional hearing 59 00:02:10,944 --> 00:02:13,504 in the other ear. And until recently we 60 00:02:13,504 --> 00:02:16,319 didn't really understand how the brain could combine 61 00:02:16,540 --> 00:02:19,500 the acoustic hearing in the typical ear and 62 00:02:19,500 --> 00:02:22,060 the electric hearing from the cochlear implant in 63 00:02:22,060 --> 00:02:22,960 the other ear, 64 00:02:23,500 --> 00:02:25,840 together in a meaningful, useful way. 65 00:02:26,139 --> 00:02:28,335 And we know that one of the many 66 00:02:28,415 --> 00:02:31,055 factors that contribute to successful outcomes with a 67 00:02:31,055 --> 00:02:34,335 cochlear implant is dedicated practice with the cochlear 68 00:02:34,335 --> 00:02:34,835 implant. 69 00:02:35,215 --> 00:02:37,615 But when you're listening with a cochlear implant 70 00:02:37,615 --> 00:02:39,615 in one ear and you have typical hearing 71 00:02:39,615 --> 00:02:41,615 in the other ear, your brain is gonna 72 00:02:41,615 --> 00:02:44,759 crutch onto that typically hearing ear because it 73 00:02:45,219 --> 00:02:46,360 obviously does so well. 74 00:02:46,979 --> 00:02:49,699 But in order to achieve maximum benefit from 75 00:02:49,699 --> 00:02:51,960 your cochlear implant, you really have to exercise 76 00:02:52,099 --> 00:02:53,400 the device by itself. 77 00:02:54,099 --> 00:02:54,599 In 78 00:02:54,979 --> 00:02:57,639 most recent years, we've seen technology advancements 79 00:02:57,939 --> 00:03:01,715 where cochlear implant processors are now incorporating Bluetooth 80 00:03:01,715 --> 00:03:02,215 technology 81 00:03:02,675 --> 00:03:03,814 into their processors, 82 00:03:04,354 --> 00:03:06,754 and this has really opened the door for 83 00:03:06,754 --> 00:03:09,574 successful hearing rehabilitation in this population. 84 00:03:10,354 --> 00:03:13,235 Streaming through Bluetooth allows our single sided deafness 85 00:03:13,235 --> 00:03:16,110 patients to strengthen the auditory pathways with their 86 00:03:16,110 --> 00:03:19,569 cochlear implant without crutching onto the other side. 87 00:03:19,949 --> 00:03:22,669 And this has led to greater acceptance and 88 00:03:22,669 --> 00:03:24,769 success with their cochlear implant 89 00:03:25,069 --> 00:03:27,069 and offers the ability for these patients to 90 00:03:27,069 --> 00:03:29,330 take advantage of binaural hearing. 91 00:03:29,675 --> 00:03:32,074 And some of those examples of binaural hearing 92 00:03:32,074 --> 00:03:35,455 include improved listening and noise, better localization, 93 00:03:35,835 --> 00:03:38,974 better sound quality, and reduced listening fatigue. 94 00:03:39,835 --> 00:03:42,634 The other population we are serving more of 95 00:03:42,634 --> 00:03:44,335 now is younger infants. 96 00:03:44,969 --> 00:03:48,009 In 2020, the FDA actually lowered the approved 97 00:03:48,009 --> 00:03:51,469 age for cochlear implantation in infants with bilateral 98 00:03:51,530 --> 00:03:53,930 profound hearing loss from 12 months to 9 99 00:03:53,930 --> 00:03:54,909 months of age. 100 00:03:55,209 --> 00:03:58,030 However, the literature actually overwhelmingly 101 00:03:58,409 --> 00:03:59,549 supports implantation 102 00:03:59,985 --> 00:04:02,465 in these children even earlier, as young as 103 00:04:02,465 --> 00:04:03,365 6 months old. 104 00:04:04,145 --> 00:04:06,224 And implanting at 6 months old is really 105 00:04:06,224 --> 00:04:08,625 becoming the gold standard here in the United 106 00:04:08,625 --> 00:04:10,164 States at pediatric, 107 00:04:10,544 --> 