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Description
A cochlear implant is not a transplant in which an organ
is removed from the body of one person and placed into
another person's body. A cochlear implant is an artificial
device imbedded into the body, which through electrical
stimulation of appropriate nerve endings, allow the
body to function in an improved way.
More specifically, a cochlear implant is a small,
complex electronic device that can help to provide a
sense of sound to a person who is profoundly deaf or
severely hard of hearing. The implant is surgically
placed under the skin behind the ear. It is comprised
of an array of electrodes, implanted into the cochlea
of the inner ear, which transmit sounds to the auditory
nerve and then to the brain, with the help of a signal-processing
unit.
An implant has four basic parts:
- A microphone
(external), which picks up sound from the environment;
- A speech processor
(external), which selects and arranges sounds picked
up by the microphone;
- A transmitter and receiver/stimulator
(external), which receive signals from
the speech processor and convert them into electric
impulses;
- And electrodes
(internal; implanted into the cochlea of the inner
ear), which collect the impulses from the stimulator
and send them to the brain.
An implant does not restore or create normal hearing.
Instead, under the appropriate conditions, it can give
a deaf or severely hard of hearing person a useful auditory
understanding of the environment, facilitate improved
lip reading ability and help him or her to understand
speech combined or not with lip reading or sign language.
How Does A Cochlear Implant
Work?
A cochlear implant is very different
from a hearing aid. Hearing aids amplify sound. Cochlear
implants compensate for damaged or non-working parts
of the inner ear. When hearing is functioning normally,
parts of the inner ear convert sound waves in the air
into electrical impulses. These impulses are then sent
to the brain, where a hearing person recognizes them
as sound. A cochlear implant works in a similar manner.
It electronically finds useful sounds and then sends
them to the brain. Hearing through an implant may sound
different from normal hearing, but it allows many people
to communicate fully with oral communication in person
and over the phone.
Who Gets Cochlear Implants?
Cochlear implants are useful for people
receiving little or no assistance from hearing aids.
Different types of deaf and severely hard of hearing
people choose cochlear implants. Both children and adults
can be candidates for implants. According to the Food
and Drug Administration 2002 data, approximately 59,000
people worldwide have received implants. In the United
States, some 23,000 people have implants; about 13,000
are adults and 10,000 are children.
Adults who have lost all or most of their hearing
later in life can often benefit from cochlear implants.
These older candidates can often associate the sounds
made through an implant with sounds they remember. This
may help them to understand speech without visual cues
or systems such as lip reading or sign language.
Young children can also be candidates for implants.
In the United States, 12,000 babies a year are born
with some degree of hearing loss. Among those, it is
believed that 1/3 would benefit from a cochlear implant.
Cochlear implants, coupled with intensive post-implantation
therapy, can help young children to acquire speech,
language, developmental, and social skills. The best
age for implantation is still being debated, but most
children who receive implants are between 2 and 6 years
old. Earlier implantation seems to perform better.
How Does Someone Receive
a Cochlear Implant?
A cochlear implant is a surgical procedure. The decision
to receive an implant should involve discussions with
many medical specialists and an experienced surgeon.
Some may choose not to have a cochlear implant for a
variety of personal reasons. Also, though surgical implantation
is almost always safe, complications are a risk factor,
just as with any kind of surgery. An additional consideration
is learning to interpret the sounds created by an implant.
This process takes time and practice. Speech-language
pathologists and audiologists are the professionals
frequently involved in this learning process. Not everyone
performs at the same level with a cochlear implant.
Prior to implantation, all of these factors need to
be discussed.
Once an individual receives
an implant, is he or she finished with the process?
Wearing a cochlear implant is a lifetime
commitment, and requires the recipient to maintain and
care for the implant. After an individual receives the
implant, he or she must return to the center for a number
of follow-up services, including the fitting of the
external components of the implant; activating and programming
of the implant and its microphone, speech processor
and transmitter; necessary adjustments and reprogramming,
and annual check-ups. In addition, recipients must undergo
rehabilitation services with members of the team. Children
who are implanted often require years of extensive aural
rehabilitation whereas adults who have been implanted
due to acquired deafness may need fewer aural rehabilitation
sessions.
What types of professionals
compose the implant team?
Among the professionals who may work
as part of the cochlear implant team are audiologists,
speech-language pathologists, educators, surgeons, medical
specialists, psychologists and counselors.
What role do audiologists
and speech-language pathologists perform in the implant
process?
Audiologists are involved in many of
the components of the cochlear implant program, including
determining the candidacy of an individual for implantation,
as well as activating and programming of the speech
processor after surgery. Both audiologists and speech-language
pathologists provide aural rehabilitation services to
implant recipients to facilitate their ability to detect
and understand speech with the cochlear implant. Aural
rehabilitation services may include processes to enhance
communication, auditory training and speechreading,
training on the use and care of the implant, and support
of the needs of the recipient and family.
What Does the Future
Hold for Cochlear Implants?
The technology behind cochlear implants
is changing rapidly. With advancements in technology
and continued follow-up research with people who have
already received implants, researchers are evaluating
new opportunities and additional possible candidates
for cochlear implants.
For more information about the cochlear implant, consult
your ear, nose and throat physician, audiologist or
contact:
 Sources:
National Institute of Deafness and Other Communication
Disorders, 2002
Wayner, Donna S. 'Hear What You've Been Missing: How
To Cope With Hearing Loss.'
American Speech-Language-Hearing Association, 2002
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