Cochlear Implant Surgery

What is Cochlear Implant Surgery?

Cochlear implant surgery is considered for individuals with severe hearing loss, and hearing aids do not benefit these individuals. 

The cochlear in the inner ear (spiral-shaped bone) is replaced by an electronic device, which partially restores the hearing function. The electronic device partially replaces the cochlear. 

A cochlear implant surgery bypasses the damaged portion of the inner ear to carry sound signals to the auditory (hearing) nerve and to the brain for the signal to be interpreted and the sound to be heard. 

This is different from a hearing aid, where the sound is merely amplified for the individual using it. 

Cochlear implant surgery is not favorable for every individual bearing a severe hearing loss and there could be possible complications. It, therefore, is recommended with thorough evaluation and deliberation. 

Even post-surgery the patient has to undergo extensive therapy and training to be acclimatized to the implant. 

How Cochlear Implant device is inserted?

A cochlear implant is a small medical electronic device. It finds its application in moderate to severe hearing loss cases. It can be used for any age group including babies. 

The device has an external and internal component. 

The external component is positioned behind the ear pinna. It comprises a microphone and transmitter. The microphone receives the sound waves; a speech processor analyzes these and converts them into digital signals which are sent to the transmitter. 

The internal receiver is held together with an external transmitter with help of a magnet. The internal receiver is positioned under the skin behind the ear. 

The receiver converts the digital signal received from the transmitter to electrical impulses. These are transmitted to the electrodes implanted in the cochlea, which now stimulates the cochlear nerve. This results in the sense of hearing. 

Although the brain can recognize them as sounds, it needs therapy and training to interpret these sounds for the near-normal experience of hearing. 

When are cochlear implants considered?

Cochlear implants although suitable for any age group, are not recommended for everyone with hearing loss. They are proposed when:

  • There is severe hearing loss in both the ears

  • There has been no significant improvement with hearing aids

  • The individual is healthy with no other conditions posing a risk to the implant surgery.

  • An Ear – Nose – Throat Surgeon typically identifies a cochlear implant as a course of action to reinstate the severe hearing loss.

What is the Pre-surgery care to be taken?

  • Regularly changing the batteries of the external component.

  • Removing the external component when going for a swim.

  • Limiting extensive involvement in sports-related activities.

  • Committing to rehabilitation for optimal acclimatization.

What exactly does a patient undergo in the surgery?

The operating surgeon generally entails the entire procedure in a simplified format for the patient to understand how exactly the hearing will be facilitated by this surgery.

  • The patient is operated on under general anesthesia, i.e. the patient is asleep during the entire procedure.

  • The surgeon makes a small incision behind the ear and makes a small depression in the mastoid bone.

  • The surgeon then makes a small hole in the cochlea and introduces electrodes through the hole.

  • A receiver is inserted behind the ear under the skin and secured to the skull, and then the incision is stitched.

  • The patient is then shifted to the recovery room to gain consciousness and to be monitored to ensure the surgery has no side effects.

  • The patient may be discharged the same day or the next day after the surgery, with instruction to care for the area that has undergone surgery.

What is the post surgery procedure ?

The doctor generally schedules a follow-up after the surgery after a week to monitor the surgery wound and its recovery. 

The activation of the implant usually is done after the surgical wound has healed completely. The external device is added then. 

The months following the surgery involve multiple visits to the doctor to make adjustments to the device.

Audiologic rehabilitation is needed as a therapy to understand how to interpret sound signals, which help develop hearing and speech. A speech-language pathologist or an audiologist facilitates the rehabilitation.

While computing the cost of a cochlear implant surgery one must also take into account the replacement or repair of parts that may be required over the years of its use. 

Having it covered under insurance can be considered with a thorough understanding of what all expenses are covered under the insurance and if it will need any out-of-pocket expenses. 

What are the risks associated with cochlear implant surgery?

  • Ringing in the ear

  • Dizziness

  • Balance related issues

  • Swelling

  • Bleeding

  • Infection at the site of surgery

  • Dry mouth

  • Change in taste

  • Facial paralysis

  • Meningitis

  • To undergo surgery to replace a defective internal component

What are the pros and cons of cochlear implant surgery?

  • Listen to and comprehend speech without significant lip reading.

  • Hear sounds such as footsteps.

  • Be able to hear voices on the phone.

  • Listen to music or watch television.

  • For babies, it normalizes the speech development process to great extent.

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