00:04:13,689 cochlear implant centers, and it has actually already 108 00:04:13,689 --> 00:04:16,089 been the gold standard in Europe and many 109 00:04:16,089 --> 00:04:16,589 places, 110 00:04:16,970 --> 00:04:18,589 in Australia as well. 111 00:04:19,290 --> 00:04:21,370 And this is wonderful because we know that 112 00:04:21,370 --> 00:04:24,669 early implantation leads to a more typical trajectory 113 00:04:24,810 --> 00:04:27,714 of spoken language development. So the earlier that 114 00:04:27,714 --> 00:04:29,875 we can get these patients started with this 115 00:04:29,875 --> 00:04:31,095 process, the better. 116 00:04:31,954 --> 00:04:33,714 Thank you, Chelsea. It sounds like there have 117 00:04:33,714 --> 00:04:35,394 been some huge strides made, and I do 118 00:04:35,394 --> 00:04:38,435 wanna touch about on the future of these 119 00:04:38,435 --> 00:04:39,894 implants a little bit later. 120 00:04:40,259 --> 00:04:42,759 But before we get to that, doctor Meyer, 121 00:04:42,819 --> 00:04:44,419 could you do us a favor and please 122 00:04:44,419 --> 00:04:46,919 describe the connection between the surgeon and audiologist 123 00:04:46,979 --> 00:04:48,839 when it comes to these cochlear implants? 124 00:04:50,019 --> 00:04:51,860 Absolutely. Well, I mean, I I hope the 125 00:04:51,860 --> 00:04:54,339 feeling is mutual, but I just, I can't 126 00:04:54,339 --> 00:04:55,560 stress enough just 127 00:04:56,074 --> 00:04:59,355 how valuable a strong relationship between a surgeon 128 00:04:59,355 --> 00:05:00,895 and an audiologist is. 129 00:05:01,834 --> 00:05:03,774 We have to be on the same page, 130 00:05:03,915 --> 00:05:06,314 and, you know, we need to make sure 131 00:05:06,314 --> 00:05:08,735 that what we're thinking also, 132 00:05:09,514 --> 00:05:11,460 aligns with what the family wants for their 133 00:05:11,460 --> 00:05:13,540 child, their goals for their child. So that 134 00:05:13,540 --> 00:05:14,040 communication, 135 00:05:15,220 --> 00:05:17,560 that open communication, frequent communication 136 00:05:18,180 --> 00:05:20,660 is just so critical to the success of, 137 00:05:21,860 --> 00:05:24,580 of any cochlear implant program, but especially for 138 00:05:24,580 --> 00:05:25,080 children. 139 00:05:25,764 --> 00:05:28,645 So we, we're very fortunate. I think we 140 00:05:28,645 --> 00:05:31,365 have just really strong relationships between our surgeons 141 00:05:31,365 --> 00:05:32,185 and our audiologists. 142 00:05:32,645 --> 00:05:34,485 I've been working with Chelsea and, 143 00:05:34,884 --> 00:05:36,964 Lisa, who was another one of the original 144 00:05:36,964 --> 00:05:38,665 audiologists who started the program 145 00:05:39,060 --> 00:05:40,500 for the entire 10 years, 146 00:05:40,980 --> 00:05:41,480 and 147 00:05:41,860 --> 00:05:43,779 it's just been a joy to to work 148 00:05:43,779 --> 00:05:44,899 with both of them and all of the 149 00:05:44,899 --> 00:05:46,419 other people that have been added to our 150 00:05:46,419 --> 00:05:48,660 team since that time. I think what was 151 00:05:48,660 --> 00:05:51,379 really great is I constantly learn from our 152 00:05:51,379 --> 00:05:53,785 audiologists, and I think that I'm hoping, anyway, 153 00:05:53,785 --> 00:05:55,865 that they learn some things from us as 154 00:05:55,865 --> 00:05:58,425 surgeons too. And, you know, we both bring 155 00:05:58,425 --> 00:06:01,644 different perspectives, different experiences, different expertise, 156 00:06:02,745 --> 00:06:05,819 to this kind