Cochlear implants: Turning deaf ear to hearing issues can impair speech ability

Hearing loss can affect everyone from infants to people in their 60s and 70s.
Image used for representational purposes only
Image used for representational purposes only

Hearing is a fundamental requirement for every individual as without this basic skill communication becomes difficult with others. The effects are profound in children, as it will affect their ability to speak apart from causing delay in language development. This impairment can also make the brain work harder to hear and fill in gaps, which can negatively impact other thinking and memory systems. it may also contribute to faster brain atrophy and dementia.

Hearing loss can affect everyone from infants to people in their 60s and 70s. This can be caused by many factors, but exposure to loud noise is the most common reason people have the condition. The ailment can’t be reversed, but surgery to treat some issues can improve hearing.

There are three types of hearing loss

Conductive hearing loss: Something keeps sound from passing through your outer ear (ear canal) or your middle ear

Sensorineural hearing loss: This hearing loss happens when something damages your inner ear over time. Sudden sensorineural hearing loss (SSHL), or sudden deafness, may happen all at once or over a few days

Mixed: This happens when you have issues in your middle or outer ear (conductive hearing loss) and your inner ear (sensorineural hearing loss) Damage to the inner ear or the nerve from the ear to the brain can cause sensorineural hearing loss, which is permanent. in adults, the causes include ageing and prolonged exposure to loud noise. in children and infants, the causes include congenital abnormalities or infections.

In this type of hearing loss, higher-pitched tones may sound muffled. it may become difficult to pick out words against a background noise. Treatment includes hearing aids and assistive devices. The impact of congenital hearing defects can affect overall development in children. “Without early detection, this condition can lead to mutism, where speech development is hindered due to the absence of auditory input. Until recently, children with such challenges relied on special schools and sign language for communication. However, with the introduction of cochlear implants, there is now hope for these children to develop speech and communication skills,” said Dr ajay Swaroop, chairman of board of management and senior consultant at Sir ganga ram Hospital, Delhi. Cochlear implantation is recommended for individuals of any age (after six months) who meet specific criteria, including children born with profound hearing loss unresponsive to hearing aids, adults not benefiting from hearing aids, and individuals with bilateral profound sudden hearing loss or recent onset unilateral profound hearing loss, he added.

Two-minute surgery

Speech processor, microphone and transmitter how it works Transmitter Receiver Cochlear implant surgery involves placing electrodes in the cochlea and an external speech processor, enabling sound perception. a receiver stimulator (internal component) is placed through a surgical procedure, with electrodes introduced into the cochlea’s turns, says Dr Basharat nadeem, consultant otologist and cochlear implant surgeon, Sparsh Hospital, Bengaluru. The external speech processor transmits sound to the internal component. “This painless cochlear implant surgery, which takes about 1-2 minutes, is performed with the utmost aseptic precautions and requires specialised training to master. However, the surgery itself constitutes only 25% of the entire process. The remaining 75% depends on how well the individual learns to understand the sounds they hear and develops verbal communication skills through auditory verbal therapy,” Dr nadeem said.

Before the surgery, a thorough evaluation is necessary, including a medical history review, physical exam, hearing tests, and scans to assess inner ear anatomy, says Dr girish anand, consultant, enT Surgery, aster CMi Hospital, Bengaluru. after these evaluations, it is recommended to consult with a surgeon to discuss the potential benefits, limitations, and risks of the surgery.

Post surgery, the recovery period includes a brief hospital stay followed by home care. “The external device is activated a few weeks after surgery, marking the beginning of rehabilitation. This phase is crucial for retraining the brain to interpret the new auditory signals from the implant and speech therapy and aural rehabilitation sessions play an essential role in this process,” Dr anand said.

He added that while cochlear implants can improve speech understanding and communication, leading to more independence and a better quality of life, it is essential to know that cochlear implants do not restore natural hearing, but instead help the brain interpret sound differently. Like any surgery, there are risks such as infection or facial nerve injury. also, the device needs regular care and maintenance.

Cost and schemes available

Cochlear implant surgery is a significant investment and is subsidised by a few government institutions for BPL patients. experts emphasise that early intervention is key to developing auditory skills, although it costs `1015 lakh per ear in india.

(With inputs from Ashish Srivastava @ New Delhi)

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