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Cochlear Implant
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Cochlear Implant

Most of the people having hearing problems are benefited by hearing aids, there are some people who have severe hearing loss and they are not benefited with hearing aids. So the cochlear implant is a boon for people having damage to the sensory cells in the inner ear. This is made possible in India at low cost by MedicoExperts. We offer affordable cochlear implant surgery in India with best surgeons and also assist you with all the logistics for your hassle free medical trip to India.

Cochlear Implant Surgery

Cochlear Implant Surgery

A cochlear implant is an electronic medical device which is implanted surgically in the inner ear. Cochlear implant makes the sounds louder compared to hearing aids. The damaged hair cells of the inner ear (cochlea) is bypassed by cochlear implants which provides sound signals to the brain. Cochlear implant has been designed especially to help severely to profoundly deaf adults and children who get little or no benefit from hearing aids. Even individuals with severe or profound “nerve deafness” may be able to benefit from cochlear implants.

Cochlear implantation is indicated in the individuals where there is damage to tiny hair cells in a part of your inner ear called the cochlea. The hair cells usually identify the vibrations of sounds and send them to the brain through the auditory nerve. If it is damaged, then the sound can’t reach that nerve. The implant helps in bypassing the damaged area and sends impulses to your auditory nerve directly.

Cochlear-web

The quality of sound which can be heard after cochlear implant is different from the natural hearing but the hearing is sufficient for the patient in understanding the speech. The patient cope ups well with the environment and surrounding sounds and also understands the speech well. The implants used are all approved by the Federal Drug Administration (FDA)

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The cochlear implant is comprised of 2 parts

1. The receiver

ci-The-receiver

2. The speech processor

The-speech-processor

Causes

The hearing loss is mainly of two types:

1. Conductive hearing loss

as the name suggests occurs if there is a problem in sound waves conduction enrouting through the outer ear, tympanic membrane (eardrum), or middle ear. It may also happen if there is something that blocks the sound waves from reaching into the inner ear. The causes for such obstruction can be infections, holes in the eardrum, fluid or wax build-up behind the eardrum, or malfunction which is caused due to an infection in the part of the ear or a sudden or extreme change in air pressure and head injury. All these causative factors can lead to partial or conductive hearing loss. In such cases the treatment of choice is often surgical or medical intervention or sometimes this can even be corrected by hearing aids

2. Sensorineural hearing loss

occurs if there is damage to the inner ear or the nerve from the ear to the brain which passes the messages from inner brain to brain. This type of case has more likely to have permanent hearing loss and more common than the conductive hearing loss. The main contributing factors for Sensorineural hearing loss includes prolonged exposure to loud noise or due to ageing. In children the hearing loss is due to the congenital abnormalities or infections. Furthermore, injuries to skull or skull fracture, brain injury and Genetic disorders can also lead to sensorineural hearing loss.

Treatment Options

The line of treatment is decided based on the type of hearing loss. Following details would give a brief idea about the treatment options available for hearing loss in India.

  • Treatment for Conductive hearing loss: The treatment suggested for conductive hearing loss is –

Medical Management The drug or form of medicine which can be used to cure the infection or the diagnosis.
Surgical Intervention which includes Canalplasty, Stapedectomy, Tympanoplasty and with or without ossicular reconstruction (Depending upon the diagnosis).
Bone Anchored Hearing Aid (BAHA) is suggested if patient is profound to nearly normal hearing on one side or complete hearing loss in one ear. This procedure fitting consists of six stages like Investigations, treatment planning, selection, verification, orientation, and validation. The implant which is used in this procedure is Titanium Implant this is placed in the bone behind the ear. Later after a couple of months an external device is hooked up to the Titanium Implant which is similar to a hearing aid.

  • Treatment for Sensorineural hearing loss

The only promising treatment available for this type is Cochlear Implant. When hearing is so poor that hearing aids provide minimal or no benefit, a cochlear implant may be considered. Over 80,000 people worldwide benefited with cochlear implants and half of all cochlear implant recipients are children’s. This device functions to stimulate the auditory nerve by passing through the injured inner ear. Patients with severe Sensorineural hearing loss still have a functional auditory nerve and the sensation of the sound is re- created by the implant.
A wide range of sound information and performance is expected from this device. With the best appropriate rehabilitation and the duration of time, patient experience clear understanding and more speech compared to the use of hearing aids.

Procedure

Cochlear Implantation
The treatment goes in stepwise manner.

Patient undergoes relevant investigations which includes MRI, CT scan, X ray studies and a thorough evaluation by the team of audiologist.

Once the patient is identified for cochlear implant the procedure begins. The patient has a consultation with the ENT surgeons for confirming his or her candidacy based on the results of initial evaluation and investigation.

