Birds chirping, the phone ringing, a song on the radio, or a baby crying-these are all familiar sounds for most of us. But imagine not ever having heard these sounds and suddenly being able to hear them? Or to have lost your hearing and to be able to regain it back? With today’s medical advances, all of this and more is possible with a cochlear implant. HEALTH meets with Steffen Rose, the Clinical Technical Manager of Cochlear to learn more about this groundbreaking device.
Social Skills
For a child, hearing and speech are essential tools of learning, playing and developing social skills. In fact, children learn to communicate by imitating the sounds they hear and if they have a hearing loss that is undetected and untreated, they can miss much of the speech and language around them and in their immediate environment. These result in not only in delayed speech/ language development, but can also lead to social problems and ultimately academic difficulties. To help with this problem, an ingenious scientific innovation—the cochlear implant– can help alleviate the deafness or poor hearing in your child’s life.
How We Hear
To understand the way a cochlear implant actually works, there should be a basic understanding of the ear anatomy and why deafness may occur. The ear is made of three major parts: the outer ear canal, the middle ear apparatus which is formed of the ear drum and 3 little tiny bones called hammer, anvil, and stirrup, the third part is the inner ear that is divided into two organs which are the cochlea and the balance organ or the Labyrinth. When we hear, sounds move through the ear, hit the ear drum and move the three tiny bones and in doing so, amplify sound. The amplified sound gets delivered into the cochlea which acts as a transformer. This transforms the sound waves into tiny electrical impulses and this travel through the nerve to the brain and sound is perceived. The cochlea’s main job therefore is to transform mechanical sound waves into electrical neurological impulses.
The Basics
According to Rose, a cochlear implant is an electronic medical device that does the work of the damaged cochlea and enable sound signals to the brain. “The first patients were implanted in 1978, by Professor Graeme Clark from the University of Melbourne, Australia,” he says and today, more than 250.000 patients have received this established, effective and long-term solution by the company “Cochlear” whose vision is to connect the hearing impaired to a world of sound by offering life-enhancing hearing solutions.
Indications
Cochlear implants can help patients, from infants to adults, who have moderate to profound hearing loss in both ears or/and receive little or no benefit from hearing aids, tells Rose. “Cochlear Implants can be considered for infants and adults and essentially it becomes a worldwide standard to implant children around 12 months of age, assuming that there are no contra-indications,” he says, however most children will be implanted between one to three years of age; however, even children up to seven years of age is still a good time to implant. And every subsequent year later, will increase the need for rehabilitation. Also the expectations of an achievable outcome should be discussed carefully with the family and caregivers. However for patients with a less significant degree of hearing loss or patients that have no hearing nerve, a Cochlear Implant is not indicated, points out Mr. Rose.
How It works
Mr. Rose explains that a Cochlear Implant System consists of an implantable device that is under the skin and an external part that is placed on the ear. “The external sound processor, worn behind the ear just like a hearing aid which captures sounds and converts them into digital code,” he explains and this transmits the digitally coded sound through a coil to the implant that is placed under the skin. The implant then converts the digitally coded sound to electrical impulses and sends them along an electrode array, which is positioned in the cochlea. “The implant’s electrodes stimulate the cochlea’s hearing nerve fibres, which relay the sound signals to the brain to produce hearing sensations,” says Mr. Rose who adds that the necessary surgery is a well-established procedure that requires about two hours, depending on the anatomy, and most patients can be discharged from the hospital the very next day.
Hearing Begins
With a Cochlear Implant, Mr. Rose explains that the individual’s brain will perceive a lot of sounds which it is not used to ‘hearing.’ “Recipients can hear immediately after the device is switched on, however, depending on various factors, individuals adapt differently to the new hearing,” he notes and stresses that this is an exciting time as there is so much to hear in our today’s busy world. Some compare it with learning a foreign language – each day you get a little bit better.
Follow-Up
Rehabilitation for children after cochlear implantation is an accepted part of the implant process, stresses Mr. Rose. “Indeed, many cochlear implant clinics feel it is so important that they require parents of young children to sign an agreement laying out the vital role of the family and their responsibilities for rehabilitation and their child’s developing communication skills after surgery,” he says. “Cochlear recognises the essential part that rehabilitation plays in achieving the best outcomes for each individual.”
Afterwards
Cochlear has developed a range of resources to support children and their families throughout their listening and language learning journey as well resources to help teenagers and adults to develop the skills that will allow them to enjoy participating in the hearing world. Mr. Rose emphasizes that many factors come into play to determine success post-surgically that is why the pre-surgical counselling and diagnostic is paramount in the decision-making process. “In other words, a team of experts reviews all test results before surgery to ensure that each patient gets a maximum of benefit,” he says and for children, experts strive to enable them to attend mainstream schools.
Hearing Milestones for your child:
Even if your newborn passes the initial hearing screening, watch for signs that he or she is hearing well. Hearing milestones that should be reached in the first year of life include:
• Most newborns startle or “jump” to sudden loud noises.
• By 3 months, a baby usually recognizes a parent’s voice.
• By 6 months, an infant can usually turn his or her eyes or head toward a sound.
• By 12 months, a child can usually imitate some sounds and produce a few words, such as “Mama” or “bye-bye.”
• Kids who seem to have normal hearing should continue to have their hearing evaluated on a regular basis at checkups throughout life.
• Hearing tests are usually done at ages 4, 5, 6, 8, 10, 12, 15, and 18 years, and at other times if there’s a concern.
A child may be at higher risk for hearing loss if he or she:
• Was born prematurely
• Stayed in the neonatal intensive care unit (NICU)
• Was given medications that can lead to hearing loss
• Had complications at birth
• Had frequent ear infections had infections such as meningitis or cytomegalovirus
The Benefits of Using Cochlear Implants
• Most people are able to perceive soft, medium, and loud sounds: People who use cochlear implants have reported the ability to perceive a variety of different sounds, such as ringing telephones, slamming doors, barking dogs, the sounds of engines, the sound of a light switch turning on or off, rustling leaves, a whistling tea kettle and more.
• Many people can understand speech without lip-reading: Even when this is not possible, using a cochlear implant helps people with lip-reading.
• Many people can make phone calls: A number of people find they can make phone calls and understand familiar voices over the phone. Some people can make phone calls and understand others they are not familiar with.
• Watching Television: A number of people can watch television more easily, particularly when they are able to see a person’s face.
• Enjoying Music: Some people with cochlear implants enjoy the sounds of certain instruments, such as guitar or piano, as well as certain voices.
