What Are Cochlear Implants?
An electronic device called a cochlear implant is used to enhance hearing. For those who are unable to hear effectively with hearing aids and have significant hearing loss due to inner ear damage, it may be an alternative.
A cochlear implant bypasses damaged areas of the ear to transmit sound impulses to the hearing (auditory) nerve, in contrast to hearing aids, which enhance sound. A behind-the-ear sound processor is used with cochlear implants. The receiver is implanted beneath the skin behind the ear to receive the sound waves captured by the processor. Electrodes inserted in the cochlea, the snail-shaped inner ear, receive signals from the receiver.
The auditory nerve receives the impulses and forwards them to the brain. Although the sounds produced by the brain are not exactly like those produced by natural hearing, they are nonetheless sounds.
Understanding how to decipher the signals from a cochlear implant requires practice and patience. Most cochlear implant users see significant improvements in speech comprehension within three to six months of using the device.
How Is the Cochlear Implant Surgery Done?
Before the Procedure
A child will have a comprehensive medical evaluation for cochlear implant surgery before the procedure. To determine the state of the cochlea and inner ear anatomy, this evaluation may include imaging tests like computed tomography (CT) or magnetic resonance imaging (MRI) scans, hearing, speech, and balance tests, and a physical examination. Based on each person's demands, the best cochlear implant will be chosen in collaboration with an audiologist and a surgeon. There are options for implants with external units behind the ear or attached to the head, and work is being done to develop fully implanted systems.
During the Procedure
To make room for the internal device, the surgeon will first make a tiny incision behind the ear and a small hole in the mastoid bone of the skull. After that, they delicately thread the internal device's electrode through a tiny opening and into the cochlea. When the incision is closed, the internal device is guaranteed to be securely positioned beneath the skin.
After the Procedure
After surgery, an individual or child can feel pressure or discomfort around the implanted ear for a short while. One might also feel lightheaded or sick. Nonetheless, most patients feel well enough to go home the same day as the procedure. The cochlear implant will then be turned on by an audiologist, who will start getting used to and acclimated to it.
What Are the Complications of Cochlear Implant Surgery?
Although cochlear implant surgery is usually considered safe, some risks and potential consequences are associated with any medical operation.
Among them are:
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Loss of Residual Hearing: In certain cases, the device implantation may cause the implanted ear to lose any residual natural hearing. The implant's location and the stimulation it gives the auditory nerve may be to blame for this.
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Meningitis: An uncommon but potentially dangerous side effect of cochlear implant surgery is inflammation of the membranes encircling the brain and spinal cord. Adults and children alike are usually vaccinated before implantation to reduce this risk. Less than 1 in 1,000 individuals with cochlear implants may experience meningitis after implantation, which is an extremely uncommon occurrence.
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Infection: Following cochlear implant surgery, infection is one of the most frequent consequences. There is always a chance that germs will get into the surgical site despite strict sterile procedures, which could result in localized irritation and even implant failure. Increased discomfort, redness, swelling, and drainage from the incision site are all possible signs of an infection. Timely medical intervention is essential to avoid more complications.
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Device Failure: While rare, the internal device can break down over time and require surgery to replace or repair. Over an extended period, less than 5 percent of people experience this.
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Facial Nerve Injury: The cochlea is situated near the facial nerve, which regulates facial movement. There is a slight chance that this nerve will be damaged during surgery, resulting in temporary or permanent facial paralysis or weakening. To reduce this danger, careful surgical technique and monitoring are necessary.
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Tinnitus: Following cochlear implant surgery, some people may develop tinnitus, or ringing in the ears. Although the precise reason for the tinnitus in these situations is unknown, it might be connected to the implant's auditory nerve stimulation. Some patients may experience unpleasant tinnitus, but as the brain adapts to the new auditory information, tinnitus frequently improves with time.
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Vertigo and Dizziness: Following cochlear implant surgery, vestibular disturbances such as vertigo and dizziness may manifest, particularly in those with comorbid balance disorders. These are usually transient symptoms that go away in a few weeks or months as the vestibular system becomes used to the implant.
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Spinal Fluid Leak: The term "spill fluid" describes the inadvertent release of cerebrospinal fluid, the transparent substance that envelops the brain and spinal cord from the surgical site. This problem can happen after having surgery, such as a cochlear implant treatment. Depending on where the leak is, a spinal fluid leak may appear as clear fluid dripping from the ear or nose. Some symptoms are headaches, nausea, vomiting, a stiff neck, and a salty taste in the mouth.
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Balance: One possible complication after cochlear implant surgery is balance issues for certain people. Symptoms of these balance problems include lightheadedness, shakiness, and trouble staying balanced. Although balance issues are not a common postoperative consequence, it is vital to be aware of this possibility. Since the inner ear is so important to balance, the surgery to implant the device may unintentionally damage balance-related tissues, which could result in balance problems that are either transient or, very rarely, chronic.
Conclusion
Even though cochlear implant surgery can significantly improve the lives of those suffering from profound hearing loss, hazards are involved. Patients thinking about getting a cochlear implant should assess the possible risks against the expected advantages and discuss any potential issues with their medical professionals. Many issues can be avoided or successfully handled with appropriate surgical technique, close observation, and postoperative care, improving patient quality of life and communication.
