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Cochlear Implant Surgery: Treatment For Hearing Loss

When Carolyn was 12 years old, her hearing impairment surfaced, and her parents’ made rounds of all the ear, nose, and throat specialists. They all agreed that she suffered from nerve deafness in both ears and would ultimately need hearing aids.

She started reading lips, and she had an interpreter at church, in college, and at work. In 2005, she started experiencing slight but frequent dizziness, so she picked up on ear, nose, and throat specialists. She went to many specialists, but the one she saw for dizziness was also a cochlear surgeon. 

She started wearing a hearing aid in March, just before her graduation in 2016. In September same year, she got second aid for the other ear. By the time she was 25, she could no longer understand the voices on the phone, TV, radio, or in person.

He talked to her, showed the success stories of cochlear implant surgery, and ran a physical and psychological test to determine if she was suitable for the implant. At that point, she was 47, and her hearing aids were useless because the nerve damage was profound. All her tests came normal.

Cochlear Implant Patient image

The microcomputer, a coil of 22 programmable electrodes, was implanted in her cochlea. The electrodes simulate receiving the impulse that the nerve cells respond to and forward to the auditory nerve. After boring some mastoid bones behind her right ear, a magnet serving as an FM receiver was embedded in the little bone bed.

She did not hear clear speech the first day, but she heard beeping noises. The next day, she heard a few words while watching the news that got her excited. Within three months after surgery, her new hearing was tested. The speech testing was something that she hadn’t scored above 0 since she was a teenager. With a cochlear implant, she scored 99 percent after three months of surgery. 

After 25 years of complete silence, she can hear music, TV, phone calls, birds singing, her son playing his guitar, and she doesn’t need an interpreter anymore. Her hearing with the implantation is better than the hearing aids that she had when she was 12.

Isn’t that amazing? If you also face a similar problem, we are here to help you guide you through your journey. Here we will talk about cochlear implantation and how it can help you to overcome your hearing loss.

Before that, let’s understand the functions and different parts of the ears and what leads to hearing loss that needs cochlear implant surgery.

Parts of Ears

What is the function of the ears?

The ear controls hearing and balance. It is made up of three parts – the outer ear, middle ear, and inner ear.     

The outer ear channels sound around us to the eardrum. 

Outer ear is made up of:

 – the part we see on the sides of our heads known as the pinna

–  the ear canals

The middle ear is where the sound is transformed from pressure waves to mechanical energy. 

Middle ear is composed of:

 – the eardrum (tympanic membrane) is made up of layers of skin.

– attached to the eardrum are three tiny bones called Hammer (malleus), Anvil (Incus), Stirrup (Stapes) that send out the vibration of the eardrum to hydraulic waves in the internal ear.

The inner ear is where nerves collect sound for delivery to the brain. 

The inner ear is composed of:

– the snail-shaped organ for hearing known as the cochlea

– the semicircular canals that help with balance

– the auditory nerves that most likely go to the brain

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issues affecting hearing loss picture

What are the common issues that can affect your hearing system?

Ageing and exposure to loud noises can contribute to hearing loss. Apart from that, excessive ear wax can temporarily reduce the sounds received by the ears. The presence of fluid in the eardrum otitis media can also cause temporary hearing loss, which reduces movement of the eardrum and tiny bones in the middle ear. Hearing loss can be treated in consultation with your doctor, and that is when cochlear implant surgery is done if it is suitable for you. So, let’s understand what it is.

What is a cochlear implant?

A cochlear implant is a small, electronic device that can offer a feeling of sound to a person who is exceptionally deaf or badly hard-of-hearing. The implantation consists of an external portion that sits behind the ear and an internal portion that is positioned under the skin. The surgery may take 1-2 hours.

 An implant has the following parts:

  • A microphone, which grabs sound from the environment.
  • A speech processor, which selects and prepares sounds picked up by the microphone.
  • A transmitter and receiver, which get signals from the speech processor, converts them into electrical impulses.
  • An electrode array is a group of electrodes that accumulates the impulses from the stimulator and sends them to various regions of the auditory nerve.

 The external part of the device picks up sounds with a microphone. It then processes sound and transmits it to the internal part of the implantation. Thin wire and electrodes in the internal part led to the cochlea, part of the inner ear. This wire sends signals to the cochlear nerve, which sends sound information to the brain to produce hearing sensation.

 An implant does not restore normal hearing. Instead, it can offer a deaf individual a valuable depiction of sounds in the environment and help them understand speech. It is different from a hearing aid that makes sounds louder but may not improve speech understanding. When a person struggles to understand speech, then a cochlear implant should be considered.

what is cochlear implant image
Different Types of Cochlear Implants

What are the types of cochlear implants available?

The most common form of cochlear implants only provides electric stimulation to the hearing nerve. The second most typical cochlear implantation is called Hybrid Implants or Electro-Acoustic Stimulation (EAS) Implants.

These hybrid implants have an added hearing aid component that provides sound amplification for low-frequency sounds. These hybrid implants are indicated to aid those with partial deafness, where the deafness affects mainly the high-frequency sounds.

There are variants to the dimension and style of both the internal and external elements. One of the most visible sections of a cochlear implant system is the external speech processor, and they are available in two significant designs. One of the most common is a behind-the-ear (BTE) or On-the-Ear speech processor worn on the ear.

This wire links to a magnet that sticks to the scalp where the implanted magnet is. The other kind is an Off-the-Ear speech processor, where the processor is incorporated totally onto the magnet.

Why should one undergo cochlear implantation?

Cochlear implants can bring back hearing in individuals with severe hearing loss who are assisted by hearing aids. Cochlear implants can boost their interaction as well as their quality of life.

