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Cochlear Implant Surgery: The Artificial Hearing Aid

Cochlear Implant Surgery

What Is Cochlear Implant Surgery?

The surgical procedure in which the cochlear part of the internal year is fitted with implants in order to restore normal hearing is known as cochlear implant surgery. Cochlea is a part of internal ear which is responsible for converting the vibrations of the sound in neural messages, which ultimately are delivered to the brain. When the cochlear part is damaged, it obviously fails to deliver the neural messages to the brain and hence loss of hearing results. This type of hearing loss is often termed as the sensorineural hearing loss. The tympanic membrane (eardrum) and three tiny bones called malleus, incus and stapes together form the middle ear and help in the conduction of sound waves to the brain to enable hearing.

Causes of Cochlear Damage:

  • Loud or extended noise exposure
  • Heavy antibiotic dosage such as that taken in bacterial meningitis
  • Natural decline in age causing wearing of the cochlea
  • Heavy blow to the ear in cases of fights, falls or trauma to the ear
  • Rupturing or hole in the tympanic membrane
  • Fluid accumulation in the tympanic cavity

Signs and Symptoms of Cochlear Damage:

  • Complete or partial loss of hearing
  • Tingling sensation in the ears; tinnitus
  • Improper balance and gait while walking, standing
  • Pain in one or both the ears
  • Dizziness or vertigo
  • Pressure in one or both the ears
  • Nausea, vomiting, sweating

Diagnosis Required Prior To Cochlear Implant Surgery:

  • Pneumatic otoscope: This test is done to examine the ability of the tympanic membrane to take pressure from sounds of different intensities. For this purpose, an instrument known as an otoscope is inserted into the ear and pressure is applied to the tympanic membrane. Various sound pressures at which the tympanic membrane vibrates are noticed. If there is a perforation of the tympanic membrane or accumulation of fluid in it, the tympanic membrane vibrates lesser or its ability to respond to the pressure from the sounds decreases.
  • Tympanometry: This procedure is used to diagnose the defects in the eardrum inclusive of the tympanic membrane and the three tiny bones namely malleus, incus and stapes. This tests makes use of air pressure to test the ability of the internal ear to convert pressure sounds into neural signals that enable hearing.
  • Acoustic reflectrometry: It is used for the detection of internal ear effusion. However this is a surgical type of diagnostic procedure; may require hospital stay for a day.
  • Tympanocentesis: This too is a minor surgical procedure in which the tympanic membrane is ruptured on purpose with the help of a small gauge needle so as to provide a pathway for the insertion of intra canal medications for middle and internal ear infections.

Treatment Procedures for Cochlear Implant Surgery:

  • The patient and family are explained all the procedures needed to be done.
  • The procedure is always performed under general anesthesia. 
  • A facial recess approach or a supramental angle approach is the choice of incision making and for the entry for implant placement. 
  • The external part of the implant is placed near the pinna, behind the ear lobe. It is fitted properly according to the lobe of the ear.
  • The internal part of the ear which is the cochlea is fitted with the internal part of the implant.
  • The cochlear implant consists of two major parts; the external and the internal components.
  • External components include:  Microphone that pick up sounds from the environment , Speech processor, Transmitter
  • Internal components include: Receiver/stimulator , Electrode array
  • Once the implant is placed inside the ear, incisions are sutured and the wound is closed.
  • The patient stays in the hospital until recover; this may take about 3 to 5 days
  • After gaining full consciousness, the patient is given instructions as to how the external part of the implant needs to be adjusted in order to enable hearing. 
  • However this is not done until full recovery of the wound is seen. The wound is covered with the help of a bandage.
  • The patient is instructed to visit the hospital one every week to check for the bandage and get it the dressing changed, if at all needed.

Complications And Risk Factors Associated With Cochlear Implant Surgery:

  • Damage to the nerve bringing taste 
  • Facial muscle weakness or paralysis
  • Dizziness
  • Even if a percent of hearing is normal, that may be lost too
  • Tinnitus which is tingling sensation in the ears
  • Fluid leakage in and around the auditory canal

Am I Good Candidate For Cochlear Implant Surgery?

You can consider yourself as an ideal candidate for the cochlear implant surgery, if you feel any of the following symptoms:

  • You are totally unable to hear from both the ears
  • You get a tingling sensation in and around the ears
  • You feel heavy in the ears
  • You get this strong urge of becoming a normal human being with hearing powers; are not scared of the surgical procedure

If you are a parent of a child who has been unfortunately born with a defective hearing aid, you must consult a pediatrician and an ENT surgeon as soon as possible in order for restoring your child’s ability to hear with the help of cochlear implant surgery. 0 to 3 year of age is the best time to get a cochlear implant placed so as to enable proper hearing since the beginning.

Cochlear Implant Surgery Recovery Time:

Healing takes around three to four weeks time. During this period, no hospital stay is needed. The patient only needs to visit the hospital regularly to get the dressing changed, if at all needed. Once the bandages are removed, the adjustment of the external part of the implant is explained to the patient so that he or she can adjust it accordingly as per the hearing needs.

Cochlear Implant Surgery Success Rate:

Children in the age group of 0 to 5 years benefit the most with the cochlear implants. The success rate is about 80 to 90 percent. Adults in the age group of 20 to 35 show a success rate of 70 percent with the cochlear implants.

Benefits of Cochlear Implant Surgery:

A cochlear implant surgery will help you in the following manner:

  • Enable you to hear properly
  • Enable proper speech articulations
  • Restore your ability to distinguish between various sounds and voices and act accordingly

Cochlear Implant Surgery Cost Comparisons:

The cost for a cochlear implant surgery is around one lakh in India. This amount is one fourth of what you will be required to pay in the United States, United Kingdom or Australia.

Why Choose India for Cochlear Implant Surgery?

India provides with one of the finest ENT specialists and surgeons spread throughout the country. They not only provide you with the best possible cochlear implant restoring your hearing ability, but also make sure the entire procedure fits into your budget without causing you additional stress. 

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