Cochlear Implants

What is a Cochlear Implant?

A cochlear implant is a small electronic medical device surgically implanted beneath the skin behind the ear. It provides a sense of hearing for individuals with severe hearing impairments. Since their introduction in the 1980s, cochlear implants have helped over 500,000 patients regain their ability to hear.

Who can benefit from Cochlear Implants?

Cochlear implants are recommended for children or adults with severe to profound sensorineural hearing loss who do not receive adequate benefits from traditional hearing aids. This implantation surgery involves placing a small device under the skin behind the ear, enabling individuals to hear a wide range of sounds.

Can young children with hearing loss undergo implantation?

Infants born with hearing loss experience delays in hearing, speech, and language development. The extent of delay is proportional to the severity of hearing loss. Even with powerful hearing aids, children with severe to profound hearing loss often struggle with listening, speech, and language skills. Cochlear implant surgery, ideally performed between 6-12 months of age, allows these children to learn to hear and speak like their hearing peers. They have gone on to complete their education and live fulfilling lives.

What is the optimal age for Cochlear Implants in children?

The brain’s establishment and development of hearing, speech, and language centers occur after birth as the child listens to sounds in their environment. If a child cannot hear, this development is hindered. It’s crucial to diagnose hearing loss early and initiate appropriate intervention as soon as possible because the brain loses its ability to learn to “hear” around 5-7 years of age. The ideal time for hearing aid fitting is as early as 3 months of age, while cochlear implant surgery is recommended between 6-12 months of age. Children implanted before 12 months tend to achieve hearing and speech skills comparable to their hearing peers.

What tests are necessary before surgery?

Before considering implantation, hearing and imaging tests are essential. These tests determine the type, site, and severity of hearing loss. Hearing tests, such as unaided audiometry, aided audiometry, BERA, ASSR, impedance audiometry, and OAE screening, provide valuable information. Imaging tests, including high-resolution CT scans of the ear bones and MRI of the inner ear, reveal the structural anatomy of the inner ear, auditory nerve, and brain. Abnormal inner ear anatomy or a thin hearing nerve may influence implant and electrode choices, as well as the expected outcome.

The Cochlear Implant Team Dr. Sharma leads an experienced cochlear implant team, consisting of surgeons, pediatric anesthetists, radiologists, audiologists, and speech therapists. The team conducts comprehensive evaluations and addresses all patient and parent queries. Additional specialists, such as developmental specialists, child psychologists, pediatric neurologists, and genetic specialists, may also be involved in the evaluation process.

The Cochlear Implantation Process After deciding to proceed with implantation, routine blood and urine tests are performed before surgery. Admission typically occurs on the day of the procedure, with discharge within 1-2 days. During surgery, the implant is inserted, and computer-aided telemetry is conducted to confirm device functionality and record brain responses. This data helps set the parameters (MAP) of the processor for the “Switch-On” stage.

The “Switch-On” The “Switch-On” marks the day when the child or adult wears the processor behind the ear and begins hearing sounds for the first time after surgery. This usually occurs 8-10 days after the procedure and is a joyous occasion for parents and doctors alike. It signifies the start of the journey towards hearing and speech development.

Post-Implantation Care and Rehabilitation

After cochlear implantation and switch-on, regular mapping sessions with the audiologist are necessary. The audiologist determines the minimum current level at which sounds are just heard and the maximum level at which sounds become uncomfortable for each electrode. The processor is then programmed accordingly.

In the initial months after surgery, frequent mapping sessions are required as healing occurs and current levels for stimulation change. Subsequently, mapping sessions may be scheduled every 6 months or longer, with the option for remote sessions via software platforms like Skype or Zoom. These remote sessions allow the audiologist to observe the child’s responses and make necessary adjustments to the device settings while the patient remains at home.

Auditory Verbal Therapy (AVT) sessions are crucial for children to maximize the benefits of the implant. AVT helps children learn to listen to sounds, understand them, and develop speech and language skills. Regular sessions with an AVT therapist are essential, with the possibility of conducting sessions through Skype for patients residing far from the center.

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