FEATURE OTOLARYNGOLOGY
Q. What types of hearing loss does hearing implants assist with? A. Severe to profound hearing loss (treatment with CI) Partial deafness (treatment with electric acoustic stimulation) and Sensorineural hearing loss as well as conductive and mixed hearing losses (treatment with middle ear implants)
Q. How does a patient know if a CI is the best solution for their hearing loss? A. Candidacy evaluation involves assessment by several professionals. An audiologist will assess the hearing both with and without hearing aids, and will assess the candidate’s ability to understand speech. An otologist will evaluate the results and determine if cochlear implantation is the most appropriate treatment. If so, the doctor will also check whether the candidate is able to safely undergo a surgery. The candidate may meet with a rehabilitation specialist to determine what help will be necessary to adjust to the implant. At some point during the process, most candidates undergo a CT or MRI scan to allow the surgeon to assess the inner ear anatomy.
Q. What are the rehabilitation challenges after receiving a CI? A. A cochlear implant is a high-tech accomplishment that can restore hearing of people who have never heard before or have lost their hearing during the course of their life. However what most people forget is that the hearing gain and re-gaining process does not simply end once the device has been implanted and the external device part has been programmed. This is in fact the beginning of a learning process, which does present certain challenges. For example it is common for patients
in the beginning, to become impatient as they anticipate the pending developments in their sense of hearing. One of the ways to manage this is for patients to adopt wearing their processor constantly. This exposes patients to as many different sounds as possible and encourages the learning process to continually evolve as the brain learns to assimilate and process. Sound experts agree that attending regular sessions with a Speech Therapist produces good results and progress.
Q. Why are majority of implants only used on one ear? How common are bilateral implants? A. With two ears there are clearly additional advantages: Directional hearing and better listening in noisy situations. Directional hearing helps us localize the position of things and people. Most current CI users are only wearing one implant. The most common reason is a financial related one. Today, in many countries the government, public insurances and charity organizations cover the treatment of severely hearing impaired patients. However as budgets are increasingly challenged coupled with a growing population, the opportunity to fund bilateral implantation is also challenged. In the case of private payers, those who have the financial means choose to take advantage of the benefits of bilateral implantation. This trend is growing steadily.
Q. When is the ideal age for a profoundly deaf child to receive an implant and why? A. The age of implantation is dependent on the individual patient, the advice of
the doctor and local practice. Today, children are being implanted in their first year of life. The reason for this early intervention is the development of speech and hearing in the first two years of life. During the first few months, infants learn to understand a variety of sounds around them. They can very quickly distinguish between human speech and other environmental sounds. The first two years are especially important for language acquisition. Experts agree that for children with untreated severe hearing loss it becomes progressively more difficult the older they become to develop these hearing abilities later on.
Q. What happens if a child is diagnosed at an older age and has not developed speech? A. The sooner hearing loss is treated, the more likely the child is able to acquire speech and language without any impairment at all. Deaf born children who have not been treated for many years and have not developed speech yet, are also able to benefit from CI but the progress rate is slower. With increasing age the brain needs more time to adapt to the newly incoming sounds signals and to learn how to interpret them. Speech can also still be established, but the older the child, the more challenging it will be. With newborn screening, hearing problems can be diagnosed at the earliest. ■
AH
MORE INFO: For more information, visit the MED-EL website:
www.medel.com
Arab Health Issue 4 2011 41
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