Why are there new cochlear implant services in the western part of the province (Montreal area)?
The opening of a new point of service in the western part of the province allows for cochlear implant services to be offered in close proximity to the population. This reduce the distance to care and services clients residing in the western part of the province.


How are services organized in the Montreal area? 
For both children and adults, the medical component (evaluation, surgery and medical follow-ups), the initial intensive programming and the programming controls during the first twelve months will be provided by the cochlear implant team of the McGill University Health Centre (MUHC). Specifically, children are cared for at the Montreal Children's Hospital, and adults are cared for at the Royal Victoria Hospital.

 

Early activation will not be part of the MUHC's clinical practice at the outset of service delivery. However, the intention is to integrate this practice as soon as possible. In this context, users will have a two-week recovery period before activation and the start of initial intensive programming. 

 

After the first year, programming controls will be provided by the Lethbridge-Layton-Mackay Rehabilitation Centre of the CIUSSS Centre-Ouest-de-l'Île-de-Montréal or by the Centre de réadaptation en déficience physique Raymond-Dewar of the CIUSSS Centre-Sud-de-l'Île-de-Montréal.

 

There is no change for intensive functional rehabilitation following surgery. It is provided by the rehabilitation center in the user's region or by one of the CIUSSS mentioned above, if the regional rehabilitation center does not offer this service.


How are services organized in the Quebec City area?

There are no changes.
 

The medical component (evaluation, surgery and medical follow-ups), early activation, initial intensive programming as well as programming controls are provided by the cochlear implant team of the CHU de Québec-Université Laval and the CIUSSS de la Capitale Nationale.

Intensive functional rehabilitation following surgery is provided by the rehabilitation center in the user's region or by the Centre de réadaptationendéficience physique de Québec of the CIUSSS de la CapitaleNationale.


How do you determine if the user resides in the west or east part of the province?

The territorial distribution established by the MSSS for the cochlear implant is as follows: 

East	West
01- Bas-Saint-Laurent	06- Montréal
02- Saguenay-Lac-Saint-Jean	07- Outaouais
03- Capitale-Nationale	08- Abitibi-Témiscamingue
04- Mauricie-et-Centre-du-Québec	13- Laval
05- Estrie	14- Lanaudière
09- Côte-Nord	15- Laurentides
10- Nord-du-Québec	16- Montérégie
11- Gaspésie-Îles-de-la-Madeleine	17- Nunavik
12- Chaudières-Appalaches	18- Terres-Cries-de-la-Baie-James

How do I apply for a cochlear implant in the West (Montreal area)?

All applications must be sent to the provincial registry of the Quebec Cochlear Implant Program which is located at the CHU de Québec-Université Laval. Depending on where the user resides, it will be determined if the appointments will be done at the point of service located in the east or west of the province. No action by the user is required.

Important: It is recommended to have a referral from a hearing specialist (e.g., audiologist, otolaryngologist, audioprosthesist) when applying for a cochlear implant.


What happens to patients who have started procedures with the CHU de Québec-Université Laval (eastern point of service), but who live in the area now served to the west?

If the user has not started the evaluation process, a file transfer is planned. The user will receive a letter informing them of the new service offer in the West as well as a consent form that they will have to sign to authorize the transfer.

If the user has begun the evaluation process, he/she is expected to continue the process at CHU de Québec-Université Laval. The following steps will be done in Quebec City: surgery, early activation, initial intensive programming. At the rehabilitation and programming control stage, the user may continue his follow-ups in Montreal if he wishes. In this case, he/she must contact the CHU de Québec-Université Laval: 
Phone: 418-691-5420
E-mail: implant.cochleaire@chudequebec.ca


For patients who reside in the east part of the province (Quebec City region), are there any changes in obtaining a cochlear implant?

No, there is no change.

The user must send his or her application to the provincial registry located at the CHU de Québec-Université Laval where it will be evaluated. 
 

CHU de Québec-Université Laval / Hôtel-Dieu de Québec 

Service d’audiologie (Implant cochléaire) 

11 Côte du Palais, Québec (Québec) G1R 2J6 

Fax : 418-691-5377 

E-mail : implant.cochleaire@chudequebec.ca 

Important: It is recommended to have a referral from a hearing specialist (e.g., audiologist, otolaryngologist, audioprosthesist) when applying for a cochlear implant. 


For users who reside in the east part of the province (Quebec City region) and who have already started the process with the CHU de Québec-Université Laval, are there any changes?
No, there is no change.


Can a user arrange for a cochlear implant in the east and west at the same time to get an appointment faster?
No. Once the user's application is received at the provincial registry of the Quebec cochlear implant program, it will be sorted according to their place of residence.


