Cochlear implant

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Cochlear Implantation

Deafness in paediatric age can adversely impact language acquisition as well as educational and social-emotional development. Once diagnosed, hearing loss should be rehabilitated early; the goal is to provide the child with maximum access to the acoustic features of speech within a listening range that is safe and comfortable. In presence of severe to profound deafness, benefit from auditory amplification cannot be enough to allow a proper language development. Cochlear implants are partially implantable electronic devices designed to provide profoundly deafened patients with hearing sensitivity within the speech range.

it has been recognized that implantation at a very early age (12–18 months) provides children with the best outcomes, taking advantage of sensitive periods of auditory development. Bilateral implantation offers a better sound localization, as well as a superior ability to understand speech in noisy environments than unilateral cochlear implant.

Benefits from cochlear implantation include not only better abilities to hear and to develop speech and language skills, but also improved academic attainment, improved quality of life, and better employment status.

When the hearing loss is severe to a profound degree and the patients (children / adults) are not getting benefit with hearing aid fitting, Cochlear implantation will help them to develop good listening capability and speech and language development. 

A cochlear implant or bionic ear is a device that is surgically implanted in the cochlea.  The implant bypasses the inner hair cells and stimulates the 8th nerve endings electrically. Due to the invasive nature of the implant, the considerable variability of performance of recipients and the high cost of the device, selection criteria for the cochlear implant are designed to identify or predict those that would benefit to have favourable outcomes. Over the years, improvements in implant technology, surgical techniques and re/habilitation methods coupled with a greater understanding of hearing loss and related issues have led to an increase in recommendation of bilateral implantation and inclusion of those with multiple handicaps for implantation. 

Appropriate selection is half the battle won, and thus all candidates must be carefully selected.  A child or adult with hearing loss has other conditions related to structure and function- example Cochlear anomalies, facial paresis, visual impairments, sensory integration issues, autism, and related issues such as poor family support that impact outcomes. Hence all assessments are done by a team of professionals

 Audiological assessment forms the basis to determine candidacy. The aim is to obtain a profile of peripheral and central abilities.  Behavioural, physiological and electrophysiological tests are carried out to do the same. This information along with radiological evaluation helps to select the ear to be implanted (in case of unilateral implantation).  

Cochlear Implant Near Me

All children should undergo Complete Ear, Nose and Throat examination to identify any debris or wax in the external ear and middle ear infection. If present Ears have to be cleaned and middle ear infections to be treated before submitting the child for further audiological evaluations. Medical assessment by the Paediatrician or Physician is typically carried out for other disorders based on signs and symptoms.

The following evaluations have to be done before taking a decision for implantation.

1. Behavioural observation audiometry / Pure tone audiometry to assess the degree of hearing loss
2. Impedance audiometry to assess the middle ear condition
3. Oto-acoustic emission studies (OAE) to assess the inner ear function
4. Brain stem evoked response audiometry to assess the cochlear nerve function
5. High resolution computerized tomography (HRCT)of the temporal bones to assess the condition of the middle ear structures and the inner ear (Cochlea)
6. Magnetic resonance imaging (MRI) of Brain, Cochlea and internal auditory canal to assess the Cochlea and Cochlear nerve
7. Hearing aid trial and fitting
8. Auditory training (Listening training) & Speech therapy
9. Unaided & Aided audiometry to assess the benefit of training with hearing aids
10. Speech & Language evaluation 

With all the above mentioned evaluations if we find that the patient has severe to profound degree of sensorineural hearing loss and is not getting sufficient benefit with hearing aids and there is delay in development of speech, then a decision to do Cochlear implantation is made. The radiological evaluations will guide us in selecting the type of Cochlear implant

Pre-Implant Counselling

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