Overview
A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin
An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.
How Does A Cochlear Implant Work ?
A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn. However, it allows many people to recognize warning signals, understand other sounds in the environment, and enjoy a conversation in person or by telephone.
Who Gets Cochlear Implants ?
Children and adults who are deaf or severely hard-of-hearing can be fitted for cochlear implants. According to the Food and Drug Administration (FDA), at the end of 2006, more than 112,000 people worldwide had received implants. In the United States, roughly 23,000 adults and 15,500 children have received them.
Cochlear implants, coupled with intensive postimplantation therapy, can help young children to acquire speech, language, and social skills. Most children who receive implants are between two and six years old. Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills. In 2000, the FDA lowered the age of eligibility to 12 months for one type of cochlear implant.
Who Is Best Suited For A Cochlear Implant ?
Research is constantly providing new information and technology resulting in changes in cochlear implant procedures and instrumentation.
It is generally agreed that the best adult candidates are those who : -
- Have severe to profound hearing loss in both ears
- Have had limited benefit from hearing aids
- Have no other medical problems that would make the surgery risky
- Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading.
Children can also be candidates for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
What Is The Process ?
Once a person is referred to the cochlear implant center extensive testing is done to determine whether the person is a suitable candidate. This evaluation usually includes extensive audiologic testing, psychological testing, examination and tests performed by the surgeon, X-rays, MRIs, physical examination, and counseling to ensure suitability and motivation to participate in the process. It is important that the candidate understands what the implant will and will not do and also understands the commitment required for care and follow-up services.
About 4-6 weeks after surgery, the person returns to the center to be fit with the microphone and speech processor and to activate and program (called mapping) the implant. The initial fitting process is done over several days and may include additional visits over several months. The reason is that, as each electrode in the cochlea is activated, it must be adjusted and programmed into the speech processor. As the person develops skill in using the implant, further adjustments and reprogramming is required. Once the optimum program is obtained, fewer visits are required. Usually there are annual visits to the center for checkups.
Both children and adults receive extensive rehabilitation services from audiologists, speech-language pathologists, teachers, and counselors as they learn to listen, improve speech, use speech-reading, and handle communication. They are taught how to use the implant and how to respond to the sounds they are receiving. For those who have heard before, sounds through the cochlear implant may seem unnatural at first. Those who have never heard must be taught what the sounds are.
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