Pros and Cons of Cochlear Implant

Surgery
People associated with the Hearing Impaired often come across the word
Cochlear Implant. Majority of us are unaware of the procedures and how it
works. The lack of information creates a lot of misconceptions. The t ruth is
that Cochlear Implant surgery is totally safe. Users confirm that they hear
much better with a Cochlear Implant. It is highly recommended in cases
where Hearing Aids do not benefit. This is mostly in the case of people
suffering from Severe to Profound Sensorineural Hearing loss.

What is a Cochlear Implant?

A Cochlear Implant is a high-tech listening device for people suffering
from deafness due to malfunction of the Inner Ear.

The meaning of Cochlear Implant as the name suggests is, a device

implanted in the Cochlea of our Ear.

Why do we need a Cochlear Implant?

The delicate Cochlea in the Inner Ear converts the mechanical motion into
electrical signals. These signals re ach the brain through the Auditory
Nerve.

Due to the damage or absence of Hair Cells, the sound waves are not
converted to electrical signals. Since no signal or a very weak signal
reaches the brain, the person cannot hear.

A Cochlear Implant provides the missing electrical signals to the Brain

through the Auditory Nerve.

Cochlear Implant Parts

Before we read further, let us get familiar with the parts of the Cochlear
Implant. For all practical purposes, the Cochlear Implant can be broadly
divided into 2 parts.
External parts of the Cochlear Implant

The only two Cochlear Implant parts one need to know about are:

1. The External Unit

The external Unit consists of the following components

 Microphone.
 Sound Processor Unit in the housing
 Transmitter with Coil
 Magnet
2. The Internal Unit
Internal Parts of the Cochlear Implant

The internal unit which is surgically implanted consists of the following

components.

 Receiver
 Antenna
 Magnet
 Electrodes

How Does a Cochlear Implant Work?

The Microphone of the Cochlear Implant picks up the speech signals. The
speech signal is digitally processed and converted to electronic data. The
wires carry the data to the transmitter which attaches externally to the
Head.
The Antenna inside the scalp picks up the Digital data. The Receiver and
Simulator convert this data into electrical signals and pass them on to the
Electrodes. The Electrodes provide the electrical signal to the Cochlea.
This signal reaches the Brain through the Auditory Nerve as Speech
signals.

Read this to understand the detailed working of the Cochlear Implant.

The Cochlear Implant vs Hearing Aid Debate.

If you are wondering why do Audiologists recommend a complex Hearing
Device which involves surgery over an easy to fit Hearing Aid? The
answer lies in the functionality of both the Hearing Devices.

The Hearing Aid amplifies the sound and feeds into our ears. The
amplified sound passes through the Outer Ear, Middle Ear and o n to the
Inner Ear. The damaged or missing sensory Hair Cells in the Inner Ear
cannot convert the sound to electrical signals. Our Brain will not receive
these signals even if the person is using a Hearing Aid. A Cochlear
Implant helps the person hear in c ases where the Hearing Aid does not
benefit.

Cochlear Implant Surgery

The Doctor and the Audiologist conduct various tests to decide if the
patient meets the criterion for the Cochlear Implant. Below are a few
points which decide whether the patient should receive a Cochlear
Implant.

 Whether the patient is suffering from Severe or Profound Hearing

loss.
 Understanding speech with a Hearing Aid is very difficult.
 The Patient’s age at the time of the Cochlear implant surgery.
 Whether the patient is deaf from b irth or has become deaf later in
life. If later, at what age has the patient become deaf?
  To find out the patient’s support system i.e. family, friends and
schools in case of children. Continuous need for Post -operative
therapy on regular basis.

Brief Description of Cochlear Implant Surgery

 Cochlear Implant surgery takes place under General Anaesthesia.
The total procedure takes about 2 hours.
 Operating team refers to the MRI or a CT scan report before the
surgery to determine the location of the bones.
 The Surgeon makes an incision or a cut behind the ear to insert the
internal part of the Cochlear Implant. The cut is dressed and
bandaged after the operation.
 Patient is shifted to the recovery room and is under observation until
the Anaesthesia wears off. T he patient is sometimes kept in the
Hospital for a few days.
 Patient should take the prescribed antibiotics to prevent infection.
 Hospital discharges the Patient.

Procedure after the Cochlear Implant Surgery

The Cochlear Implant does not start working or is not switched on
immediately after the surgery.

The wound has to heal completely before the next step. This takes about 3
to 6 weeks. The patient can resume normal activities and is not confined
to the bed.
Healed Scar after Cochlear Implant Surgery

After the wound has healed, the external parts of the Cochlear Implant are
connected. After checking all connections the Cochl ear Implant is
switched on or activated.

Pros and Cons of Cochlear Implant Surgery

Majority of People have confirmed that they hear better with a Cochlear
Implant. The benefits of Cochlear Implants are:

The Pros or Advantages of Cochlear Implants

 Cochlear Implant users are able to hear sounds which were not
possible with a Hearing Aid. The sound of a doorbell, telephone bell
are clearly heard. The person can also hear the footsteps of people
walking and the door shutting.
 Users can understand Speech better. There is less dependence on
lip reading.
  People feel relaxed as there is no stress associated with the effort
to lip read and catch the missing words.
 The Cochlear Implant user can easily talk on the phone.
 The person can watch television.
 It’s a boon for children as they can hear and follow the teacher at
the school.

The Cons or Disadvantages of Cochlear Implants

The disadvantages or associated risks are far less than the advantages of
having ones hearing restored.

 There has been a very small percentage o f cases where the

Cochlear Implant has not functioned. Additional surgery corrects this
situation.
 It can cause infection. But the chances are very remote.
 The sound received through the Cochlear Implant is not as natural
as normal speech. Cochlear Implant users who could hear earlier
and have lost their hearing later, have described it as “robotic” or
“mechanical”
 No upgrades for the internal part of the Cochlear Implant. The
Companies manufacturing Cochlear Implants generally upgrade the
external sound processors. The new Sound processors are
compatible and include the latest developments in technology.
 The Cochlear Implant is more expensive than a Hearing Aid, extra
care needed to avoid damage.
 It is expensive to maintain as batteries and connecting cords are
expensive.
 A person using a Cochlear Implant cannot go back to using Hearing
Aids.
The advancing technology has made Cochlear Implant surgery very safe.
The sound quality of the digital Cochlear Implants has improved over the
years. The leading manufacturers are Cochlear, Med El andAdvanced
Bionics.
The Government of India offers free Cochlear Implants to deserving
candidates. Please check the Central Government
sponsored ADIP(Assistance for Disabled Persons) Scheme and the
eligibility criteria from the nearest Regional Centres.