Cochlear Implants

There are 5special senses that a human body possesses which include hearing, taste, vision, touch and smell. Amongst these hearing is the only sense which even if absent since birth or lost due to any reason, can now be reinstated by surgery.

A Cochlear Implant (CI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf. Cochlear implants are often called bionicears.

Cochlear Implants may be considered in patients who present with profound sensorineuralhearing loss. Usually they are advised to undergo hearing aid trial with regular speech therapy. Only in those patients who do not benefit with hearing aids is cochlear implant considered.

Cochlear Implants may be considered in all patients above 12months of age. No upper limit of age. In children with deafness since birth, good results are seen if surgery is done below 5years of age and optimal results are seen if implantation is done within first 10years of age though the age group can vary.

Bilateral profound sensorineural hearing loss can be due to damage to cochlea or inner hair cells in cochlea. Many a times the cochlear nerve is normal. In such patients the cochlear implant is inserted in the cochlea which directly stimulates the cochlear nerve.
Unlike hearing aids which merely amplify the sound, cochlear implants simulates the natural way of hearing.

Newer devices and processing-strategies allow recipients to hear better in noise, enjoy music, and even use their implant processors while swimming. Implants make speech discrimination easier. Patients have better communication skills and educational quality, better professional opportunities like any other normal person.

What is a Cochlear Implant?

First true bionic sense organ  2 primary components:  An internal implant placed just under the skin, behind the ear  An external sound processor

Patient selection criteria in prelingual children

AGE: >12months & <10years, above 10 years the selection criteria depends on amount of
 hearing loss, the hearing stimulation received and the speech development in an individual
Bilateral severe or profound sensorineural hearing loss
Little or no benefit from hearing aids
Post lingual children can be selected as per case to case basis depending on speech development

Patient selection criteria in adults 

Bilateral severe or profound sensorineural hearing loss
Post lingual
Little or no benefit from hearing aids

Benefits of hearing in stereo

Improved speech understanding in noisy environment
Listening is easier (not exhausting)
Sound is more balanced
Safety
Communicate more easily
Better academic and professional opportunities

Post operative considerations

Device activation: Done 2-4 weeks post operative
Neural response telemetry(NRT): Measures the action potential in auditory nerve
Post operative rehabilitation is absolutely critical in getting best results