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A cochlear implant consists of an external voice processor that is worn behind the ear like a hearing aid and the implant itself, which is surgically inserted into the abalone. The microphone, cable and coil voice processor converts sound vibrations into electrical signals. From these it encodes pulse patterns that are sent to the implant by radio waves or induction. The recipient of the implant decodes the signals and forwards them via an electrode into the cochlea. There, the electrical impulses stimulate the auditory nerve. It passes the signals to the brain, which processes the information like a natural acoustic event.
An intact auditory nerve and an intact central auditory pathway are the basic prerequisites for a cochlear implant. If the auditory nerve is destroyed, a so-called auditory brainstem implant may instead partially restore the hearing.
Unlike children, adults who have already been born deaf usually do not use cochlear implants. Your brain has never learned to recognize and interpret acoustic stimuli. Since it is already mature, it is unlikely that it can still provide the appropriate skills for a sound-language understanding.
The operation is always under general anesthesia. In a first step, the surgeon opens the skin behind the ear to rake out a depression in the now exposed skull bone. Here, too, the external speech processor is attached later. From there, he drills a canal to the middle ear, from where he creates an opening in the inner ear through another hole. Through this access he pushes the electrode into the cochlea. He anchors the actual implant in a separate bone bed behind the ear. During the operation, the cochlear implant is tested and the function of the auditory nerve is checked.
Cochlear implants open up many possibilities for those affected: they can communicate with their fellow human beings more easily and thus have (again) a greater share of the social encounters. The quality of life increases significantly after care with a cochlear implant. However, disadvantages and limitations should always be considered before surgery.
If a person goes through the process of hearing loss, and wants to compensate it, there is some special kind of hearing aid. Cochlear ear implants is the technology of the future that may solve the problem forever. What is it, and where a patient may go through this procedure?
Cochlear implants have been developed to imitate the function of a healthy inner ear (cochlea). They replace the function of the damaged hair cells within the cochlea so that you can hear more clearly.
Cochlear implants can provide access to sounds that you have never been able to hear before.
The Cochlear™ Nucleus® system consists of the following two main components:
- the external sound processor
- the implant inserted under the skin in a surgical procedure, to which an electrode holder is attached, which is inserted into the cochlea
What is Cochlear Implant?
This is a hearing implant that performs the functions of damaged parts of the inner ear. It may supply sense of hearing in case of serious hearing loss, but it does not restore it actually. An implant has two parts: internal and external. It is placed under the skin behind the ear, and its electrodes are put in cochlea or inner ear. The external part looks like hearing aid and sends received signals to electrodes.
When the microphone catches sound, it is converted into electrical signals and then are being transmitted by inner part of the device. Electrode stimulates hearing nerve and sends signals directly to where brain perceived and interprets them.
Cochlear implant and hearing aid are different things. While hearing aids makes sound louder (which won’t be a good idea for a child), implant bypasses distorted parts of the ear, e.g. hair cells, and sends signals right to the hearing nerve. Thus, it is a better option for patients who can’t use usual hearing aid for this or that reason.
How does the cochlear implant work?
Cochlear implants convert sound into electrical impulses that stimulate the auditory nerve in the cochlea (inner ear). So speech and sounds can be perceived again. A cochlear implant consists of two parts: the implant, which is surgically inserted behind the ear, and the speech processor (SP) with the transmitting coil, which is worn behind the ear like a hearing aid.
In the speech processor, received sound vibrations are converted into electrical signals via the microphone, which are forwarded after processing as an electrical pulse pattern via the cable to the coil. The coil held by magnetic force above the implant sends these coded signals via radio waves through the skin to the implant. This decodes the signals and forwards them via the electrode into the cochlea. These electrical impulses stimulate the auditory nerve, which subsequently generates so-called action potentials and forwards them to the brain. The brain receives the action potentials of the auditory nerve and recognizes them as an acoustic event (speech, sound, noise). In contrast to the cochlear implant, a hearing aid amplifies the sound and can rely on a sufficient number of functioning hair cells in the cochlea for sound transmission.
There are around 300,000 cochlear implant carriers worldwide, of which about 30,000 are in Germany. These are estimated numbers.
Who Are Recommended a Cochlear Implant?
This is a good solution for people suffering from sensorineural hearing loss in one or both ears. Who exactly may benefit from such ear surgery?
- Doctors recommend cochlear implant for children starting from 12-18 months and older. Well-times implantation allows a kid to start and finish education successfully and without problems in communication.
- Adults of any age (including the elderly) can also experience considerable benefits of cochlear implants: autonomy and freedom of communication.
- People with bilateral hearing loss will find such a device very useful. They are implanted in both ears, but not during one operation to estimate their effectiveness and patient’s reaction better. In this case, a cochlear implant makes up for better location of sound and helps to comprehend speech in noisy environments.
For whom is the cochlear implant suitable?
"If a person with a hearing impairment can no longer talk on the phone, that is, if he no longer has a speech understanding about hearing, he is eligible for a cochlear implant" says Professor Roland Laszig, Director of the University ENT Clinic Freiburg. The basic requirement for successful implantation is always a healthy auditory nerve. Whether the auditory nerve is intact can only be determined in an ENT clinic. A cochlear implant may be particularly useful for pre-or during language acquisition dormant adults. With reasonable expectations, deaf adults can also benefit from the cochlear implant.
How much does a cochlear implant installation cost?
The costs for a cochlear implant installation, including rehabilitation measures, are around 40,000 euros.