of partnership, but I think 157 00:06:05,819 --> 00:06:08,779 that they're complementary and we really continue to 158 00:06:08,779 --> 00:06:10,879 grow and I think also push each other, 159 00:06:11,339 --> 00:06:13,500 to stay up to date on what's, you 160 00:06:13,500 --> 00:06:15,419 know, the newest in the literature and and 161 00:06:15,419 --> 00:06:16,779 push each other to say, well, how can 162 00:06:16,779 --> 00:06:18,540 we make our program better? How can we 163 00:06:18,540 --> 00:06:20,560 take better care of our patients? So 164 00:06:21,014 --> 00:06:23,115 having that just open dialogue, 165 00:06:23,415 --> 00:06:25,975 open relationship, and also open to feedback is 166 00:06:25,975 --> 00:06:28,454 just so critical, and I feel very lucky 167 00:06:28,454 --> 00:06:30,154 that our program has all of that. 168 00:06:31,014 --> 00:06:32,774 Thank you, doctor Meyer. I'm glad you mentioned, 169 00:06:33,014 --> 00:06:34,074 commune the communication 170 00:06:34,454 --> 00:06:34,954 aspects 171 00:06:35,279 --> 00:06:37,680 of making this program work. And, Chelsea, you've 172 00:06:37,680 --> 00:06:39,680 already touched a little bit on on some 173 00:06:39,680 --> 00:06:41,920 of the different types of patients that you're 174 00:06:41,920 --> 00:06:43,460 dealing with at Children's Minnesota. 175 00:06:44,480 --> 00:06:47,120 Building onto that, what strategies have been most 176 00:06:47,120 --> 00:06:49,600 effective in meeting each child and and families' 177 00:06:49,600 --> 00:06:50,899 individual hearing goals? 178 00:06:51,975 --> 00:06:54,375 Yeah. I find that one of the most 179 00:06:54,375 --> 00:06:57,254 important things that we can do as provide 180 00:06:57,415 --> 00:06:59,355 providers in the cochlear implant, 181 00:06:59,735 --> 00:07:00,235 specialty 182 00:07:00,615 --> 00:07:02,795 is counseling on realistic expectations. 183 00:07:03,639 --> 00:07:05,800 We know that each child has their own 184 00:07:05,800 --> 00:07:06,860 unique circumstances 185 00:07:07,240 --> 00:07:09,160 and that that is going to contribute not 186 00:07:09,160 --> 00:07:11,979 only to their candidacy for a cochlear implant, 187 00:07:12,039 --> 00:07:14,279 but also what their outcomes with the cochlear 188 00:07:14,279 --> 00:07:16,774 implant may be. So it's really important for 189 00:07:16,774 --> 00:07:19,495 us to have honest and open conversations with 190 00:07:19,495 --> 00:07:19,995 families 191 00:07:20,455 --> 00:07:23,175 about the outcomes we may expect for their 192 00:07:23,175 --> 00:07:25,355 child so that they can make an informed 193 00:07:25,415 --> 00:07:27,654 decision on if a cochlear implant is the 194 00:07:27,654 --> 00:07:30,395 right thing for this child and their family. 195 00:07:30,870 --> 00:07:32,790 So, again, making sure that we are being 196 00:07:32,790 --> 00:07:34,330 honest and open with families, 197 00:07:34,709 --> 00:07:35,930 from the very beginning 198 00:07:36,230 --> 00:07:38,629 about what their child could potentially get from 199 00:07:38,629 --> 00:07:40,470 a cochlear implant so that they can make 200 00:07:40,470 --> 00:07:41,370 the best decision. 