Twelve-month-old Zachary Revenig spent his Monday like many other days: at his home in Monticello, smiling and happily talking to himself as he played.

However only Zachary knows what, if anything, he heard.

At Fairview-University Medical Center last Friday, Zachary became the youngest Minnesotan to get a Cochlear implant.

But other than a four-inch incision extending from behind his right ear, it is hard to tell he underwent surgery at all.

The implant, which turns sounds into electronic pulses meant to stimulate auditory nerves, will be turned on once Zachary recovers from the surgery.

His hearing problem was first diagnosed during a routine screening a couple days after he was born at the St. Cloud Hospital.

“He didn’t pass the screening,” said Melissa Revenig, Zachary’s mother. “But he was so responsive, from the beginning he had always been very verbal and he startled to loud noises. So we were pretty sure that he heard.”

But his testing at three months old confirmed he couldn’t hear.

By the time Zachary was three and a half months old, he was wearing hearing aids and making regular trips to the University to have his hearing tested.

“If you can get them identified and amplified before six months old, the outcome in the long run is much, much better,” Melissa said.

The Revenigs said early diagnosis and intervention was important to language and speech development. They are thankful Zachary was born in a hospital that screened for newborn hearing.

“Because he was identified early, the hope is for normal speech and language acquisition and mainstream schooling,” said Melissa.

Zachary became eligible for a Cochlear implant when the FDA lowered the age requirement for the procedure from 18 to 12 months old.

He has been diagnosed with severe to profound hearing loss, which means he can hear 80 to 100 decibels of sound. The average person’s hearing ranges from 0 to 10 decibels, and a normal conversation is about 20 decibels.

The Revenigs said they looked for any excuse to put off getting Cochlear implants, but after researching their possibilities, the implants looked like their best bet.

Once they decided on the implants – which cost between $50,000 and $75,000, surgery, hospital and rehabilitation costs excluded – the Revenigs wanted to do the procedure as early as possible to give Zachary a chance to develop his speech and language skills.

Frank Rimell, the surgeon who performed the procedure and the coordinator of pediatric otolaryngology at Fairview-University, also stressed the importance of early detection and help with hearing.

“The earlier the brain is stimulated to sound, the better off they’ll be,” he said.

The average age of hearing loss detection is approximately 2 years old, said Rimell. Specialists would like to lower the average to diagnose children less than 6 months old to improve their chances of speech and language development, he said.

While hearing aids can only amplify sound, Cochlear implants improve sound quality because they convert sound waves into electric current and stimulate the auditory nerve directly.

Zachary will wear a small box that looks like a hearing aid that houses a microphone and is hooked to the implant.

The Ear, Nose and Throat Clinic at Fairview-University has acted as a pilot center for the FDA and Cochlear device companies, said Rimell. The clinic has implanted Cochlear devices in more than 250 patients since the early 1990s, and approximately 100 of them have been children, he said.

Zachary is still using a hearing aid until he recovers from his surgery. Then doctors will start turning on the implant little by little.

Rimell said most children cry when the devices are turned on for the first time because the sounds are such a shock, but within a week it’s the first thing they reach for in the morning.

The Revenigs have no family history of hearing loss, and doctors still are not sure about the cause of Zachary’s hearing loss.

Approximately 80 percent to 90 percent of deaf children are born to hearing parents, said Rimell.

While it is hoped the implant will help Zachary to hear, he will still have to work with speech pathologists and his parents to develop his language skills.

The implant only allows patients to hear noise, not to detect separate words, Rimell said.

The Revenigs plan to learn and teach Zachary sign language – along with his older brother and sister – even if the Cochlear implant is as effective as they hope it will be.

Sandy De Quesada is a member of the Cochlear Implant Club Minnesota and serves as a mentor to people who are considering implants. Although her implants have worked, she said there is no guarantee when it comes to Cochlear implants.

“(People considering implants) have to keep their expectations low but their hopes high,” said De Quesada.

Liz Kohman covers the Academic Health Center. She welcomes comments at [email protected]