Cochlear implant

DEFINITION A cochlear implant is a small, complex electronic device that provides direct electrical stimulation to the auditory nerve in the inner ear. The cochlear implant does not result in “restored” or “cured” hearing. It allows for the perception of the sensation of sound.

Unlike a hearing aid, it does not make sound louder or clearer Unlike a hearing aid, it does not make sound louder or clearer. Instead, the CI device converts acoustic sound into electrical and bypasses damaged parts of the auditory system (cochlea) and directly stimulates the auditory nerve.

EXTERNAL PARTS Receiving microphone: Speech Processing  Picks up sound from the environment and send it to the speech processor.   Speech Processing Analyzes the sound and converts it into an electrical signal. Transmission Link Sends the signal to the internal part, where it's decoded. Battery Provide the power to the electronic device.

INTERNAL PARTS Receiving Microphone Electrode Array The receiver is just under the skin behind the ear. The receiver takes the coded electrical signals from the transmitter and delivers them to the array of electrodes that have been surgically inserted in the cochlea. Electrode Array The electrodes stimulate the fibers of the auditory nerve, and sound sensations are perceived.

COCHLEAR IMPLANT COMPONENTS Internal part EXTERNAL PART

HOW IT WORKS?! Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain. The brain recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn. It allows many people to recognize warning signals, understand other sounds in the environment, and enjoy a conversation in person or by telephone.

WHO IS BEST SUITED?! It is generally agreed that the best adult candidates are those who: Have severe to profound hearing loss in both ears Have had limited benefit from hearing aids Have no other medical problems that would make the surgery risky Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading Have lost their hearing after speech and language development

Who is best suited?! It is generally agreed that the best child candidates are those who: Have profound hearing loss in both ears. Have had limited benefit from hearing aids. Are healthy and have no medical conditions that would make the surgery risky. Are involved (when able), along with their parents, in all the steps in the process. Understand (when able), along with their parents, their role in the successful use of cochlear implants. Have (when able), along with their parents, realistic expectations for cochlear implant use. Are willing to be actively involved in their habilitation/rehabilitation. Have support from their educational program to emphasize the development of auditory skills.

Pediatric considerations Predicting success Adult considerations Pediatric considerations Onset of deafness. Duration of deafness. Mode of communication. Commitment. Motivation. Age at implantation. Aural (re)habilitation. Family commitment.

Pre-Operation Examination of external, middle, and inner ear for signs of infection or abnormality. Various tests of hearing. A trial of hearing aid use to assess its potential benefit. Exams to evaluate middle and inner ear structures. CT (computerized tomography) scan. MRI (magnetic resonance imaging) scan. Psychological examination to see if the patient can cope with the implant. Physical exam 

THE OPERATION It is done under a general anesthesia. The operation usually takes from 1½ to 5 hours. The patient usually goes home the same day, some of them may stay in the hospital for one or tow days. An incision is made in the skin behind the ear. The surgeon drills into the mastoid bone, creating a pocket for the receiver/stimulator, and then into the inner ear where the electrode array is inserted into the cochlea.

Skin infection. Onset of tinnitus. Damage to the vestibular system. Damage to facial nerve. Device failure.

After the surgery by almost four weeks the implant is "activated" by connecting an external sound processor to the internal device by a magnet

Effectiveness of cochlear implant The CI has been effective for the large majority of people. However, its effectivity depends on numerous variables. The younger a person receives their implant. The shorter duration of deafness. The level of expectations and motivations of the patient and parents. Good medical professionals are essential for both the surgery and rehabilitation A large number of adults who are deaf and have cochlear implants derive substantial benefit from them when they are used in conjunction with speech reading.

The implant is by no means a cure for deafness and will not restore normal hearing. It will take time to be effective There will be no success with a cochlear implant without follow-up and rehabilitation services. Having a cochlear implant does not guarantee the ability to speak.

number of different things determines the effectiveness of cochlear implant 1-The health and structure of the person's cochlea: The number of nerve cells the person has is important. 2-Implantation variables: These variables include the depth and type of implanted electrode and signal processing technique. 3- Learnability: How rapidly the person learns to use the implant. 4- The communicativeness and intelligence of the person. 5-The length of time the person has used the implantation. 6-The quality and dedication of the person's learning support structure

Increase the level of hearing, which makes it easier for them to communicate and function in mainstream society. Children with cochlear implant are often able to function in mainstream schools rather than special schools for the deaf. Safety. Such as the ability to hear ambulance sirens or someone yelling. Can improve safety and security. The restoration of some auditory perception.

