OM SAI CLINIC

Cochlear implant is a medical device that provides direct electrical stimulation to the hearing nerve in the inner ear. Children and adults with a severe hearing loss may be helped with cochlear implants. A cochlear implant is a prosthetic substitute directly stimulating the cochlea and it does not cure deafness or hearing impairment.

A cochlear implant completely by-passes the normal hearing mechanism and stimulates the auditory nerve directly by means of an internally implanted electrode assembly. The implant consists of an external portion that located behind the ear and an interior portion which is surgically implanted under the skin. An implant has a microphone, a speech processor, a transmitter and an electrode array. The sound from the environment is picked by microphone and transmitter and receiver/stimulator sends them to speech processor to convert them into electric impulses. The speech processor placed with the microphone behind the ear, or it is a small box-like unit worn in a chest pocket. The speech processor digitizes the sound signals and sends them to a transmitter just behind the ear. The electrode array collects the impulses from the stimulator and sends those to different regions of the auditory nerve. The electrodes stimulate the fibers of the auditory nerve, and sound sensations are perceived.

A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so that they can be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Hearing via a cochlear implant is different from normal hearing and takes time to adjust. However, it enables many people to understand other sounds in the environment, recognize warning signals, , and understand speech in person or over the telephone.

The benefits from a cochlear implant depend on many factors, such as the age of the patient when he or she receives the implant, the hearing loss present pre or post patient developed language skills and finally the motivation of the patient and family support.

Once a person is referred for cochlear implant, more testing is done which includes audio logic testing, psychological testing, medical examination, and tests performed by the surgeon. It is done to ensure that the candidate will benefit from a cochlear implant and will have the motivation to participate in the process. Once the decision is made to go ahead, the surgery is done. Sometimes it involves an overnight stay in the clinic, and sometimes it is done on an outpatient basis. Six weeks post-surgery, patient is fitted with the external microphone and speech processor and implant is activated and programmed.

The best candidates are those having severe hearing loss in both ears, limited benefit from hearing aids, medical condition that makes surgery risky. Children can be considered for cochlear implants if they have the similar conditions as adults and in addition have support from their educational institutions to development of auditory skills.

Hearing is one of the five senses that you or anyone else relies on for communication and a whole host of other things. Among the five senses, touch, smell, taste, hearing and sight, it is often hearing, which is the most easily affected. You don't have to be a senior citizen to experience hearing loss as it is quite common among younger people as well. This problem is also getting widespread with each passing day.

Before coping with hearing loss, the first job is to detect it-
If you have a hunch that you or any of your loved ones is suffering from hearing loss, it is important that you get it diagnosed. Some of the common symptoms of hearing loss will be:

1. Hearing difficulties while talking to someone over the phone
2. Straining to hear conversations with family members or friends in household situations 
3. People usually need to repeat what they talk to you with a louder voice
4. You often hear complaints that you keep the TV too loud.
5. In crowded situations, such as family gatherings or a restaurant, you have problems listening to people.

Although this condition tends to affect senior citizens, an increasing trend shows younger people i.e. people mostly in their 40 and 50s and even younger than that suffer from this condition.

How to deal with hearing loss?
Some of the options to deal with hearing loss are mentioned below.

1. Once diagnosed with hearing problems, change your ways of communication: If you or your loved ones have been diagnosed with hearing problems, it is important that both adjust your ways to deal with the problem. Rather than getting angry at the other for not being able to communicate effectively, develop and strategize ways to make communication less problematic and erratic.
2. Cochlear implants: This is a newer technology, which has gained popularity in the past decade or so. These are directly implanted into the inner ear and are designed to bypass the damaged areas of the ear and directly stimulate the auditory nerve. These have become very popular, although, are not a replacement of natural hearing. It is only prescribed for people who have severe hearing loss or are deaf.
3. Hearing aids: Although selecting a hearing aid is difficult as the patient needs to be comfortable, once selected it is one of the best solutions for the hearing impaired. The functionality of these devices can be extended with the hearing assistive technology or HAT devices that can focus the audio waves depending on the situations and give a more tailored approach for every individual's needs.

Loss of hearing cannot be reversed or cured. However, it can be treated. Even people who have lost all hearing can hear sounds again with the help of modern medicine. Treatment for hearing loss depends on a number of factors. This includes the type of hearing loss, the severity of hearing loss, budget etc. The most common treatment options for a loss of hearing are:

Removal of Wax Blockage: Ear wax that accumulates in the inner ear canal is a common cause for temporary loss of hearing. In such cases, cleaning the ear wax can help restore hearing. This should not be attempted at home as damaging the ear canal can result in a permanent hearing loss. To remove the ear wax, a doctor will need to loosen it with oil and then suction out the softened wax.

Surgery: Loss of hearing caused due to a traumatic ear injury can be treated with surgery. This usually involves the insertion of small tubes to help fluid drain out of the ear. This surgery may also be beneficial in the case of temporary loss of hearing caused by recurrent infections.

Hearing Aids: Permanent loss of hearing is usually caused by damage to the inner ear. In such cases, a hearing aid can help. There are many different types of hearing aids available. These hearing aids work by amplifying the sound received and thus making it easier for a person to hear. Hearing aids are removable and can be taken off whenever needed. The most common types of hearing aids are:

1. Behind the ear hearing aids – These are large, powerful hearing aids that are used to treat severe loss of hearing.
2. In the ear hearing aids – These are small hearing aids that fit within the outer ear and can be used to treat mild to severe loss of hearing.
3. In canal hearing aids – These are very small hearing aids that fit inside the ear canal and are thus not visible from outside. They are used to treat mild to moderate loss of hearing.

Cochlear Implants: Severe hearing loss caused by irreparable damage to the inner ear canal can be treated with a cochlear implant. This works by amplifying sounds and transmitting them to the auditory nerves while bypassing the damaged ear canal. A cochlear implant needs to be surgically inserted behind the ear and can be used by children and adults. Cochlear implants have been successfully used to treat people who were born with a loss of hearing. In case you have a concern or query you can always consult an expert & get answers to your questions!

Sudden sensorineural hearing loss (ssnhl) is characterized by a sudden decrease in hearing of at least 30 db, affecting at least three frequencies over a 72-hour period or less. Tinnitus is an almost universal effect of ssnhl.Sensorineural hearing loss occurs when there is damage to the cochlea or to the nerve pathways from the inner ear to the brain. This is much more difficult to treat as it involves nerve damage. There is currently no cure for sensorineural hearing loss but there are therapies that can significantly mitigate the damage and reduce the sound level of tinnitus.

Sudden sensorineural hearing loss is a frightening subset of sensorineural hearing loss. It can occur over a few hours, a few minutes, or even instantaneously. People afflicted with ssnhl typically feel a fullness in the ear before the onset of hearing loss. They may experience a “pop” in the ear and frequently have vertigo. In most cases ssnhl affects only one ear.

Roughly one-third of those afflicted with ssnhl have a complete restoration of hearing. Another third experience a partial restoration and a third have continued hearing loss with no improvement.

Causes of ssnhl and tinnitus

Many believe ssnhl results from an auto-immune condition or a viral infection. Accordingly, they treat this with steroids or anti-viral medications. In about 90% of cases there is no specific cause that can be identified. This is termed idiopathic ssnhl.