Are the PQIC selection criteria for obtaining a cochlear implant at the CHU de Québec-Université Laval and the McGill University Health Centre the same?
Yes, the selection criteria are the same since it is a single provincial program with two points of service (east and west). 


Is early activation part of the clinical practice at the McGill University Health Centre?

Not at this time. It is planned that early activation of the cochlear implant will be implemented as soon as possible at the MUHC. For the moment, the user returns 2 weeks after surgery for activation and programming of the cochlear implant. 
 

In the Eastern Point of Care (Quebec City area), the activation of the cochlear implant is performed the day after the surgery and the user usually returns 2 weeks later for the initial intensive programming. 


For users whose files are transferred to the McGill University Health Centre (Montreal region), is there an impact on the position on the waiting list or on the delay in obtaining the surgery?
There is no impact on the position on the waiting list. 


When will users be able to have their assessment in Montreal? 
The order on the waiting list will be respected. It is expected that the first users will be seen during the month of October 2022. 


When will users be able to have cochlear implant surgery in Montreal?
The order on the waiting list will be respected. The first surgery will be scheduled for early 2023.

1984

Dr. Pierre Ferron, ENT specialist, performs the first cochlear implant surgery at HDQ.
 

1987

HDQ and the IRDPQ join forces on the Programme québécois pour l’implant cochléaire (Québec cochlear implant program) to offer comprehensive cochlear implant services.

Dr. Ferron operates on the first child in Canada to receive a multielectrode cochlear implant.
 

2000

Dr. Ferron installs a cochlear implant in a 5-month-old baby, a world first.
 

2003

A research study allows people with a visual impairment to receive bilateral cochlear implants.
 

2006

Another research study on bilateral implantation gets underway in Québec City, this time on young children.

The first auditory brainstem implant is installed in Québec City, at Hôpital L’Enfant-Jésus.
 

2007

The program is granted formal recognition under the name of Centre québécois d’expertise en implant cochléaire.

In order to offer quality services as close as possible to users’ homes, other regional rehabilitation centres can now provide intensive functional rehabilitation services (following initial programming).
 

2008

Dr. Bussières operates on the oldest person in Québec to receive a cochlear implant, a 90-year-old woman.
 

2012

Dr. Bussières operates on a 4 1/2-month-old baby, who remains one of the youngest children in the world to receive a cochlear implant.

Bilateral implantation is now covered in Québec by the Ministère de la Santé et des Services sociaux, in limited numbers and according to certain criteria.

2016

The first cochlear implantation surgeries are performed for people with single-sided deafness and tinnitus as part of a research study.
 

2019

 

Early activation of cochlear implants. For the first time in North America, cochlear implants are activated the day after surgery.

 

TODAY

Nearly 3300 cochlear implantation surgeries have been performed to date, including on the youngest patient, who was 4 months old, and one the oldest patient, who was over 91.

To learn more about the history of cochlear implantation, you can consult the article “Petite histoire de l'implant,” published in the journal Sourdine, no. 221, December 2017. This article is taken from the video “Le moulin à sons,” presented at the 3^e Colloque québécois sur l’implant cochléaire (3^rd  Québec conference on cochlear implantation) on May 30, 2014, to mark the 30^th anniversary of the first cochlear implant in Québec.

Click here to watch Le moulin à sons 

Surgeons (ENT)

Dr Richard Bussières (Director)
Dr Mathieu Côté
Dr Daniel Philippon
Dr Mathieu Trudel

 

Audiologists (Programming)

Valérie Audet
Julie Belzil
Francis Comtois
Sandra Fortin
Amélie Gaudreault
Jérôme-Olivier Lebrun
Marie-Ève Rochon
Nicolas Rouleau

Director of technical support

France Bouvry

Administrative staff

Nicole Gagnon (L'HDQ)
Fabienne Astrou (IRDPQ)

Audiologists (Rehabilitation)

Catherine Champagne
Mélanie Laferrière
Maryse Landry
Isabelle Millette
Geneviève Tremblay
 

Speech therapists (Rehabilitation)

Myriam Adam
Anne-Marie Bégin
Mélissa Dostie
 

Psychologists (Rehabilitation)

Caroline Guay
Geneviève Mainville
Anne Rochefort

Specialized educators (Rehabilitation)

Élizabeth Arsenault
Caroline Couture
Caroline Gingras
Mathilde Maheu-Lessard

Social worker (Rehabilitation)

Marie-Hélène Gravel-Grenier
 

Researchers

François Bergeron (Université Laval et CIRRIS)
Louise Duchesne (UQTR et CIRRIS)

Ongoing research studies : 

 

1. Implantation in single-sided deafness/tinnitus.

2. Benefits in speech perception in noise with signal processing features of the Naída CI Q90 sound processor.

3. French adaptation of the Pediatric AzBio sentence corpus.

 
Find out more information about our presentations/publications.
 