Cochlear implants might be positioned in one ear (unilateral) or both ears (bilateral). Cochlear implants in both ears have begun to be utilized regularly to treat common severe hearing loss– specifically for infants and kids learning to speak and refine the language. Adults and children who are as young as 6 to twelve months old can benefit from cochlear implants.

reasons to undergo cochlear implant
benefits of cochlear implant

Benefits of Cochlear Implant and who is it for?

Individuals that have cochlear implants report enhanced:

  • Capability to listen to speech without requiring visual signs such as reviewing lips
  • Acknowledgment of regular, daily environmental sounds
  • capacity to listen in a loud environment
  • Ability to find where sounds originate from
  • Capability to listen to tv programs, songs, and telephone conversations

To be qualified for a cochlear implant, you should have:

  • Hearing loss that is so severe that it disturbs spoken interaction
  • Limited gain from hearing aids as determined by specialized hearing tests
  • No medical problems or factors that increase the dangers related to cochlear implants

Why choose India for cochlear implantation?

It has around 200 modern cochlear implant facilities throughout India, in each major city, with talented professionals and well-equipped habilitation systems for extensive management of deaf people.

why cochlear implant in India

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Cochlear Implantations Procedure

How does the cochlear implant procedure work?

The Cochlear implant surgical procedure is done under general anaesthesia. This means during the procedure; you will be in a sleep-like state throughout the treatment. 

 You might need to:

  • Quit taking certain medicines or supplements for a certain time
  • Prevent eating or drinking for a certain time

Your medical professional will certainly provide you with specific directions to aid you in preparing.

You will require an in-depth medical examination to determine if cochlear implants are a good option. 

A doctor will indeed conduct an assessment that might include:

  • Ordering examinations of hearing, speech, and sometimes balance
  • Executing a checkup to assess your inner ear’s health
  • Getting MRI or CT imaging examinations of the head to analyze the condition of the cochlea and internal ear structure
  • Getting psychological health and wellness (emotional) testing in select situations to determine your capability to find out to utilize cochlear implants
  • Your surgeon will then produce a tiny opening in the cochlea to thread the electrode of the inner tool. 
  • Your surgeon will cut (incision) behind your ear and develop a tiny hole in the part of the head bone (mastoid) where the internal device rests.

The skin incision is stitched to make sure that the inner gadget is under your skin.

 You could experience:

  • Stress or pain over the implanted ear or ears
  • Dizziness or nausea

Most people feel well enough to return home the day of surgery or the following day.

An audiologist will not switch on (trigger) the cochlear implants for two to 6 weeks after your surgical treatment– to offer the surgical procedure time to recover.

To activate the cochlear implantation, an audiologist will:

– Change the sound processor to fit you 

– Inspect the elements of the cochlear implantation to make sure they function

– Establish what seems you or your child hears

– Give you info on the appropriate treatment and use of the tool

– Set the device so that you can hear to the best of your capacity

cost of cochlear implant in India

Cost of Cochlear Implantation in India

How much does cochlear implantation cost?

Without insurance, a cochlear implant cost in India can range between $30,000 – $50,000 on average. Most insurance coverage providers cover cochlear implants or a portion of them. The device is likewise protected by Medicare, Medicaid, and Veterans Affairs.

In time, you’ll likely need to change components like microphones and magnets. You may additionally require repair work. Some insurance policies cover these expenses. You’ll intend to speak to your insurance company to discover what’s covered and whether you’ll have any out-of-pocket expenditures.

What is the success rate of cochlear implantation?

Cochlear implants have a high success rate since only less than 0.2% of receivers decline them. The normal-hearing children can describe 77.93% of 100 words, the cochlear implant children can describe 26.87%, and for deaf children with conventional hearing aids is 20.32%.

Cochlear implant customers’ performances have continued to increase for several years. Adults typically benefit right away after the placement of the implantation. The high sound quality continues to boost for about three months after the preliminary tuning sessions.

Conclusion

 The results of cochlear implantation vary for everyone. The outcome of cochlear implantation depends on the age when hearing is lost and the type of cochlear implant surgery. The best results for children occur when getting implantation at a younger age. The best results for adults can be seen with a shorter period of hearing loss before implantation.

Frequently Asked Questions and patient concerns:

Is cochlear implantation a major surgery?

It is considered a minimally invasive surgery where an electronic device can partially restore hearing.

What are the risks involved in cochlear implant surgery?

Cochlear implant surgery is usually safe, but there might be some risks such as inflammation of the brain and spinal cord membranes after the surgery. At times, the device might fail, and surgery might be needed to repair the device. There might be some rare complications, which include bleeding, infection, and dizziness.

How long do cochlear implants last?

The surgically implanted device will last for a lifetime, but there can be chances of equipment failure which needs to be replaced.

Can you normally hear with a cochlear implant?

It allows deaf people to receive and process the sound, but it does not restore normal hearing.

What is the best age to get a cochlear implant?

Children from 10-12 months of age can receive cochlear implants; the earlier, the better.

Does insurance cover cochlear implants?

90% of all commercial health plans cover cochlear implants. Cochlear implant centres usually take the responsibility of obtaining prior approval from the appropriate insurance companies before surgery.

Can the sound processor be removed at night?

Yes, it is recommended to turn it off to save the battery.

Can people with implants swim, shower, and participate in sports?

Yes, people with implants can swim, shower, and participate by removing the external equipment.

Will the child outgrow the internal device and require a new device?

No, the cochlea is fully formed at birth, and the skull structure achieves full growth by 2.

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