Details of cochlear implant surgery
Today, operation of cochlear implant insertion has become a routine thing in many advanced clinics. However, this is a difficult procedure that requires high professionalism of doctor and proper preparation.
Before a surgery, a patient is given general anesthesia to make sure he or she will not move. For anesthesia to be safe and easy to go through, a person should follow strict rules concerning eating and drinking. The surgery lasts about 2-4 hours, but together with preparations and recovery it requires 6 hours. The operation is performed as follows:
- The surgeon shaves hair around the ear. A small cut is made behind the ear, and some space is created in the bone behind the ear so that the implant was protected.
- A small hole is drilled in the bone to put an electrode in the cochlea.
- The implant is secured in the space behind the ear, and skin is closed with a few stitches. They are dissolvable – there is no need to remove them.
- After that, the patient is moved to recovery room.
Although a person does not need hospitalization after the surgery, regular examinations and checking of hearing should be done to ensure that the device helps. This is not the end, though. It will take months until a person learns to use and perceive sound. During this time, regular visits to audiologist should be done.
Phase of the path to an cochlear implant. Subjects to be consider
- Information on available services should include cochlear implantation
- Adaptation of hearing aids
- Direct referral after diagnosis
- Consideration of middle ear problems
- Interdisciplinary assessments are required
- Include meeting expectations: meet other adults
- Consideration of middle ear problems
- Information about reviews forwarded
4. Joint decision
- Adult patient and cochlear implantation team make the decision, available information will be forwarded
- Choice of ear / hearing aid and implant / bilateral implants
- By experienced surgeons and surgical team
- Trained and experienced nursing staff
- Latest technologies and methods are available
6. First adaptation
- Available with the latest technologies and methods
- Use of a hearing aid has been considered
- First habituation to new sounds
7. Learn to use the new hearing through the implant
- Stay persistent!
- Learn from other porters and families
- Access to appropriate audio therapy and support
8. Lifetime support and maintenance
- Access to audiotherapy
- Access to affected and family groups
- Ongoing debugging capabilities are required
- Availability of spare parts - individual parts and sound processors
- Monitoring progress - adapting to changing needs
- Technologies are available as needed: all sound processor features, FM systems, accessories, upgrades
- Monitoring the functioning - re-implantation as needed
Where to Go Through Cochlear Implant Surgery?
Where to get professional and reliable medical help? People who worked with German Medical Group know that this company helps to find a good clinic where the best and most qualified specialists work. There are at least five reasons to choose treatment in Germany:
- Treatment in Germany is 20-30% cheaper that in the USA. The same concerns cochlear implant cost.
- Going to the USA is five times more expensive than travelling inside Europe. A plane ticket from any European city to Berlin is worth averagely $80-120.
- European patients do not need Visa to enter the country.
- German doctors speak English, and will be able to communicate with patients without an entrepreneur.
- German medicine is advanced, and professionals may use the latest methods and medications to ensure proper and safe treatment. This country is among the leaders of medicine development.
So if you are a European patient, this is the most sensible alternative to American clinics. Be sure: you will get highly professional medical assistance, and enjoy maximum comfort and care provided by medical personnel. German Medical Group offers the most advanced and clinics in different cities of the country.
Steps to get a cochlear implant
Obtaining a cochlear implant can change lives and is easier than you think. From the first evaluation to the re-entry into the world of hearing, obtaining an implant is a proven and easy process. Your hearing specialist will accompany you every step of the way. You can also get hands-on and emotional support by sharing with other cochlear implant users. Realistic expectations and active participation in audiotherapy are essential for a quick and hurdles-free re-entry into the world of hearing with your new cochlear implant.
The first step on the way to a cochlear implant is the examination by the hearing specialist. If the first tests suggest you could benefit from a cochlear implant, you will be referred to a cochlear implant clinic for further testing. If these tests confirm your suitability for a cochlear implant and you choose the implant, a specialist will discuss with you the procedure, benefits, and potential risks before you get an appointment for the procedure.
2. The implantation
The procedure is performed under general anesthesia and usually takes only about two hours. The response to anesthesia is different for everyone, but usually patients only need a short recovery time.
Before activating the cochlear implant, wait about three to six weeks for the implantation site to heal. At the next appointment, the audiologist will activate the device and fine-tune the follow-up appointments based on your feedback. Everyone experiences the first activation of the cochlear implant differently. Most cochlear implant wearers say that the sound changes over time and gets better if used consistently every day.
4. Hearing rehabilitation (audiotherapy)
Daily practice is very important as you need time to get used to the new method of hearing sounds. In audiotherapy, new listening skills are developed through daily practice such as the following:
- using the implant system for as many hours a day as possible
- reading aloud alone or in front of family and friends
- listening to audiobooks while reading the printed book
- playing songs that are easily recognizable
If you have been seriously hearing-impaired for a long time, you may need support from a listening training program that:
- It encourages the practice of language and environmental sound recognition
- Communicates hearing techniques for communication
- It helps you and your family to develop efficient communication techniques
What you can expect after the installation of the cochlear implant
Re-entering the world of hearing with a cochlear implant is a great and exciting experience, but it also requires your full cooperation. Knowing what's happening to you every step of the way will help you get the most from the implant and master all the challenges along the way. It is important that you have realistic expectations regarding your hearing after activation and know that the first year of audiotherapy is crucial for the long-term success of your cochlear implant. During this time, you work closely with your audiologist and other hearing and speech professionals to fine-tune your implant and learn how to listen and communicate again.