People who suffer from hearing impairment or complete hearing loss may have, on various occasions, come across the term cochlear implants. They are however not as popular as hearing aids and hence many of us are unaware of what a cochlear implant can do for us and how it can be extremely beneficial to patients suffering from hearing loss. Over the years, cochlear implant surgery has gained some stardom and being a very safe procedure, it is now being recommended to a majority of patients who suffer from hearing loss.
What is a cochlear implant?
A cochlear implant is a small electronic device that has two components – an external component containing a microphone which is placed outside the ear and an internal component which consists of a wire and electrodes that are implanted into the cochlea. The microphone picks up sound signals and transmits it into a synthesiser placed inside the internal component. The sound signals are then converted into electric impulses and are transmitted to the electrodes. The electrodes in turn stimulate the cochlear nerve which sends signals to the brain.
Who needs a cochlear implant surgery?
Deafness is a condition in which people are unable to hear properly or at all. Deafness can either be partial or complete and can occur at any age, due to a variety of reasons. No matter the reason and time of occurrence, deafness can play a major role in crippling the quality of life of the affected person. Physical dangers such as failing to hear warning sounds and cars honking, emotional trauma leading to withdrawal from society and preferring an introverted life are some of the negative impacts’ deafness can have on the affected person’s life.
In the case of children, deafness can cause an obstruction in personality development. They fail to recognise sounds, which in turn affects their speech. There will be a certain amount of disability involved in learning as well, which affects the overall personality.
There is no definitive cure for deafness, however there are various methods through which one can improve their hearing ability. Hearing aids being one of them. Nevertheless, hearing aids are of little use to a person whose deafness is caused by a damaged cochlea. This is where cochlear implants come in.
A cochlear implant is a device that stimulates the cochlea to improve the hearing ability. Cochlear implants are recommended to those who do not gain any improvement in hearing after using hearing aids. While hearing aids try to improve the hearing ability by amplifying the volume of sounds, cochlear implants work by stimulating the cochlea. A cochlear implant avoids the damaged part of the ear and transmits the sounds directly to the auditory nerve, which is then delivered to the brain. So, as long as there is some connection between the auditory nerve and the brain, the cochlea implant will be able to help the patient – even in cases where the patient suffers from severe to profound hearing loss.
To be eligible for a cochlear implant, the following criteria needs to be fulfilled:
- Patient suffers from severe to profound hearing loss and this interrupts their communication
- Hearing aids did not improve their ability to hear
- Patient does not suffer from any underlying health issues or medical conditions which can increase the risks associated with cochlear implant surgery
- Patient clearly understands what the cochlear implant can and cannot do for them.
Cochlear Implant Surgery – The Process
A cochlear implant surgery is a minor surgery and within days of the surgery, the patient can resume their normal, every-day activities. Cochlear implant surgery is an outpatient surgery, which takes about two hours to be completed. Before a patient can undergo a cochlear implant surgery, their doctor and audiologist will conduct various tests to confirm that the patient is eligible for a cochlear implant. These tests usually include X-rays/MRI scans, thorough medical examination and audiologic testing.
Once this step is completed, the next is to select the cochlear implant. There are various types of cochlear implants that are suitable for various patients. The type of cochlear implant that is best suitable is decided by the doctor after a careful evaluation of the patient’s condition.
- The surgeon creates a small incision right in front of the mastoid bone, which can be found behind the ear.
- The cochlea is then accessed via this incision.
- Next, a small cut is made in the cochlea and via this cut, the implant is placed inside.
- The cochlea is then sutured and the incision behind the ear is also closed
- The cochlear implant does not get activated immediately
- The wound needs to heal before the activation and this usually takes 3-6 weeks
- During this healing period, a patient can go about their regular life, taking care they don’t indulge in any activities which can lead to an infection of the wound
- Once the wound has healed, the external component for the cochlear implant is placed and connected to the internal component
- Before activation, an audiologist will adjust the sound level and ensure the components are working fine
- Once the equipment has been checked, it is then activated
Patients who’ve decided to ahead with a cochlear implant will need to undergo few sessions of counselling and speech therapy. This helps them adapt to the implants and enables them to decipher the sounds produced by the implants correctly.
Cochlear Implant Surgery – Pros and Cons
Cochlear implants provide the best results when placed at an earlier age. Babies with congenital or acquired deafness can benefit a great deal from the earlier placement of the device. As their age progresses, the ability of a person to adapt to the implant also decreases correspondingly.
The benefits of cochlear implants are manifold in comparison with hearing aids.
Some of the major benefits are:
- For most cases, the patient’s hearing improves to a considerable extent
- The user can hear and distinguish between sounds, such as doorbells, footsteps, telephone bells and doors closing
- Users can understand speech better so their dependence on lip-reading decreases
- Users can watch TV and enjoy music
- Users can easily talk on the phone
- In children, the use of cochlear implant can help them follow their lessons in school
- This definitely helps increase the self-confidence of the users
The disadvantages of a cochlear implant are far fewer than the advantages, but there are undoubtedly, certain risks involved with a cochlear implant surgery. They are:
- In very rare cases, the first cochlear surgery may fail to correct the issue and secondary surgeries may be required
- If the wound is not taken care of properly, it may get infected
- A cochlear implant is more expensive than a hearing aid, hence additional care should be taken
- Cochlear implants do not guarantee improved hearing
- Can cause interferences with other electronic devices
- Those wearing cochlear implants cannot undergo certain medical tests like MRI, Piezo -electric surgeries, radiation therapy etc.
- There are various risks associated with cochlear implant surgery itself, such as bleeding, possible infection, contraction of meningitis etc.
- The placement of the implants may result in complete loss of any natural hearing ability.
It is always advisable to get an annual check-up done to ensure the device is working perfectly, or even to re-program the device, if needed.
Questions to ask your doctor before getting the implants
Before the decision is made to get a cochlear implant fitted onto a patient, doctors and audiologists conduct various tests, to make sure that the cochlear implant is the best option available to the patient. Similarly, a patient should also ask their doctors certain questions, leading up to the surgery.
- What are the risks/complications associated with the surgery?
- Is the surgery painful?
- What results can you expect from the surgery?
- What happens if you require a medical procedure such as an MRI scan?
- What instructions should you follow before coming in for the surgery?
- Will you require more surgery as new technology becomes available?
- Can cochlear users swim, shower and take part in sports?
Cochlear Implant Surgery in India
Cochlear implant treatment in India is extremely advanced and is considered to be among the best in the world. There are various hospitals in India offering cochlear implant treatment at a fraction of the cost as compared to countries such as the USA, the UK and Australia. Paediatric cochlear implant surgery in India also offers a very high rate of success.
The approximate costs of cochlear implants in India will be in the range of 15,000 to 24,000 USD. These prices vary due to various factors such as the hospital selected, the duration of stay in the hospital – if travelling from abroad, then the airfare and hotel stay costs will also be added. Some of the best hospitals offering cochlear implant surgery in India are: Kokilaben Ambani Hospital, BLK Hospital and Columbia Asia.
According to WHO, over 466 million people live with hearing disability and 34 million of these are children. Unless appropriate measures are taken, this number is all set to rise in the near future. Which is why it is very important to educate people and raise awareness about cochlear implant, especially among parents whose children suffer from hearing loss. Early detection and involvement can help lessen the negative impact deafness can have on a child’s life.