1- Implantation in single-sided deafness/tinnitus.
 

Anthony Lambert, Mathieu Côté, Richard Bussières, François Bergeron.

The objective of the study is to explore the benefits of cochlear implantation with respect to tinnitus, auditory performance, and quality of life in patients with single-sided deafness and tinnitus.

The recognized surgical indications for cochlear implantation are primarily severe-to-profound bilateral deafness. In adults, an improvement in auditory performance is clearly established. In children, implantation favours the development of speech, language and communication.

Given the functional benefits of binaural hearing, bilateral cochlear implantation is currently gaining in popularity. Studies show improvements in sound localization and speech perception, especially in the presence of competing noise.

Ipsilateral tinnitus presents a therapeutic challenge in people with single-sided deafness, making it difficult to use the usual masking techniques. Cochlear implantation could be a suitable alternative.

In keeping with the principles of tinnitus management and the development of bilateral implantation, this specific population could potentially benefit from an implant that offers them the benefits of binaural hearing while also lessening the intensity of their tinnitus.
 

2- Benefits in speech perception in noise with signal processing features of the Naída CI Q90 sound processor.

Bergeron, F., Lemolton, A., Agrawal, S.

The Naída CI Q90 sound processor from Advanced Bionics (AB) incorporates new sound processing algorithms based on the technology used in Phonak hearing aids, which were developed and adapted for use with cochlear implants. These algorithms include an adaptive acoustic beamforming system, called UltraZoom, designed to improve auditory performance in noise, in particular when the speaker is directly in front of the person with hearing loss. The Binaural VoiceStream Technology (BVST) streams data wirelessly between two Naída sound processors (bilateral implants) or between a Naída CI sound processor and a Naída hearing aid (bimodal device). Wireless transmission between ears forms a third-order acoustic beam through the use of four microphones (two in each ear). This additional directional beamformer (called StereoZoom) should further improve speech comprehension in noisy environments. The BVST also delivers the signal received in one ear to the contralateral ear, allowing for better hearing when using the phone (DuoPhone feature) or in situations where the signal desired may not be in front of the listener (for example, when driving a car; ZoomControl feature). The BVST allows people with a single implant to use a CROS wireless hearing aid in the non-implanted ear to transmit sounds from this ear to the Naída CI Q70/90 sound processor on the implanted side.

These characteristics are designed to further improve the auditory benefits of cochlear implantation for people with severe hearing loss. According to the perspective of evidence-based practice, it is essential to document the auditory benefits related to the application of these characteristics. The data collected will help to confirm the efficacy of these new options for cochlear implant users, support clinical decisions related to the implementation of these characteristics, and help to establish guidelines for selecting the best options on an individual basis. 

Objectives :
1- Assess the benefits of the Naída CI Q90 sound processor’s directional technology in a common but difficult listening situation in people with a unilateral implant.
2- Assess the additional gains provided by a CROS hearing aid for these people in the same daily environment.
 

3- French adaptation of the Pediatric AzBio sentence corpus.

The improvement of auditory perception is one of the main objectives of audiology interventions in the hearing-impaired population. Several tests are available to guide and assess the efficacy of these interventions. Ideally, these tests should measure the complex abilities used by hearing-impaired people on a daily basis.
 
The AzBio Sentence Test was developed to :
1- provide unbiased patient assessments based on representative sentences from daily life,
2- enable assessment across a wide variety of conditions,
3- create sentence lists with an equivalent level of difficulty to enable intra-individual comparison.
4- provide an estimate of performance consistent with the patient’s perceived performance in daily life (Spahr et al., 2012).
Since its introduction, the AzBio Sentence Test has been widely used by English-speaking cochlear implant teams, in particular, because of the high level of complexity of the material, including a high level of language, the use of several speakers, and masking noise consisting of multiple talkers, which prevents the ceiling effects often seen with other assessment tools. Work was recently done to develop and standardize an international French version for adults (Bergeron et al., 2016). The adaptation of the pediatric version of the original AzBio Sentence Test (Spahr et al., 2014) proposed by this project is a complement to this work. 

Objectives :
The goal of this project is to continue adapting the AzBio Sentence Test to produce an international French version. This phase targets the pediatric version of the test. 

The specific objectives are :
1- Create a corpus of French sentences.
2- Validate the corpus with French-speaking children in kindergarten and grade one.
3- Generate sentence lists from the validated corpus.
4- Verify the equivalence of the lists with hearing-impaired listeners.
 
This work is needed to provide researchers and clinicians with a reference tool for establishing the efficacy of technological/therapeutic interventions in deaf children. This practice is consistent with the contemporary evidence-based medicine approach whereby decision-making must be based on interventions that are proven effective.