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Theory of Sensations, Music and the Need for Cochlear Implant

Does your ear buzz or ring? Is there a mild sensation or sometimes a roaring sensation? It all starts with mild hissing which later aggravates to a condition called Tinnitus, characterised by noise or ringing in the ears. Exposure to unpleasant and loud music hampers cochlear signals and interrupts rhythmic brain activities, thereby increasing odds of hearing impairment or deafness.

Pertaining to the fact that tinnitus accounts for 1 in 5 cases. Tinnitus can also occur due to age factor, injury in the ear or a circulatory system disorder. When everything else fails, cochlear implants come into the picture.

What is a cochlear implant?

A cochlear implant is a surgically implanted electronic device that holds potential in partially restoring hearing. It becomes inevitable for people, who are suffering from hearing impairment from inner-ear severe damage and who gain a small amount of benefit from hearing aids, to undergo the surgical cochlear implantation.

Hearing aids amplify sounds whereas a cochlear implant bypasses portions of the ear to stimulate the damaged sound signals to the auditory nerve.

A cochlear implant, which uses a sound processor, is fitted behind the ear. The processor potentially receives sound signals and transmits them to a receiver implanted under the skin behind the ear. And then the signals are sent to the electrodes implanted in the snail-shaped inner ear, known as cochlea. The auditory nerve is stimulated, which is then directed to the brain, and the signals are interpreted as sounds. After one year of exposure, most people with cochlear implants make significant benefits in understanding speech.

Cochlear implant holds potential in improving communication and quality of life for people with a severe hearing impairment who gain little to no benefit from hearing aids. Moreover, bilateral cochlear implants are the standard treatment for profound hearing impairment — chiefly for babies and kids who are learning to speak and interpret language.

Diagnosis

The various types of audiological tests that a patient may undergo are as follows:

  • Auditory brain stemimplant (ABR) or electrocochleography (ECochG).
  • Behavioural testing, which involves visual response audiometry testing.
  • Older children suffering from post-lingual deafness are made to undergo standard pure tone and aided free field tests along with speech discrimination tests.
  • An audiogram.
  • Patients are made to undergo CT or MRI skull imaging to evaluate the condition of the cochlea and structure of the inner ear.

 Who is eligible for a Cochlear Implant?

Both paediatrics and adults are eligible candidates for cochlear implants, but it depends on the hearing impairment. As per American Speech-Language-Hearing Association, general candidacy include:

  • Hearing loss that is profoundly severe and hampers spoken communication
  • Restricted to zero benefits from hearing aids as determined by specialized hearing tests
  • A patient should not have any medical conditions or factors that may up the risks linked with cochlear implants
  • Should be motivated to join rehabilitation sessions
  • Patients should have the know-how of cochlear implants

What are the preoperative assessments? 

The evaluation includes:

  • Assessment of hearing
  • Spoken skills
  • Cochlear morphology
  • Middle ear and mastoid status
  • General developmental issues

What are the procedures available?

The various surgical techniques are as follows:

Implantation

Implantation of the internal components is done under the influence of general anaesthesia. The procedure involves positioning the receiver assembly inside the temporal bone, and then the electrodes are inserted into the cochlea, thereby stimulating the hearing nerve. This surgery takes about one to two hours.

Mapping & Switch On

It takes three to four weeks for the incision to heal. Simultaneously, the programming of the speech processor is performed, and the external parts of the implant will be hooked up. The receiver will begin to hear them.

Auditory Verbal Therapy or Speech Therapy

Children with auditory problems are made to undergo extensive rehabilitation so that their speech, language and hearing skills can be improved. The specialists here stick to a multi-disciplinary approach which encourages passive learning. The implants have shown promise in potentially resolving receptive and expressive language skills.

Best Hospitals and ENT Specialists for Cochlear Implant in India

  • Fortis Escorts Hospital, New Delhi- Dr Sanjeev Chawla
  • Fortis Memorial Research Institute, Gurugram – Dr Atul Kumar Mittal
  • BLK Super Speciality Hospital, New Delhi- Dr WVBS Ramalingam
  • Artemis Hospital, Gurugram- Dr. Anish Gupta
  • Columbia Asia Hospital, Ghaziabad- Dr. Samresh Kashyap

Cochlear Implant Cost in India

Cochlear implant in India is comparatively affordable. The cost of the procedure is USD 2000 to USD 4000 each ear, and the cost of the highest quality implant is USD 6000 to USD 10, 000 each ear.

The cost of a Cochlear implant in India also depends on various other factors.

  • Choice of hospital
  • Preference of the ENT specialist
  • Post-operative care and expenses

 Life after Cochlear Implant

Patients who undergo cochlear implant experienced noteworthy benefits. They could hear TV programs and conversations over the phone. They did not need any visual cues for interpreting sound and could also routinely environmental sounds and noises.

Cochlear implant does not require hospital admittance, the patients can return to their home after the surgery. After a week or so, the patients will have to visit the doctor so that the stitches can be removed. Initially the implantee would feel pressure over the ears and may also experience dizziness or nausea.

The cochlear implants will only be activated after two to six weeks post surgery so that the sight of surgery can be healed.

Activation

For activating the cochlear implant:

  • The sound processor would be adjusted
  • The components of the cochlear implant would be checked
  • Determine the sound waves the implant receiver hears
  • Explain the proper care and device usage

Indian hospitals have earned international trust for performing ground-breaking procedures with utmost meticulousness. Various healthcare platforms in India like Medmonks have revolutionised the healthcare services. Team Medmonks not only provides medical assistance and connects patients to the best hospital but also helps patients get a medical visa.

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