201 00:07:42,884 --> 00:07:44,964 One of the reasons I really love working 202 00:07:44,964 --> 00:07:47,925 with cochlear implants in Audiology is that there 203 00:07:47,925 --> 00:07:49,144 are a lot of appointments, 204 00:07:49,685 --> 00:07:51,845 and you get to know patients and their 205 00:07:51,845 --> 00:07:53,224 families pretty well. 206 00:07:53,685 --> 00:07:56,004 And when we have a better idea of 207 00:07:56,004 --> 00:07:58,089 what a patient's day to day life is 208 00:07:58,089 --> 00:08:00,350 like, we are able to better help them. 209 00:08:00,970 --> 00:08:01,790 For example, 210 00:08:02,329 --> 00:08:04,649 who is spending time with the child during 211 00:08:04,649 --> 00:08:06,970 the day? If both parents are working outside 212 00:08:06,970 --> 00:08:08,649 of the home, you know, who is watching 213 00:08:08,649 --> 00:08:10,410 that child? Because they are spending a lot 214 00:08:10,410 --> 00:08:12,595 of time with that child and we are 215 00:08:12,595 --> 00:08:14,454 going to need their support, 216 00:08:14,915 --> 00:08:17,235 in helping achieve the goals that we are 217 00:08:17,235 --> 00:08:19,095 hoping to achieve with this child. 218 00:08:19,555 --> 00:08:22,615 So I like to encourage families to invite 219 00:08:22,675 --> 00:08:23,735 these family members 220 00:08:24,035 --> 00:08:25,875 to some of our appointments so that they 221 00:08:25,875 --> 00:08:29,009 can learn more about cochlear implants and ask 222 00:08:29,009 --> 00:08:29,509 questions 223 00:08:29,889 --> 00:08:32,129 so that they feel more empowered to help 224 00:08:32,129 --> 00:08:34,289 support these children in their when they're in 225 00:08:34,289 --> 00:08:34,950 their care. 226 00:08:35,809 --> 00:08:38,529 Another example of this is, you know, getting 227 00:08:38,529 --> 00:08:41,054 to know does the patient spend time between 228 00:08:41,054 --> 00:08:42,195 2 different households? 229 00:08:42,735 --> 00:08:44,815 This is actually really helpful for me to 230 00:08:44,815 --> 00:08:47,375 know because when I'm ordering equipment for the 231 00:08:47,375 --> 00:08:49,294 child, in these cases, I like to make 232 00:08:49,294 --> 00:08:51,054 sure I have, you know, 2 full sets 233 00:08:51,054 --> 00:08:53,154 of batteries, 2 full sets of chargers 234 00:08:53,535 --> 00:08:55,455 so that these can be split between the 235 00:08:55,455 --> 00:08:58,120 households and parents don't have to constantly be 236 00:08:58,120 --> 00:09:00,519 worrying about packing everything every time the child 237 00:09:00,519 --> 00:09:03,100 transitions from one home to the other. 238 00:09:03,800 --> 00:09:06,040 So yeah. Really getting to know the kids 239 00:09:06,040 --> 00:09:08,279 and the family dynamics so that we can 240 00:09:08,279 --> 00:09:10,519 best support them because, you know, no 2 241 00:09:10,519 --> 00:09:12,945 child no 2 children are exactly the same, 242 00:09:12,945 --> 00:09:14,465 and we really need to get to know 243 00:09:14,465 --> 00:09:17,365 them better to help support their best outcome. 244 00:09:18,785 --> 00:09:20,545 This is a question for either doctor Meyer 245 00:09:20,545 --> 00:09:22,384 or Chelsea, but what sort of feedback have 246 00:09:22,384 --> 00:09:23,045 you gotten, 247 00:09:23,745 --> 00:09:25,205 from parents and 248 00:09:25,559 --> 00:09:27,639 really the children who have been receiving these 249 00:09:27,639 --> 00:09:29,899 implants and how it's enhanced their lives? 