Cochlear implants

There are varying degrees of hearing loss. Some individuals use hearing aids or other devices to enhance their hearing, while those with extreme hearing loss may undergo surgery and have a cochlear implant placed inside their head. A cochlear implant is often called a bionic ear and it is used to stimulate the auditory nerves within the cochlea.

The has several different areasthat help it to interpret sounds. The cochlea is one part of the inner ear that is used as the auditory portion of the ear. The largest part of the cochlea is the organ of corti which is the sensory organ of hearing. The cochlea is a spiraled portion of the inner ear that looks similar to a screw. When the cochlea stops functioning properly, the individual is considered “hard of hearing” or they cannot hear at all and are considered profoundly deaf.

Around 20,000 people in the United States have cochlear implants. The cochlear implant is very different from a hearing aid because it does not amplify sound, it instead stimulates the sound nerves within the ear and causes them to hear and interpret the sound. The cochlear implant is an electronic device and has 2 parts. One part is surgically inserted into the head behind the ear and the external portion sits outside the head behind the ear.

A cochlear implant has a microphone, processor, transmitter, and an electrode array. Each part has a different function in stimulating the nerves. The microphone will pick up the sound from the environment and send it to the speech processor which then arranges the sounds. The sounds will then be sent through the transmitter which converts the sounds into electric impulses. The electrode array collects the electric impulses and sends them to the auditory nerve. One common misconception about cochlear implants is that people think it will give them the ability to hear. A cochlear implant will not restore normal hearing to an individual; it simply gives the person a representation of the sound and helps them to understand noises or speech.

An ear that has damage to different areas may have a hard time deciphering the sounds and the cochlear implant may not be able to help at all. Cochlear implants are normally given to individuals that have extreme hearing problems and are unable to find help through hearing aids or other hearing devices. The brain is responsible for interpreting the sounds sent through the cochlear implant and the nerves may be damaged significantly to the point where the cochlear implant cannot stimulate them.

Individuals that have experienced normal hearing have reported that hearing through a cochlear implant is very different. It often takes time for the individual to learn how to hear again. For most people the cochlear implant is a way to help them recognize danger, carry on a conversation, and listen to other sounds. Some smaller noises are unable to be detected by the cochlear implant, making them silent to the individual.

Before a cochlear implant is suggested by a doctor, the patient will undergo a series of tests to determine if the cochlea is damaged and to determine just how much hearing loss they have. Normally a test will consist of a physical exam, an auditory test, and a CT or MRI scan. Doctors will only suggest the use of a cochlear implant to individuals that are severely hard of hearing or are deaf. Elderly individuals that have lost most of their hearing often obtain cochlear implants. These adults are able to have all or most of their hearing restored from the device.

Individuals that have lost their hearing and re-gain it from the cochlear device will be able to associate signals with the sounds they can remember. Since these individuals can recognize the sounds, their brain is able to interpret certain words when they carry on a conversation. Quite often individuals that are hard of hearing or deaf learn sign language or lip reading to help them carry on a normal conversation. The cochlear implant helps the individual recognize the words without any visual contact, which means these individuals, can carry on a conversation over the telephone or other communication device without seeing the other person.

Young children that are born deaf often are good candidates for cochlear devices because they are learning how to interpret sounds and speech. Their language skills and social skills will greatly improve from the use of a cochlear device if the nerves respond to the device. Children as young as 12 months old can undergo cochlear implant surgery.

Since the cochlear device is placed beneath the skin, patients will need to undergo surgery. The surgery normally takes 2-5 hours and the patient generally does not have to stay overnight in the hospital. The surgery consists of cutting a small portion of the skin behind the ear and the implant is inserted into the skin. This portion of the cochlear implant has an RF receiver that is connected to the transmitter with a magnet. The outside portion of the cochlear implant will be responsible for receiving the sounds and sending them to the processor and transmitter. The procedure is safe and has been successfully performed on over 60,000 people in the world. Individuals can adjust the sound level of their cochlear device using the speech processor.

The largest barrier most people face with a cochlear device is the cost of the surgery and the cochlear implant and the therapy required to learn how to use the device. The total cost of a cochlear implant is around $40,000 to $60,000. Before the decision is made to have a cochlear implant, the patient must check with their insurance provider. Some health insurance providers will cover the surgery, but not the cost of the device. Other health insurance providers will pay for everything and the patient only has to pay for their deductible. A special cochlear-implant surgeon will need to implant the device in the head and the specialist may have to be flown in for the surgery. The therapy required on how to use the device is also expensive and time-consuming. Learning how to interpret the sounds is hard for most individuals with a cochlear device and the therapy needs to be cleared with an insurance company before the procedure is done.

There are some risks that come with a cochlear device. Individuals that have the cochlear implant surgery are unable to use hearing aids, as they will provide no benefit to the user. Once the cochlear implant surgery has been performed, the surgery is non-reversible. Individuals that are considering cochlear implant surgery need to think carefully about their decision and discuss it with their loved ones and doctor before they make the decision. Some children have contracted meningitis from their cochlear implants; however the risk of meningitis is minimal. Before a patient can receive a cochlear implant, they must have a series of different vaccinations to prevent diseases.

As mentioned previously, the cochlear implant does not help an individual understand speech and it does not amplify speech or sounds. The cochlear device will vary for each individual and it is up to that person to learn how to use it by going to therapy. Individuals that are post-lingually deaf or have auditory nerve systems can benefit greatly from the cochlear device and are pretty good at understanding speech. Most patients have reported that their hearing is limited to understanding limited topics of information. Speech reading, gestures, and sign language is still used by most patients because it aids them with interpreting what is being said.

People that have received cochlear implants are still considered deaf. Every night the individual must remove the external portion of the cochlear device, leaving the person deaf or extremely hard of hearing. The device is not a cure for deafness; it merely assists the person in hearing and interpreting speech.

The post-operative portion of the surgery is lengthy and frustrating for many people. Since individuals need to re-learn how to hear, it can be difficult for them to change their thinking process when they are interpreting words and sounds. Doctors recommend that patients should continue to receive therapy for their cochlear device for months, even years after the initial surgery. The longer an individual waits to receive the implant, the harder it is for them to understand how the device works. Individuals that receive the cochlear implant surgery need to have a strong commitment to the therapy and should learn sign language as well to help them interpret conversations. Doctors often recommend that patients continue or learn lip reading, as it will aid them with the cochlear device.

Several researchers are looking for ways to make the cochlear device more effective and easier to use. Since people have to re-learn how to hear, several people rule out a cochlear device. While it may not help an individual understand what they are hearing, it will allow them to hear things they may not have been able to hear before. Currently researchers are trying to create a cochlear device that will attach directly to the eighth nerve and make it easier for patients to hear and to interpret what they are hearing.