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Cochlear Implants

Cochlear Implants

Ear Surgery cochlear implants are small, electronic devices used to electrically stimulate the cochlear nerve (the nerve used in hearing) and to correct hearing loss in those who are suffering from complete deafness or difficulty to hear sounds clearly. The device has both internal and external parts.

The external part of the cochlear implants is located behind the ear when it receives sounds with a microphone, processes the sounds and sends information to the internal part. The internal part is implanted under the skin at the back of the ear during outpatient surgery. It is implanted into the inner ear (cochlear) with tiny electrodes which bypasses the damaged parts of the ear to directly reach the auditory nerve and send sound signals to the brain to provide a hearing sensation.

Cochlear implants surgery improves hearing ability by increasing the awareness of sounds in the environment which is aided by lip reading and listening. Cochlear implants can benefit both adults and children above 12 months of age. The success of cochlear implants depends on how long a person has been deaf, how many nerve fibers remain undamaged and their personal motivation to hear.

What You Need to Know about Cochlear Implant surgery

A cochlear implant is different from a hearing aid. A hearing aid is used to make sounds louder but does not have the ability to significantly restore hearing and speech understanding while a cochlear implant does. A cochlear implant, which is a small electronic device, may be an option when appropriately fitted hearing aids do not provide the clarity of sounds needed to understand speech and spoken language.

Early intervention is very important. If there is a delay in taking action concerning hearing loss, the case may worsen as opportunities for improvement decrease over time. This has proven true especially in hearing loss cases in children.

Rehabilitation and training after surgery are required in order to achieve optimal hearing ability.

When do you require cochlear implant surgery?

You, your health care provider and an audiologist may consider a cochlear implant if you are experiencing loss of hearing or difficulty in hearing and need to rely heavily on lip reading. Candidates for cochlear implant surgery include people who:

  • Are experiencing hearing loss and hearing aids have little or no significant effect.
  • Can hear with both ears but with poor clarity of sounds
  • Struggle to hear half or more of spoken words, without lip reading, even when wearing hearing aids

In cases of more moderate loss of hearing, a partially inserted cochlear implant is used to maintain hearing so that both a hearing aid and the cochlear implant may be used simultaneously in the same ear. However, in more severe cases of hearing loss, a cochlear implant is fully inserted into the ear, in order to achieve the full benefit of an electrical hearing.

The rate at which cochlear implants help differs from person to person. Most individuals’ experience significant growth in their awareness of sounds within days after their cochlear implant is turned on, which is about four to six weeks after surgery. Understanding of spoken language later improves with time gradually, with most people noticing the most significant improvement within the first six months. The magnitude of this improvement varies considerably between people. Improvements in speech understanding and spoken language can be aided with auditory, or hearing, therapy as post-surgical care.

Is cochlear implant surgery the right choice?

Delay may be dangerous when it comes to making decisions about the right time for a cochlear implant surgery as the chances of restoring good hearing conditions decrease with time. With successful surgery and rehabilitation, the individual may be able to:

  • Perceive different sounds, such as footsteps, a door closing or a phone ringing
  • Understand speech without relying too much on the ability to lip-read
  • Understand voices over the telephone
  • Watch TV without closed captioning
  • Hear music, radio sounds, and other audio sources

However, before thinking about a cochlear implant, it is important to understand certain facts. These include:

A cochlear implant requires a long period of training, rehabilitation, and therapy after surgery. During this time, the person will learn how to care for the implant. The person will also have aural, or hearing, rehabilitation to assist with learning how to interpret the new electrical signals, as well as how to apply these new listening skills for better communication. This will help to improve the use of the implant. The frequency and duration of this aural rehabilitation depend on the goals and progress of the person involved.

Cochlear implants do not restore hearing to normal. In a small minority of people, they may not help with hearing at all.

A natural hearing may even be lost where the implant is inserted; a hearing aid is more preferable instead to maintain the remaining natural hearing ability.

There may need to renew or recharge the batteries of cochlear implants daily

The external part of the cochlear implants should be removed while bathing or swimming

Before undergoing an MRI scan, a special procedure may be performed

Special care is to be taken when playing sports so that the implants are not damaged

Not all cases of cochlear implants are successful, in some rare conditions, further surgery may be needed

Always set an appointment with the appropriate professionals e.g. an otolaryngologist, an audiologist or speech-language pathologist

Physical tests such as hearing tests may be performed and also imaging tests such as MRI scan may be performed to determine the structure of the ear.

Risks of Cochlear Implant Surgery

Cochlear implant surgery is a generally safe procedure. Rarely, as with all surgeries, risks can occur, including bleeding, swelling, infection in the penetration site, tinnitus (ringing in the ears), dizziness, numbness around the ear, dry mouth, facial numbness due to injury to the facial nerve, discharge in the ear, meningitis and anesthetic risks

Procedure

Cochlear implant surgery is an outpatient procedure. The surgery lasts two to four hours. It is done under general anesthesia. A surgical cut or incision is made behind the ear. Facial nerves are identified and opened to reach the cochlea. The implant electrodes are then inserted into the cochlea.

An electronic device called the receiver is then placed under the skin behind the ear, securing it to the skull. The incisions are then closed, and the patient is placed under close observation.

Post-surgical Care

The patient should learn the necessary care for the implants. The patient should learn how to change dressings and clean the implant area daily. The implant is turned on after some days after the patient must have healed. About four to six weeks after the surgery, the external parts of the cochlear implant will be added which include a microphone and speech processor. At that time, the speech processor is programmed and activated, which causes the implant to stimulate the cochlear nerve in response to sound vibrations.

Further adjustments may be required after the surgery for optimal use of the cochlear implants.

Cochlear Implant Surgery in Children

A cochlear implant may be recommended for a child with significant hearing loss in order to improve learning spoken language and understand speech. This may be aided by lip-reading for effective speech understanding.