Cochlear Implantation Breaking the boundaries of Silence

1. Cochlear Implantation: Breaking the boundaries of Silence Cochlear Implants Cochlear Implants are medical devices that enable hearing in people with severe or profound loss of hearing, especially in cases where hearing aids offer very little to no benefits. In recent years, the cochlear implant industry has made significant progress with technological advancements abound, such as improved sound quality, effective sound processing even in loud or noisy environments, minimally invasive and safer options, etc. The implants can enable the users to carry out activities of a wide range, from watching television to understanding conversations with much more ease and even participating in them, amongst others.

2. How do they work Unlike hearing aids which amplify the sound signals, cochlear implants bypass the damaged portion of the ear and access the auditory nerve directly, enabling direct sound processing by the brain. Cochlear implants consist of an external component and an internal component. The external component is a sound processor for processing the incoming sound waves, that is fit close to the ear and the internal component, implanted surgically beneath the skin behind the ear, is an array of electrodes that transmits the processed sound signals into the auditory nerve. The signals then reach the brain and are therein processed as sound. Although cochlear implants enable hearing, the sound generated might not be exactly the same as the original, that is, an individual using a cochlear implant would perceive sound differently from an individual without any hearing difficulties. Thus, the sound generated from the implant would require relearning sound perception and getting used to it. Before the Surgery The patients are assessed pre-surgery to determine if they are suitable candidates for cochlear implantation. The tests include ear examination for infections or any other abnormalities, hearing tests such as audiogram assessments, speech, and language assessment with hearing aid trial to determine its potential use/benefit. Apart from these, a CT scan and/or MRI scan of the ear and brain is performed to check for abnormalities, if any. CT scan is generally employed in patients with a history of middle ear disease or meningitis. MRI is usually the preferred mode of imaging, as it detects all abnormalities crucial for patient management.

3. During the Surgery Cochlear implant surgery is performed after anesthetizing the patient with general anesthesia. The area adjacent to the site of implantation is shaven and an incision is made behind the ear. The cochlea (a bone in the inner ear responsible for auditory transduction) is accessed, and the implant electrodes are inserted into the cochlea. A device called ‘the receiver’ is placed right under the skin behind the ear and it is secured to the skull. The incision is closed, and the patient is moved to the recovery area for the effect of anesthesia to wear off. As the anesthesia wears off, the patient may experience discomfort or pressure around the implanted area and might feel dizzy in some cases, but these effects don’t last very long.

4. After the Surgery Post-surgery, the patient would be under observation for a short while, followed by a hospital stay, that could range between a few hours to two days, depending on the necessity. The patient would be given instructions on post-surgery care, including dressing change, handling stitches and other dos and don’ts, prior to discharge. Implant Activation The implant needs to be activated for it to start functioning; however, the activation does not take place immediately after the surgery. Usually, a healing period of around 3-6 weeks is allowed after the surgery, where the incision heals completely and the swelling reduces. Once the incision is healed completely, the external component: a sound processor will be added. The sound processor is programmed/mapped and activated, thus activating the internal device to stimulate the cochlear nerve, which will, in turn, commence responding to sounds thereafter. Time to hear Over the next few months, programming sessions are conducted, where the processor is fine- tuned for optimum sound output. The sound processor is adjusted to suit the needs of the patient with testing and fine-tuning, followed by assessing the sounds heard by the patient. In the meantime, the patient gets familiarized with the functioning of the implant and the sound generated, as it would require some time to get used to hearing with the implant. References: 1.Cochlear Implant Surgery. Published 2021. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cochlear- implant-surgery 2.Cochlear implants - Mayo Clinic. Mayoclinic.org. Published 2020.

5. https://www.mayoclinic.org/tests-procedures/cochlear-implants/about/pac-20385021 3.Center for Devices and Radiological Health. Before, During, & After Cochlear Implant Surgery. U.S. Food and Drug Administration. Published 2018. https://www.fda.gov/medical-devices/cochlear-implants/during-after-implant-surgery 4.Best Cochlear Implant Surgery Hospital in Delhi NCR, India | Indraprastha Apollo Hospitals. Apollohospitals.com. Published 2016. https://delhi.apollohospitals.com/procedures/cochlear-hearing-implant-service Contact Us Address: Plot no.444, Phase III, Udyog Vihar, Sector 19, Gurugram, Haryana 122015 Web - https://neubio.in/ support@neubio.in Toll Free: 1800 103 2234 Blog - https://neubio.in/blog Social Link https://www.instagram.com/neubioindia/ https://twitter.com/NeubioI https://www.facebook.com/Neubio-India-106242201726920/