The trial of anaesthesia is done. The procedure is performed under general anaesthesia through an incision behind the ear. The whole procedure takes nearly 2-3 hours for the completion. Post discharge the recovery is in few days and follow ups and recuperation will be advised. Post- surgery you may see a swelling behind the ear which is normal and it may take some time to subside.

This is hooked up to the stimulator or the receiver after four weeks of surgery.

The patient is then advised to undergo intensive rehabilitation under implant audiologist to cope up with the listening of sounds through the device.

Are you a Candidate?

The candidate for cochlear implant are both Adult and children.

Adult individual who is more than 18 years age or older can be a candidate is they have moderate to profound sensorineural hearing loss in both ears and if they have not been benefited with the hearing aids. The adult can be candidate regardless to if they had developed language before losing their hearing. These kind of case have more success rate compared to non-developed language candidate.

Children’s from 12 months to 17 year age can be a candidate for cochlear implant. Children having Severe to profound Sensorineural hearing loss and the one who got limited benefit from binaural amplification and if has no contraindication preventing surgery. Child with delayed speech and language development due to hearing loss or rarely responding to his/her name or have lost the sense of hearing after a head injury or illness, are also candidates for cochlear implant surgery

 

Expected Results

Candidate should be aware that the best result from cochlear implant is achieved by patience, motivation, commitment to fitting and the proper rehabilitation sessions. Cochlear implant improves the independence of a person, enabling them for better speech understanding and phone conversations, a wide range of outcomes can be experience from this implant. After using this for several months the patient will feel it more natural and familiar. In children cochlear implants benefit expected are quite drastic as compared to adult patient as it depends on the time the patient had the implant after the deafness.

 

Recovery Timeline

Post-surgery the patient have to stay in hospital for around 1-2 days, the patients shall have stitches and the prevention caring instructions for the stitches will be advised and after a week the stitches are removed and the implant site is examined.

The external device is given after a month of surgery in the first programming session. The implant is activated after 3-6 weeks of surgery. If the patient had used hearing aids then the developed auditory skills is benefited in rehabilitation. The maximum benefit of the surgery is expected from rehabilitation which starts with speech processor, transmitter and battery pack fitting. To understand how to learn the sound and how to response to the sound the patient is thought well rehabilitation speech.

 

Cost

The approximate cost for unilateral cochlear implant would range between USD 12000 to USD 18000 with basic implant. The cost estimate would vary depending upon the quality, version and brand of the implant, expertise of the surgeon and the facility where you choose to get the procedure done.

Frequently Asked Questions and patient concerns:

1. What extent of hearing loss would qualify a child for cochlear implant?

For children 12 months and older with moderate to serious sensorineural hearing loss in both ears, cochlear implants are suitable.

2. How long does the surgery take and what is the time of recovery?

The surgery is around 2-3 hours long. Depending on the child, the recovery time may be from 1-4 days. In order to assess the surgical site, the child will be seen two weeks after surgery to follow up with the otologist.

3. Are cochlear implants appropriate for older adults?

Cochlear implants greatly benefit older adults too. Unfortunately, there is common confusion as to when elderly people should be recommended for a cochlear implant and many health care systems continue to ignore hearing as a major health problem. Studies have shown that the results for older adults do not vary greatly from children.

4. How does a cochlear implant work?

5. How common is the surgery?

About 150,000 people worldwide have received cochlear implants, with recipients split almost evenly between children and adults.

6. Are there any restrictions on a cochlear implant patient’s lifestyle post-implant?

When not wearing the external equipment, users can swim, shower, and participate in any number of water activities. The only restriction placed on implant users relates to skydiving and scuba diving because the significant air-pressure changes encountered in these activities, which are not advisable. Participation in all other athletic pursuits is unrestricted, though protective head gear is recommended.

7. How is a cochlear implant different from a hearing aid?

For your child, hearing aids usually amplify sounds. In cases where the cochlea is impaired leading to extreme or significant hear loss, a hearing aid is often unable to make noises loud enough. A cochlear implant does not make sounds louder, but sends sound, bypassing the impaired parts of the cochlea, directly to the hearing nerve.

8. How long does a cochlear implant last? Will there ever need to be a replacement?

It is intended that the surgically implanted device will last a lifetime. There have however been several instances where equipment failure has occurred and the system has been surgically replaced. Also. since the external processing device technology continues to develop, the internal technology will not be compatible with the external technology at some point in time. This could lead to medical intervention to correct the compatibility.

9. When can my child go back to school after the surgery?

As soon as they feel confident, a child can resume activities. This can vary from one child to another. For example, on Thursday, some kids receive the implant and return to school the following Monday. In order to feel confident to return to their daily activities, some will take longer. It is important that the school is conscious of the surgery and requires your child to temporarily refrain from events such as physical education class and some activities in the playground.

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