Cochlear Implant Associate With Development Of Speech Perception

What is the Cochlear Implant?

A cochlear implant is an electronic device which passes the sound in the form of electrical signals via the hearing nerve to the brain. Hearing aids are quite successful for hearing loss people but there are some people who suffer from severe to a profound hearing loss for whom hearing aids do not provide enough sound benefit. For these people with severe damage to the sensory cells in the inner ear, a cochlear implant is often the best option for better hearing. The first cochlear implant was invented by Dr William House, in 1961.

Sound can be categorized into two types:

  • Low frequency – providing the foundation and structure of sounds like vowel sounds and the melody of speech – these are important for voice recognition and detecting emotions.
  • High frequency – providing the additional details of sound, helping you identify and differentiate words and improving quality and clarity – these are important for speech understanding, particularly in noisy situations.

Benefits of a cochlear implant

  • Hear better with a cochlear implant compare to hearing aids.
  • With cochlear implant achieve an average of 80% sentence understanding, compared with 10% sentence understanding for hearing aids.
  • Easy focus on the noisy environment.
  • Can easily interact with people across meeting tables, in restaurants and other crowded places.
  • Reconnect with missed sounds that they could not hear before their cochlear implant.
  • Feel safer in the world as they can hear alarms, people calling out and approaching vehicles.
  • Talk and hear on the phone.
  • Enjoy music.

Cochlear implant parts – How it works

The cochlear implant has two main parts: an external (outside) part and an internal (surgically implanted) parts that work together to allow the user to perceive sound.

External component:- The external component of a cochlear implant contains a microphone, a speech processor, and a transmitter. The microphone is a small part that looks like behind the ear. The microphone picks the sound and sends it to the speech processor. A small wire links microphone and speech processor to the transmitter. Speech processor is a computer that analyzes and digitizes the signal before sending it to the transmitter. The transmitter sends the coded signals to an implanted receiver just under the skin.

Internal component:- The internal part of a cochlear implant includes a receiver and electrode. The receiver is located under the skin behind them, and one or more electrode arrays. The receiver takes the signals from the transmitter and delivers them to the array of electrodes. These electrodes directly stimulate the auditory nerve throughout a portion of the cochlea and the brain then interprets these signals as sound.

Cochlear Implant Surgery

Cochlear implant surgery lasts about two to three hours and is performed while the patient is under general anaesthesia. It is done by an implant team otology surgeon, a cochlear implant audiologist, a radiologist, and, as needed, a social worker, a psychologist or psychiatrist, and/or an education specialist, who will give you a series of tests.

The surgeon place the cochlear implant behind the ear. Then, the implanted receiver is attached and the electrode array is carefully inserted into the cochlea. Before completing surgery, the implant is checked to ensure that it is working properly.

What happens after surgery:

 a patient may feel while walking:

  • pressure or discomfort over the implanted ear
  • dizziness
  • sick to the stomach
  • disoriented or confusion
  • a sore throat for a while from the breathing tube used during general anaesthesia

Then, a patient can expect to:

  • keep the bandages on for a while
  • have the bandages be stained with some blood or fluid
  • go home in about a day after surgery
  • have stitches for a while
  • get instructions about caring for the stitches, washing the head, showering, and general care and diet
  • have an appointment in about a week to the stitches removed and have the implant site examined
  • have the implant “turned on” (activated) about 3-6 weeks later

Who is a candidate for a cochlear implant?

A cochlear implant can be used by both children and adult according to their hearing loss. The FDA (US food and drug administration) approves criteria when new devices are brought to market but insurance companies also set criteria of their own. As a result, cochlear implant candidacy is usually determined on a case-by-case basis.

Cochlear implant for children

Profound deafness in childhood affects the development of auditory speech perception, speech production, and skills. A child with hearing loss can affect the development of themselves. A cochlear implant can give these children renewed hope for the future by providing useful hearing with access to environmental sounds and spoken language. Children with hearing loss as young as 1 year old can be eligible for a cochlear implant. Children are considered viable candidates when they:

  • Have profound hearing loss in both ears.
  • Get little or no benefit through the use of hearing aids.
  • Are healthy and any medical conditions would not compromise surgery.
  • Understand along with their parents, their role in the successful use of cochlear implants.
  • Have support from an educational program that will emphasize the development of auditory skills.

Cochlear implant for Adults

A cochlear implant provides access to sound for people with severe or profound hearing loss, who can no longer hear with hearing aids. Adults who face hearing problem after their development typically have greater success with cochlear implants than those who had not developed language before losing their hearing. Adult candidates are generally eligible for an implant if they:

  • Have severe or profound hearing loss in both ears.
  • Get little or no benefit from hearing aids.
  • Have no medical problems that could put them at risk during surgery.
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading.

Cochlear implant cost

A Cochlear implant cost depends on the variety of factors, including the duration and extent of a patient’s hearing loss prior to surgery. The average cost for the entire procedure, including the post-operative aural rehabilitation process, exceeds $40,000. However, cochlear implantation consistently ranks among the most cost-effective medical procedures ever reported, according to research completed by the Johns Hopkins University and the University of California-San Diego. These studies indicate that cochlear implantation can result in a net savings of more than $53,000 per child versus the more than $1 million average expected lifetime cost of a child who has profound hearing loss prior to language development. Following are the cost comparison in a different country:

Country India US Turkey UAE
Cochlear implant surgery cost ($) $4000 $80000 $37000 $9600

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