Are Cochlear Implants The Hearing Miracle You Are Looking For?

A cochlear implant is an electronic device that restores partial hearing to individuals with severe to profound hearing loss who do not benefit from a conventional hearing aid.  It is surgically implanted to the inner ear and activated by a device worn outside the ear.  Unlike a hearing aid it does not make sound loud or clearer.

Instead, the device bypasses damaged parts of the auditory system and directly stimulates the nerve of hearing, allowing individuals who are profoundly hearing impaired to receive sound.

What is normal hearing?

Your ear consists of three parts that play a vital role in hearing – the external ear,, middle ear, and inner ear.

Conductive hearing:  Sound travels along the ear canal of the external ear causing the ear drum to vibrate.  Three small bones of the middle ear conduct this vibration from the eardrum to the cochlea (auditory chamber) of the inner ear.

Sensorineural hearing:  When the three small bones move they start waves of fluid in the cochlea, and these waves stimulate more than 16,000 delicate hearing cells (hair cells).  As these hair cells move they generate an electrical current in the auditory nerve.  The electrical signal travels through inter-connections in the brain to specific areas of the brain to the specific areas of the brain that recognize it as sound.

How is hearing impaired?

If you have disease or obstruction involving your ear canal, tympanic membrane (ear drum) or middle ear, your conductive hearing may be impaired.  Medical or surgical treatment can probably correct this.

An inner ear problem however can result in a sensoineural impairment or nerve deafness.  In most cases, the hair cells are damaged and do not function.  Although many auditory nerve fibers may be intact and can transmit electrical impulses to the brain, these nerve fibers are unresponsive because of hair cell damage.  Since severe sensorineurical hearing loss cannot be corrected with medicine, it can be treated only with a cochlear implant.

 How do cochlear implants work?

Cochlear implants bypass damaged hair cells and convert speech and environmental sounds into electrical signals and send these signals and send these signals to the hearing nerve.

A cochlear implant has two main components:

1. An internal component that consists of a small electronic device that is surgically implanted under the skin behind the ear, connected to electrodes that are inserted inside the cochlea.
2. An external component, usually worn behind the ear that consists of a speech processor, microphone, and battery component.  The microphone captures sound, allowing the speech processor to translate into distinctive electrical signals.  These signals or “codes” travel up a thin cable to the headpiece and are transmitted across the skin via radio waves to the impaired electrodes in the cochlea.  The electrodes’ signals stimulate the auditory nerve fibers to send information to the brain, where it is interpreted as meaningful sound.

Cochlear implant surgery

Cochlear implant surgery is usually performed as an outpatient procedure under general anesthesia.  An incision is made behind the ear to open the mastoid bone leading to the middle ear space.  Once the middle ear space is exposed, an opening is made in the cochlea and the implant electrodes are inserted.  The electronic device at the base of the electrode array is then placed under the skin behind the ear.

 Is there care and training after the operation?

Several weeks after surgery, your cochlear implant team places the signal processor, microphone, and implant transmitter outside your ear and adjusts them.  They teach you how to look after the system and how to listen to sound through the implant.  There are many causes of hearing loss and some patients may take longer to fit and require more training due to individual differences.  Your team will ask you to come back to the clinic for regular checkups and readjustment of the speech processor as needed.

What can I expect from an implant?

Most adult cochlear implant patients notice an immediate improvement in their communication skills.  Children require time to benefit from their cochlear implant as the brain needs to correctly interpret the electrical sound input.  Also, 90 percent of adult cochlear implant patients are able to discriminate speech without the use of visual cues.

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