The cost is very high. It costs almost 150,000 to 200,000 riyals in non-governmental hospitals. The brain may have difficulties translating the electronic pulses into understandable language. The natural sounds and the way sounds are transmitted through a cochlear implant are different. There is a risk associated with the surgery (damage to the auditory nerve or facial nerve). The cochlear implanted should immunize for bacterial meningitis due to its higher incidence.

The patient may be prohibited from certain activities that could damage the cochlear implant such as swimming. There will be future limitations on medical testing which can be done after surgery as the device contains magnets to connect the outer portion to the surgically implanted base.

Bilateral Cochlear Implants There are certain criteria to implant two cochlear including; Children (under 18): If they have at least 90 decibels of hearing loss. Don't benefit enough from hearing aids. A hearing aid trial has not worked. For adults: A 70 decibel or greater hearing loss. Limited or no benefit from hearing aids. Both ears should also be in good physical condition for implantation.

Having two "ears" is better than having only one "ear“. A person with only one implant is similar to someone with a unilateral hearing loss. bilateral implants overcome noisy environments it can help filter sounds and making easier to hear speech. Cochlear implants may destroy residual hearing. They may not be able to benefit from the future improvements in hearing technology. There is an increase in surgical risks.

Criticism and Controversy Deaf community which consists of pre-lingual deaf people, is strongly against cochlear implant. Some of them consider Cochlear implant as an offence to their culture. The problem emerged in the18th century with the argument of manualism vs. oralism. This is consistent with medicalisation and the standardisation of the normal body in the 19th century, when differences between normal and abnormal began to be argued about.

It is important to consider the sociocultural context, especially in the deaf community, which considers itself to possess its own unique language and culture. Many do not believe that deafness is something that needs to be cured. The cochlear implant can act as a tool deaf people can use to access the hearing world without losing their deaf identity.

Cochlear implants for congenitally deaf children are considered to be most effective when implanted at a young age, during the critical period in which the brain is still learning to interpret sound. Hence they are implanted before they can decide for themselves. Children with cochlear implants are more likely to be educated orally without using sign language. They are often isolated from other deaf children and from sign language. As cochlear implants for children grows, some schools now are integrating cochlear implants with sign language in their educational programs.

COST In U.S.A. the cost is from US$45,000 to US$125,000 In K.S.A. the cost if from SA 150.000 to SA 200,000

references Cochlear Implants & Cochlear Implant Technology." N.p.,Web. 11 Dec. 2014. "Cochlear Implants." Cochlear Implants. N.p., ASHA. Web. 11 Dec. 2014. "U.S. Food and Drug Administration." What Is a Cochlear Implant? N.p., n.d. Web. 10 Dec. 2014 Fehlig, Kami, Au.D. "Cochlear Implants & BAHA Candidacy, Criteria, & Outcomes." Cochlear C Hl I Implants L T An Overview (n.d.): n. pag.Http://www.aocoohns.org/. Web. "Cochlear Implants." Http://www.asha.org/. N.p., n.d. Web. "Cochlear Implants & Cochlear Implant Technology."Http://www.cochlear.com/. N.p., n.d. Web. "Cochlear Implants." Http://www.nidcd.nih.gov/. N.p., n.d. Web. Taormina-Weiss, Wendy. "Cochlear Implants – Facts, Benefits, and Risks."Disabled World. N.p., 28 Mar. 2012. Web. Berke, Jamie. "Cochlear Implants - Bilateral Cochlear Implants - For Both Ears." Http://deafness.about.com/. N.p., 14 July 2013. Web. Henshaw, Ashley. "The Pros And Cons of Cochlear Implants From SymptomFind.com." Symptomfind.com. N.p., 14 June 2012. Web. Awn, Abdullah. "150 ألفا تكلفة زراعة القوقعة." Makkah. N.p., 1 June 2014. Web. Stacey, Diane. "The Pros and Cons of Cochlear Implants." Livinghealthy. N.p., 13 Aug. 2007. Web.

Done by: Asma Alfassam Maram Abuassaf Mawahib Alnafea Sarah Almohanna Wejdan Alweheby