250 00:09:30,840 --> 00:09:32,519 I I mean, I think it's incredible as 251 00:09:32,519 --> 00:09:34,679 you see, you know, now that we've have 252 00:09:34,840 --> 00:09:36,120 you know, some of the kids that we 253 00:09:36,120 --> 00:09:38,460 implanted in the early years of our program 254 00:09:38,519 --> 00:09:39,179 are now 255 00:09:39,794 --> 00:09:41,794 know, in late elementary and even, you know, 256 00:09:41,794 --> 00:09:44,615 thinking about middle school. And to see them 257 00:09:45,154 --> 00:09:47,954 grow into these just, you know, really lovely 258 00:09:47,954 --> 00:09:49,714 people and see how far they've come. You 259 00:09:49,714 --> 00:09:51,095 know, when you meet a family 260 00:09:51,554 --> 00:09:53,954 and they receive the news that their child 261 00:09:53,954 --> 00:09:54,115 has 262 00:09:54,870 --> 00:09:56,070 you know, that is deaf or hard of 263 00:09:56,070 --> 00:09:58,570 hearing, and especially if it's a very significant 264 00:09:59,029 --> 00:10:00,970 hearing difference that puts them, 265 00:10:01,269 --> 00:10:03,690 you know, on the path towards cochlear implantation, 266 00:10:04,549 --> 00:10:06,309 it can it it often comes out of 267 00:10:06,309 --> 00:10:08,490 nowhere for these families. So you see, 268 00:10:09,725 --> 00:10:11,725 where they start, you know, where they start 269 00:10:11,725 --> 00:10:14,205 this journey. And then when you see them 270 00:10:14,205 --> 00:10:16,044 on the other side of the journey where 271 00:10:16,044 --> 00:10:17,964 their their kids are, you know, out on 272 00:10:17,964 --> 00:10:20,924 the soccer field, they're having sleepovers with their 273 00:10:20,924 --> 00:10:23,084 friends, they're, you know, they're just living their 274 00:10:23,084 --> 00:10:23,964 best life. It 275 00:10:24,779 --> 00:10:26,779 I mean, it is pretty it is a 276 00:10:26,779 --> 00:10:29,339 very special and remarkable thing. And I think 277 00:10:29,899 --> 00:10:31,039 I mean, families, 278 00:10:31,500 --> 00:10:33,659 for the most part, are, I I think, 279 00:10:33,659 --> 00:10:36,139 just incredibly grateful and and but it's kind 280 00:10:36,139 --> 00:10:37,875 of their normal life. You know? It just 281 00:10:38,034 --> 00:10:40,034 becomes, like, well, this is what we do. 282 00:10:40,034 --> 00:10:40,534 And 283 00:10:40,914 --> 00:10:42,835 and that's another special part to see how 284 00:10:42,835 --> 00:10:43,975 they come so far 285 00:10:44,274 --> 00:10:45,634 and and, you know, saying how am I 286 00:10:45,634 --> 00:10:47,075 going to do this? How are we gonna 287 00:10:47,075 --> 00:10:48,215 do this as a family? 288 00:10:48,674 --> 00:10:50,434 To then being, like, well, this is just 289 00:10:50,434 --> 00:10:52,534 what we do is is is pretty remarkable. 290 00:10:54,289 --> 00:10:57,009 That's certainly very heartwarming, and hopefully, more children 291 00:10:57,009 --> 00:10:57,669 will have 292 00:10:58,129 --> 00:11:00,529 access to this technology as time goes on. 293 00:11:00,690 --> 00:11:02,850 Another question for you, doctor Meyer, and that 294 00:11:02,850 --> 00:11:04,769 simply is what are you excited about or 295 00:11:04,769 --> 00:11:06,449 focused on when it comes to the future 296 00:11:06,449 --> 00:11:08,149 of pediatric cochlear implants? 297 00:11:09,024 --> 00:11:10,705 Yeah. I mean, it's an an incredible time 298 00:11:10,705 --> 00:11:12,625 to be in our field. There's just so 299 00:11:12,625 --> 00:11:14,865 much that's changing all the time. Some of 300 00:11:14,865 --> 00:11:15,924 the things that Chelsea, 301 00:11:16,465 --> 00:11:18,384 you know, pointed out as far as where 302 00:11:18,384 --> 00:11:20,225 we've come in the past 10 years. I 303 00:11:20,225 --> 00:11:21,909 think a couple of the things, you know, 304 00:11:21,909 --> 00:11:24,490 and most of what we're working on is 305 00:11:24,629 --> 00:11:27,049 really maximizing the benefits, knowing 306 00:11:27,829 --> 00:11:30,730 who could best benefit from this amazing technology 307 00:11:30,870 --> 00:11:32,549 and when. When is the best time to 308 00:11:32,549 --> 00:11:34,134 do it? How can we, 309 00:11:34,595 --> 00:11:36,595 put the child in the best position to 310 00:11:36,595 --> 00:11:37,495 meet their potential, 311 00:11:38,434 --> 00:11:40,294 with this implant and this technology? 