Bıonıc ear (cochlear ımplantatıon)
What is a bionic ear and to whom is it applied?
Cochlear implant is a device that is applied in cases of congenital or subsequent hearing loss where the hearing aids are insufficient and in cases of advanced and very advanced hearing loss (where the hearing loss exceeds 70-80 dB). These devices convert sounds coming from the outside into electrical impulses and send them directly to the auditory nerve in the inner ear. Thus, they are perceived by the brain as sound.
Children with congenital hearing loss should be diagnosed early and start using hearing aids in the first 6 months. Cochlear implant application can be done from 9 months of age. Ideally, the implant application process should be performed at the closest time to the age of one. The longer the age of implant application is delayed in children with congenital hearing loss (especially after the age of 5), the less efficiency from the device.
Cochlear implantation can also be applied to adult patients if severe-to-profound hearing loss develops in any period of life after speech development is completed.
Can cochlear implant surgery be applied to every ear?
In order to this surgery to be performed, the inner ear structure must be sufficiently developed and the auditory nerve must be present. Ear tomography and MRI scans should be performed before surgery in order to detect them. These screenings also give an idea about which ear would be more appropriate to apply an implant (This is important especially in patients who will be performed an implantation in a single ear). It is not possible to apply a cochlear implant in cases where the inner ear structure is not developed or the auditory nerve is absent. In such cases, different surgical procedures called brainstem implantation and types of implants are applied.
How is the operation process?
The duration of the operation is about 2-3 hours, depending on the experience of the surgeon who will perform the procedure and the anatomical structure. Surgery starts with a 4-5 cm incision made behind the auricle and is completed by placing the inner part of the implant in the inner ear after the ear bone is removed. During the surgery, some measurements are made and it is determined that the device is placed in the right place and is in working condition. After all these are provided, the incision is closed and postoperative dressings are made. During the surgery, some measurements are made and it is determined that the device is placed in the right place and is in working condition. After all these are provided, the incision is closed and postoperative dressings are made.
What are the advantages of applying cochlear implantation to the both ears?
Especially in congenital hearing loss and childhood severe to profound hearing loss, the application of cochlear implantation to both ears is very important in terms of providing sound depth and determining the direction of the sound. In addition, for any reason, situations such as temporary malfunction in one of the implants, damage due to trauma, and dysfunction due to infection may occur. In this case, the presence of an implant working in the other ear means that the child will not be deprived of sound until the defective device is revised or re-implanted. Because revision-re-implantation processes can sometimes take months.
How should training processes be after surgery?
Post-implantation process requires a long effort. Before the operation, the child and his family should be prepared for implantation, and the family should continue to follow up regularly for the adjustment of the device, the development and education of the child after the operation. After implantation, patients, especially pediatric patients and their families should be trained intensively by experts. In these trainings, adaptation to the cochlear implant device, learning to listen to new sound stimuli, making sense of these stimuli and transferring them to speech development are developed. The best educational environment is home and family environment. For this reason, the support of the family and relatives is very important in rehabilitation. The duration of the training varies depending on whether the patient has a congenital or acquired hearing loss, whether he used a hearing aid before implantation, receiving speech training and family support.
The rehabilitation program for adults includes speech understanding training, listening training and the participation of family members in rehabilitation.
Prof. Dr. Özcan Öztürk – Ear Nose Throat Diseases
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