Cochlear Implants

Last updated date: 19-Aug-2023

Originally Written in English

Cochlear Implants

Cochlear implants refer to an electrical device that restores hearing to some extent. It may be a viable alternative for those who have significant hearing loss due to inner-ear damage and have exhausted all other options, including hearing aids. 

The cochlear implants convert sound into electrical impulses, which the brain interprets. Its purpose is to take over the function of the cochlea. Nevertheless, the device is not for everyone, and there are some risks involved. Using a cochlear implant successfully also necessitates intensive therapy and training. 

 

How do the Cochlear Implants Work?

A cochlear implant is a small electronic medical device that assists people with hearing loss, ranging from mild to severe. It is useful for adults, children, and newborns with hearing loss or problems. 

The cochlear device works by stimulating the cochlear nerve electrically. It is made up of both external and internal components. Normally, the external piece is put at the back of the ear and comprises a microphone that picks up sound waves. The speech processor evaluates sounds and converts them into digital signals. 

These signals are then transmitted to a transmitter, which passes them on to the internal receiver. A magnet holds the transmitter and receiver together.

The internal part of the cochlear implants device is inserted underneath the skin. The receiver receives the digital signal and converts them into electrical impulses. The impulses are then transmitted to the electrodes in the cochlear devices to stimulate the cochlear nerve. They are forwarded to the brain by the nerve, and as a result, a sense of hearing develops. 

Even though the brain detects sounds and noises, they are not the same as regular hearing. To learn how to appropriately interpret such sounds, rehabilitation, as well as speech therapy, is essential.

 

Who Needs the Cochlear Implants?

Who Needs the Cochlear Implants?

Not every person is a good candidate for a cochlear implant. However, babies, children, and adults who have the following characteristics may be ideal candidates; 

  • Both ears have considerable hearing loss
  • Hearing aids have not been found to provide any benefits
  • There are no medical problems that could make surgery more dangerous.

If you are an adult, you might be a good fit if;

  • You have a hearing loss that makes it difficult to communicate verbally
  • Later in life, you lose all or most of the hearing
  • Even with hearing aids, you still rely on lip reading
  • You are willing to make a commitment to rehabilitation
  • You know the cochlear implants pros and cons or what they can and can't do

Your ENT (ear, nose, and throat) surgeon and audiologist will determine if the cochlear device is suitable for you. You should also note that both cochlear implants and hearing aids are a medical device that helps with hearing loss. 

However, as compared to the cochlear implant, it does not use electrodes to transfer sound signals. Instead, the hearing aids make sounds much louder by using an amplifier, microphone, and speaker. This can assist you in hearing things more clearly. 

Hearing aids are not implanted surgically, either. They can be worn behind or inside the ear. If you have mild to moderate hearing loss, then hearing aids are generally the best option. 

 

How to Prepare for Cochlear Implants Procedure 

Cochlear implant operation is usually done under general anesthesia. This implies that during the procedure, you or the child will remain unconscious. Therefore, you or the child may be required to do the following; 

  • Refrain from taking specific drugs and supplements for a set period
  • Refrain from consuming food or drinking anything for a particular time

The ENT specialist will provide you with detailed advice to assist you during the preparation.

 

What does Cochlear Implants Procedure Involve?

You will first undergo a comprehensive medical analysis on the scheduled day or a day before the cochlear implants procedure. This is to evaluate whether cochlear implants are the best alternative for you. The evaluation might include the following; 

  • Conducting speech, hearing, and at times a balance tests
  • Performing a physical check to determine the health of the inner ear
  • Ordering a skull MRI or a CT scan to check the status of the cochlea and inside of the ear structures
  • In some situations, the physician can order psychological tests to determine your capacity to learn how to use cochlear implants. 

During the cochlear implants procedure, the ENT surgeon will start by creating incisions at the back of the ear and open the mastoid bone. After that, he or she will locate the facial nerves and make the gap between them in order to gain access to the cochlea, which is subsequently opened. The implant electrodes are then inserted into the cochlea. 

The surgeon will then insert an electrical device known as the receiver to the skull in this area by placing it beneath the skin at the back of the ear. The wounds are then sealed, and you'll be transferred to a recovery room where you'll be closely monitored. After about two hours of monitoring, you will be released.

 

What Happens After Cochlear Implants Procedure?

The physician will give you guidelines on how to take care of the surgical incisions before you leave the hospital. You'll learn ways of changing the dressings and look after your sutures as well. 

After one or two days, you can clean your ear as usual. For further inspection of the incisions and removal of the stitches, a follow-up visit is scheduled for around a week after or at activation. Make sure that you notify your ENT specialist if you experience severe pain, discharge, or a fever after the procedure. 

After the initial operation, you will get time to recover before the cochlear implant is turned on or activated. The exterior portions of the cochlear implant will be added about four to six weeks following surgery. A microphone and a speech processor are also included. The speech processor is programmed and turned on at that point. This makes the inside device trigger the cochlear nerve in reaction to sound.  

You'll also learn the fundamentals of how to use and care for cochlear implants. For modifications, you may have to return for numerous visits to the hospital over a number of days. Over the next few months, there will be more fine-tuning. It takes time to get used to using a cochlear implant. It'll almost certainly necessitate consultations with speech-language audiologists and pathologists. Generally, cochlear implants can improve your quality of life if you put in the effort. 

 

Cochlear Implants Results 

Cochlear Implants Results

The outcomes of the cochlear implants procedure differ from one person to another. Various factors can influence the results of the implantation. These can involve the age at which hearing loss occurred and the period between hearing loss and the cochlear implant surgery. When it comes to young children, obtaining a cochlear implant at a tender age usually yields the best results. 

Adults who have had a short period of intense hearing loss prior to the cochlear implantation procedure have had the best results. Also, adults who have had little to no contact to sound are less likely to benefit from cochlear implants. 

The following are some possible results; 

  • Clear hearing: Most individuals who meet the hearing requirements for the cochlear implantation procedure may benefit from the device in the long run.
  • Enhanced tinnitus: Whereas tinnitus (ear noise) is not the main reason for getting a cochlear implant, it can help to suppress or enhance the severity of tinnitus while it's being used. Tinnitus severity is rarely worsened by it.

 

Risks and Complication of Cochlear Implants 

Cochlear implants surgery is typically considered to be risk-free. The following are some of the possible side effects and risks of cochlear implants

  • Residual hearing loss: For some patients, implanting the cochlear device can result in the loss of the remaining, natural, and unclear hearing in the implanted ear. 
  • After cochlear implants surgery, inflammation of the membranes around the brain and spinal cord (meningitis) occur. Adults and minors typically receive vaccines to minimize the chances of meningitis prior to implantation.
  • Failure of the cochlear device: A defective internal device may necessitate surgery to fix or replace.

Complications are uncommon, although they can sometimes occur. These complications can include; 

  • Bleeding
  • Paralysis of the face
  • An infection that develops at the surgical site.
  • Infection of a device
  • Problems with balancing 
  • Dizziness
  • Disturbance of taste
  • Ear noise that is new or has worsened (tinnitus)
  • Leakage of spinal fluid

 

Conclusion 

You may be a suitable candidate for cochlear implants if hearing aids fail to enhance your hearing and speech. The cochlear device is surgically implanted in the cochlea. This turns sounds into electrical signals, which the brain interprets. 

The specialist will order hearing examination and imaging tests to assess if it's suitable for you, including your degree of hearing loss. It's also critical to commit to audiology therapy after surgery. This is generally vital for changing your viewpoint and proper use of cochlear implants.