312 00:11:40,915 --> 00:11:42,674 So, one example that we have, 313 00:11:43,154 --> 00:11:46,115 is, you know, unfortunately we do see children 314 00:11:46,115 --> 00:11:48,440 that have meningitis and meningitis, 315 00:11:48,899 --> 00:11:49,779 is a very, 316 00:11:50,259 --> 00:11:52,899 significant risk factor for developing a significant hearing 317 00:11:52,899 --> 00:11:53,639 loss. So, 318 00:11:54,340 --> 00:11:55,080 and it's 319 00:11:55,539 --> 00:11:57,139 a cause of hearing loss that if it's 320 00:11:57,139 --> 00:12:00,580 not identified early and intervened for early, it 321 00:12:00,580 --> 00:12:01,080 can, 322 00:12:02,285 --> 00:12:04,684 it may not ever be able to, have 323 00:12:04,684 --> 00:12:06,764 a cochlear implant, for example, that's very time 324 00:12:06,764 --> 00:12:07,904 sensitive. So, 325 00:12:08,764 --> 00:12:11,965 there really wasn't a meningitis protocol to follow 326 00:12:11,965 --> 00:12:14,205 that was published, and it was the standard. 327 00:12:14,205 --> 00:12:16,459 So we had a very small, 328 00:12:17,159 --> 00:12:19,820 baby that came into our hospital with meningitis. 329 00:12:20,759 --> 00:12:21,259 And, 330 00:12:22,039 --> 00:12:24,360 we actually, she was the youngest patient to 331 00:12:24,360 --> 00:12:26,600 receive a cochlear implant. We did it here 332 00:12:26,600 --> 00:12:28,940 at Children's Minnesota, and that really 333 00:12:29,414 --> 00:12:32,554 helped us develop a meningitis protocol. 334 00:12:33,414 --> 00:12:33,914 Basically, 335 00:12:34,294 --> 00:12:36,054 a protocol to follow when a child is 336 00:12:36,054 --> 00:12:37,894 admitted to the hospital for meningitis, how to 337 00:12:37,894 --> 00:12:40,054 follow their hearing so you don't miss that 338 00:12:40,054 --> 00:12:42,554 critical window, and we've since published that protocol, 339 00:12:43,289 --> 00:12:45,850 for other centers to use. So that's, you 340 00:12:45,850 --> 00:12:48,169 know, an an exciting thing that we're very 341 00:12:48,169 --> 00:12:50,089 proud of. I think in Minnesota, you know, 342 00:12:50,089 --> 00:12:52,250 we're the only state that screens all infants 343 00:12:52,250 --> 00:12:53,629 for congenital cytomegalovirus, 344 00:12:54,649 --> 00:12:56,809 and that is a virus that can cause, 345 00:12:57,129 --> 00:13:00,065 hearing loss later in life or it can 346 00:13:00,065 --> 00:13:01,585 cause a child to be born deaf or 347 00:13:01,585 --> 00:13:02,404 hard of hearing. 348 00:13:03,024 --> 00:13:04,784 And so we're in in a very exciting 349 00:13:04,784 --> 00:13:06,164 position in the state of Minnesota 350 00:13:06,865 --> 00:13:07,365 to, 351 00:13:07,745 --> 00:13:10,004 be able to follow these children and understand 352 00:13:10,065 --> 00:13:11,909 because a lot of them, are not I 353 00:13:11,909 --> 00:13:14,089 shouldn't say a lot, but several of these 354 00:13:14,149 --> 00:13:15,429 children that are born of this end up 355 00:13:15,429 --> 00:13:18,230 being cochlear implant candidates and and determining, okay, 356 00:13:18,230 --> 00:13:19,750 when when is the best time to do 357 00:13:19,750 --> 00:13:21,110 it? What are the other things we should 358 00:13:21,110 --> 00:13:22,250 be watching for? 359 00:13:22,950 --> 00:13:24,870 We're in a really great position that we 360 00:13:24,870 --> 00:13:25,370 can, 361 00:13:26,404 --> 00:13:28,424 you know, share this knowledge that we're learning. 