We asked ENT (Ear, Nose and Throat) specialists at Hisar Hospital Intercontinental to answer common questions about the Cochlear Implant, also known as the 'Bionic Ear'.
What is a Cochlear Implant (Bionic Ear)?
The Cochlear Implant, also known as the 'Bionic Ear', is an internal ear prosthesis fitted through surgery, designed to help people with severe or profound hearing loss who do not benefit sufficiently from hearing aids or for whom hearing aids are no longer adequate. The bionic ear system has two parts. The first is the internal part of the implant, which is placed inside the inner ear during an operation lasting 2 to 4 hours. The second part is the external part, worn behind the ear, which contains the microphone that picks up speech, the sound sensitivity unit and the sound adjustment control. Sounds are picked up by the microphone in the external part and converted into electrical signals, which are sent to the speech processor. Here they are encoded and transmitted via radio waves through the skin to the implant. A series of electrical stimuli is then sent to the electrodes of the implant located in the cochlea (snail-shaped organ). In this way, the auditory nerve receives these stimuli and conveys them to the brain. The brain perceives these signals as sound.
Who can benefit from this procedure?
Children aged 0 to 5 years and adults who have experienced hearing loss, whether congenital or acquired,
Those whose hearing loss results solely from a problem in the inner ear and who cannot obtain adequate speech understanding with hearing aids,
Adults who lost their hearing after an illness, surgery or accident while they still had hearing ability,
Those with a loss of 95 dBHL or greater,
People with severe, profound and total hearing loss may benefit from this procedure.
For whom is this procedure not suitable?
If a well-fitted hearing device provides the person with sufficient speech and comprehension ability,
If severe hearing loss has been present for a very long time,
If the main cause of hearing loss is not the cochlea,
If the cochlea is too damaged to accept the electrodes, or the auditory nerve is damaged or absent,
If the person is not healthy enough to tolerate anaesthesia and surgery, a Cochlear Implant is not suitable.
What are the benefits of a Cochlear Implant?
Hearing everyday sounds: Cochlear implant users may gain a greater ability to hear environmental sounds. This gives the person a better chance to connect more closely with their surroundings.
Understanding speech: Although this may take some time in children, speech sounds become understandable. The ability to hear what is being said is especially helpful for those who lip-read and greatly facilitates communication in daily life for most users.
Improving and refining speech: Implant users can gradually correct their own speech by hearing their own voice and the speech of others.
Listening in noisy environments: Thanks to rapid warning capacity and an advanced speech processor, speech can be understood in noisy environments.
How is Bionic Ear (Cochlear Implant) surgery performed?
For a candidate who is fit for surgery in every respect, the Cochlear Implant operation takes approximately 2 to 4 hours under general anaesthesia. The risks of the operation are comparable to those of other ear operations. A space for the implant is created in the bone behind the ear. A small opening is made into the inner ear. The electrode carrier is inserted into the cochlea (inner ear). The electrode carrier and implant package are secured. The electrode function is tested before the wound is closed. Patients usually experience no discomfort when they wake up. If needed after surgery, painkillers are given, and protective antibiotic treatment is given to reduce the risk of infection. Patients who get up on the same day are generally discharged from hospital after 3 to 5 days.
How does hearing with a cochlear implant work?
The speech processor, custom-prepared for the person by an audiologist, is fitted 3 to 6 weeks after the operation. The programme of the speech processor, which is connected to a computer, includes settings for the timbre, loudness and timing of sound. The computer transmits the signals it generates at controlled levels to the user via the speech processor. The lowest sound level the user can hear (threshold level) and the highest sound level that is not uncomfortable (most comfortable level) are determined. These two levels are set separately for all electrodes within the cochlea. In this way, sounds are heard without causing discomfort to the patient. This programme is readjusted in subsequent sessions. During the follow-up process, the user and their family must strictly follow the follow-up programme arranged by the cochlear implant team in order to achieve the greatest benefit.
