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Cochlear Implant



Cochlear Implant

The Cochlear Implant is a miniature device which enables patients with profound degree hearing loss to perceive the sounds. Device includes an array of electrodes implanted within the cochlea or the inner ear. The electrodes generate electrical activity which is used to directly stimulate the auditory nerves. The auditory nerve then passes this information along to the hearing center of the brain. This is labelled as the internal part of the device.

The Cochlear Implant is recommended for the children with profound hearing loss in both ears and who have shown little prior success with hearing aids. Cochlear Implantation can be a very effective alternative in this situation.

Hearing loss is caused by a number of different problems that occur either in hearing nerve or parts of the middle or inner ear. The most common type of deafness is caused by damaged hair cells in the cochlea. When hair cells stop functioning, the hearing nerve remain unstimulated and the person cannot hear. Hair cells may be destroyed by the number of reasons e.g. infection, trauma, loud noise, aging and birth defects.

How a Cochlear Implant Works

  • Sound waves are picked up by a small microphone.

  • Signal sent to speech processor.
  • Speech processor codes the signal.
  • Coded signal sent to coil.
  • Signal sent through intact skin to implant.
  • Implant decodes the signal.
  • Electrodes stimulate the auditory nerve.
  • Nerve impulses sent to the brain.

Digisonics (SP) of Neurelec is ceramic/titanium case which is bio compatible and strongly resistant. No breakage failure has been recorded for more than 10 year. The case is hermatically sealed using lazer technology and no failure of leakage has been recorded. Digisonics (SP) has a thin and convex profile to facilitate the minimal invasive surgery to secure placement specially for peadiatric implantation. An innovative fixation system has been integrated in the latest generation for atraumatic surgery, very small incision and no bleeding.

Some further unique features of Nurelec cochlear implantation system are as follows:

  • It does not require the implant bed drilling on the mastoid bone thus saving cochlear implantation time, energy and complexity hence surgery becomes very easy & risk free.
  • 20 channels
  • MRI compatible.
  • The Digi SP is the only behind the ear processor available in the market that is equipped with a directional dual microphone system.
  • Digi SP implant is the only system available in the market that allows a totally objective adjustment for the yound children using electro-psychological measurements.
  • The Digi SPK uses only two standard batteries which last an average of 8 days thus the low cost and lack of dependence on a power supply are undisputable advantages.
  • The Digi SPK is the lightest processor available in the market.
    Due to the best quality design of Digisonic, not a single case of meningitis has ever been reported.

Surgical Procedure

The surgical procedure can be performed on an outpatient basis for adults and adolescent patients. In children, it is often performed with a one night stay in the hospital. The internal parts of the implant are placed under the skin behind the patient’s ear. After sterilization of the skin the surgeon makes an incision behind the ear and opens mastoid bone (the ridge on the skull behind the hear) leading to the middle ear. The Surgeon then goes through the opening in the mestoid bone to create a new opening in the cochlea for the implant electrodes. The electrode is then very slowly and carefully threaded through this new opening. Care is taken during the procedure. Neurelac Digisonic (SP) has the additional advantage of minimal bleeding and very safe surgery. Once in place, the device is tested to be certain of its working. If all is well, the Surgeon then closes the incision. The entire operation takes around less than an hour with Neurelec device.

After Care

For a short period of time after the surgery ,a special bandage is worn on the head during sleep. After about one month, the surgical wounds are healed and the patient returns to the implant center to be fitted with the external parts of the device and to have the device turned on and mapped. Mapping involves the fine tuning of the speech processor and setting the levels of stimulations for each electrode from soft to loud.

The patient is then trained how to interpret the sounds, heard through the device. The length of training e.g speech education varies from days to years, depending upon how well the person can interpret the sound.

The Benefits of Cochlear Implant

  1. Hearing every day sounds
  2. Virtually all users benefit by being able to hear more environmental sounds. This helps people to keep in touch with their environment. It is an also important safety consideration and it enables people to hear traffic, sirens alarms and so on. But it is essential that realistic expectation of the likely benefit are held by the patient and family. What to expect and what not to expect should be discussed thoroughly with the implant team.

Hearing and understanding speech

All users will hear speech sounds through the cochlear implant. It usually takes some time before they begin to understand speech sounds through cochlear implant. Being able to hear speech can be of great help to those who lip read and it makes every day communications much easier. 

Listening in Background Noise

When there is a background noise it is difficult for all of us to hear speech but more difficult for the people using hearing aids and the cochlear implant. The Digisonic (SP)
Cochlear implant has a unique feature of directional microphone and fast stimulation rate and advanced speech processing strategy provides amazing speech understanding in background noise.

Using the Phone Can Become a Reality

The users of cochlear implant are very comfortable on talking on telephone

The Limitation of Cochlear Implant

There is no test yet available which actually predicts how much benefit any patient will receive with cochlear implant as it depends on multiple factors.

Risk of Device Failure

As with any technical device there is a small risk that implant will break down, this rarely accurs but if it happens, re implantation with a new implant is very successful.

Every Day Considerations and Precautions
The cochlear implant system is easy to use but certain precautions should be taken

Avoid the sports which could cause a severe blow to the head. But sports such as boxing however is not advised.
Sources of radio frequencies (mobile phones etc.) can cause some temporary interference with the sound through the implant for some users.
Cochlear Implant users can continue to participate in most everyday activities. 

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