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Cochlear implant

A cochlear implant is a small, complex electronic device that can help provide a sense of sound to a person who is severely deaf or severely hard of hearing. The implant consists of an external part that is behind the ear and a second part that is surgically placed under the skin (see picture). An implant has the following parts:

  • A microphone that picks up sound from the environment.
  • A speech processor that selects and arranges sounds picked up by the microphone.
  • A transmitter and receiver / stimulator, which receive signals from the speech processor and convert them into electrical impulses.
  • An electrode array, a group of electrodes that receives impulses from the stimulator and sends them to different parts of the auditory nerve.

An implant does not restore normal hearing. Instead, it can provide a deaf person with a useful representation of sounds in the environment and help him or her understand speech.

How does a cochlear implant work?

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 parts of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent through the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant is different from normal hearing and it takes time to learn or relearn. However, it allows many people to recognize warning signals, understand other sounds in the environment, and understand speech in person or over the phone.

Who Gets Cochlear Implants?

Children and adults who are deaf or severely hard of hearing can be adjusted for cochlear implants. As of December 2012, approximately 324,200 registered devices have been implanted worldwide. In the United States, approximately 58,000 devices have been implanted in adults and 38,000 in children. (Estimates provided by the US Food and Drug Administration [FDA] as reported by cochlear implant manufacturers.)

The FDA first approved cochlear implants to treat hearing loss in adults in the mid-1980s. Since 2000, cochlear implants have been approved by the FDA for use in eligible children from the age of 12 months. For young children who are deaf or severely hard of hearing, the use of a cochlear implant at an early age exposes them to sounds during an optimal period of time to develop speech and language skills. Research has shown that when these children receive a cochlear implant followed by intensive therapy before they are 18 months old, they are better able to hear, understand and speak sound and music than their peers who receive implants as they get older. to be. Studies have also shown that eligible children who receive a cochlear implant before they are 18 months old develop language skills at a rate comparable to that of children with normal hearing.

Some adults who have lost all or part of their hearing later in life may also benefit from cochlear implants. They learn to associate the implant's signals with sounds they remember, including speech, without the need for visual cues, such as those of lip reading or sign language.

How does someone get a cochlear implant?

The use of a cochlear implant requires both surgical intervention and significant therapy to learn or relearn hearing. Not everyone performs at the same level with this device. The decision to receive an implant should be discussed with medical specialists, including an experienced cochlear implant surgeon. The process can be expensive. For example, a person's health insurance can cover costs, but not always. Some people may choose not to have a cochlear implant for a variety of personal reasons. Surgical implantations are almost always safe, although complications are a risk factor, as with any type of surgery. An additional consideration is learning to interpret the sounds created by an implant. This process takes time and practice. Speech therapists and audiologists are regularly involved in this learning process. All these factors must be considered prior to implantation.

What does the future look likeout for cochlear implants?

The NIDCD supports research to increase the benefits of cochlear implants. Scientists are investigating whether the use of a shortened electrode array inserted into part of the cochlea can help people whose hearing loss is limited to the higher frequencies, while preserving their lower frequency hearing. Researchers are also looking at the potential benefits of pairing a cochlear implant in one ear with another cochlear implant or a hearing aid in the other ear.

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