362 00:13:28,804 --> 00:13:30,504 I think even things like, 363 00:13:31,205 --> 00:13:33,625 like gene therapy. So there is, 364 00:13:34,245 --> 00:13:35,705 there is a specific 365 00:13:36,644 --> 00:13:39,205 genetic cause of hearing differences that actually causes 366 00:13:39,205 --> 00:13:41,544 something called auditory neuropathy that 367 00:13:42,230 --> 00:13:45,269 there are successful gene for gene therapy for 368 00:13:45,269 --> 00:13:47,129 this specific gene change. 369 00:13:47,750 --> 00:13:49,509 And I think this is probably just the 370 00:13:49,509 --> 00:13:50,409 start of 371 00:13:50,949 --> 00:13:51,449 other 372 00:13:51,829 --> 00:13:55,514 genetic causes of hearing differences to potentially have 373 00:13:55,514 --> 00:13:58,554 that option of, gene therapy. So it's really 374 00:13:58,554 --> 00:14:00,634 exciting. And then figuring out, well, how does 375 00:14:00,634 --> 00:14:02,014 the role of cochlear implantation, 376 00:14:03,434 --> 00:14:04,735 you know, how do we 377 00:14:05,115 --> 00:14:07,855 tie that into these advancements in in medicine? 378 00:14:07,914 --> 00:14:10,690 And and do we learn more about, you 379 00:14:10,690 --> 00:14:13,570 know, again, who should have a cochlear implant? 380 00:14:13,570 --> 00:14:15,409 When should we do it? And is the 381 00:14:15,409 --> 00:14:17,169 gene therapy, how does that play a role? 382 00:14:17,169 --> 00:14:19,889 So it's it's really kind of exciting. There's 383 00:14:19,889 --> 00:14:21,330 all of these new things. And and I 384 00:14:21,330 --> 00:14:23,985 think the other thing is that the implants 385 00:14:23,985 --> 00:14:24,485 themselves 386 00:14:25,184 --> 00:14:27,425 continue to just get better and better all 387 00:14:27,425 --> 00:14:29,345 of the time. The tech the advances in 388 00:14:29,345 --> 00:14:29,845 technology, 389 00:14:31,345 --> 00:14:33,504 you know, like Chelsea mentioned, just being able 390 00:14:33,504 --> 00:14:36,705 to stream to practice with the implant, which 391 00:14:36,705 --> 00:14:38,565 is really critical for some patients. 392 00:14:39,949 --> 00:14:42,269 It's just crazy to think how much things 393 00:14:42,269 --> 00:14:43,870 have changed in the 10 years that I've 394 00:14:43,870 --> 00:14:46,429 been doing this surgery or actually 13 years 395 00:14:46,429 --> 00:14:48,350 that I've been doing this surgery, but 10 396 00:14:48,350 --> 00:14:50,269 years here at Children's. And then to think, 397 00:14:50,269 --> 00:14:51,870 well, where are we gonna go over these 398 00:14:51,870 --> 00:14:54,295 next 10 years is is just is pretty 399 00:14:54,295 --> 00:14:56,695 amazing to to think about and to be 400 00:14:56,695 --> 00:14:57,435 a part of. 401 00:14:58,375 --> 00:15:00,535 Doctor Mein, Chelsea, thank you so much for 402 00:15:00,535 --> 00:15:02,455 being so generous with your time and insights 403 00:15:02,455 --> 00:15:04,535 on this program. We cannot wait to share 404 00:15:04,535 --> 00:15:06,055 them with our audience, and we look forward 405 00:15:06,055 --> 00:15:07,995 to connecting with you guys again soon. 406 00:15:08,793 --> 00:15:10,073 Thank you so much. Thank you for having 407 00:15:10,073 --> 00:15:10,573 us.