For people with hearing loss, life may be improved with the use of a hearing aid. Hearing aids are small removable devices placed inside the ear to amplify sound.
With the advancement of technology and breakthroughs in science, hearing aids have been able to help many people improve their hearing, which may have been lost through illness, congenital conditions or the natural aging process.
With that being said, there are some people whose hearing impairment cannot be improved through the use of a hearing aid. These individuals may suffer extreme damage to the inner ear, leading to hearing loss that won’t be helped by the amplification of sound.
They may suffer from partial or total deafness due to the loss of sensory cells that reside in the inner ear. These sensory receptors are responsible for changing sound vibrations into electrical impulses, which are then sent to the auditory nerve and up into the brain for final processing.
These sensory receptors are millions of tiny hairs located in the snail-shaped part of the inner ear called the cochlea. If the sensory receptors are damaged or missing, the resulting hearing loss is usually severe.
Without the ability to change vibrations to impulses, the sounds are never heard. Therefore, sensorineural hearing loss cannot be eased by the use of sound amplification.
In recent years, however, there has been a development that can help people who suffer this type of loss. It is a cochlear implant, and for the people who need it, the device can carry enormous benefits.
At the same time, it can also carry some risks as well. What is a cochlear implant and what are some of the risks associated with it? While the procedure is largely without complications, the process and risks are discussed below.
What Is a Cochlear Implant?
The cochlear implant is made up of two parts, an external device worn behind the ear which is similar to a hearing aid, and an internal electrical device made up of two elements, one that is placed just under the skin behind the year, and a second that is placed inside the cochlea in the inner ear.
The external part and the piece implanted under the skin maintain contact through the use of magnets. The magnets also serve a further purpose in allowing for the conduction of sound signals.
The external part of the unit contains a microphone, a speech processor and a transmitter. The internal receiver, implanted just under the skin, is tasked with sending the signals via a small wire to the electrodes implanted in the cochlea.
The system is a mini computer and runs efficiently to capture and process sounds. Its purpose is to help a person with profound hearing loss have a chance at gaining some sense of sound processing back.
What Are the Risks?
All medical procedures carry some risk. However, the risks are fairly limited for those receiving cochlear implants. A doctor will be sure to inform a patient of these risks several times throughout consultation and preparation for surgery.
Even beyond surgery, some signs and symptoms indicate something might be wrong with the implant process.
As with every surgical procedure, no matter how minor, the number one risk a patient is advised of is the potential for an adverse reaction to anesthesia.
This substance is a concoction of drugs administered in various ways depending on the procedure, and it is essential for surgery.
It puts you to sleep and keeps your pain receptors numb, so the brain doesn’t alert you and wake you up. An anesthesiologist is a doctor who administers this medication during surgery.
This person has been specially trained to provide the correct amount of drugs at precise intervals to ensure you stay asleep, unmoving, and free from pain. This in conjunction with local numbing agents injected directly at the surgical site will keep your body from reacting.
Some people have an adverse reaction to some anesthesia medication which isn’t always known until it is administered. The reaction can run the gamut from rash to ineffectiveness to anaphylactic shock and possible death. However, the most common side effect is nausea and vomiting upon waking.
The rarest and most significant side effects that may occur after a cochlear implant procedure are:
- Excessive bleeding in the ear
- Loss of any hearing that may have remained
- Leaking of fluid in and around the cranial cavity
- Balance and dizziness due to damage to other inner ear components
- Nerve damage resulting in paralysis of the face or other parts of the head
- Tinnitus or a constant ringing sensation in the ear
- Meningitis (people with hearing loss caused by inner ear damage are highly susceptible to the virus)
The most common post-surgical risk is infection. Infection can occur at or near the incision and implant site, and may be the result of a number of unforeseen factors.
Doctors have come to prescribe a round of antibiotics as a preventative measure to help keep an infection from occurring at all. If the antibiotics don’t work, and there is still an infectious occurrence, then more medical attention is necessary.
If an issue is suspected, a round of testing including an MRI and other diagnostics may be performed. The resulting diagnosis may cause removal and replacement of one or more of the elements that make up the implant. In extremely rare cases, the entire device is removed.
The doctor will discuss all these risks and the chances of them occurring. Of course, even though these types of reactions are rare, they can and do still happen.
The procedure itself typically takes no more than two hours to perform from start to finish. It can be done in an outpatient facility unless there are complications.
How Does a Cochlear Implant Work?
The transmission sequence of a cochlear implant goes something like this.
A sound is picked up by the microphone (external), which sends the sounds to the speech processor where the sound is broken down and digitized for transport.
The new digital version travels to the transmitter where the signals are coded and sent to the internal portion of the system via conduction with the magnet.
From there the receiver collects the coded signal and converts it to electrical pulses which are shot down the wire to the electrodes implanted inside the cochlea in the inner ear. From there, the pulses directly stimulate the auditory nerve and are sent to the brain for processing.
Whereas in the past a person with severe hearing loss had no chance of a sound getting past the damaged cochlea, with the help of the cochlear implant, the damaged cells are bypassed by the electrodes.
The entire process takes milliseconds and results in the person being able to “sense” the sound. Whether the sensed sound is clear or not depends on the person.
The result varies and can range from hearing a sound and being able to understand it with the assistance of lip reading all the way up to near perfect hearing.
The cochlear implant is not a cure for deafness or hearing loss, but it is a way for those afflicted with same to gain some hearing abilities back.
Who Can Benefit from Having a Cochlear Implant?
Getting a cochlear implant can drastically change an individual’s life by allowing him or her the opportunity to hear sounds previously unheard. Children with inner ear damage are some of the most critical patients who undergo the procedure.
This is due, in large part, to the speech processing deficiency that accompanies a person who is born with profound ear damage and resulting hearing impairment.
Because words can’t be heard, they can’t necessarily be spoken back. Among children with hearing damage who do learn how to speak (through speech and auditory therapy), speech can be limited.
A cochlear implant affords children the chance to be more successful in hearing, speaking and even learning throughout the crucial developmental stages.
Implants can be placed in babies as young as 1 year old and provide the most benefit for children younger than 5 years old. This doesn’t mean a person older than 5 won’t benefit from the implant.
Adults with hearing loss in both ears also benefit from the procedure. Adults who are the best candidates:
- Lost their hearing after already being able to speak
- Have received little to no help with hearing aid use
- Know and understand that the device is not a restoration of hearing
In some instances, a cochlear implant can dramatically improve the life of a person with a profound hearing loss. It can provide users with the chance of processing sounds and words in a way they have either lost along the way or, in the case of some people, never possessed.
It is essential to keep the risks in mind when weighing the benefits, and speaking to your doctor throughout the process is important. Even a doctor can’t predict how successful an implant will be in advance.
One of the most crucial things to keep in mind is patience, understanding, and a willingness to take a leap that could lead to improvement in hearing and change the course of your life.