Cochlear Implant Surgery at World Class Hospitals in India

A cochlear implant is an electronic device that can restore useful hearing and provide improved communication abilities for persons who have severe to profound sensorineural hearing loss (nerve deafness) and who cannot benefit from hearing aids.

How is an Implant different from a hearing aid?

Cochlear implants differ from hearing aids in two important ways:

• Hearing aids simply amplify sounds. A cochlear implant, on the other hand, transforms speech and other sounds into electrical energy that is used to stimulate the hearing nerve in the inner ear.
• Unlike most hearing aids, cochlear implants have both internal and external components. The implant system consists of an external speech processor and headset (worn behind the ear) and an internal, surgically placed implant consisting of a receiver/stimulator package with an electrode array.

How does the Cochlear Implant Work?

For people who are cochlear implant candidates, the outer ear and the middle ear function normally. However, in the inner ear (cochlea), the tiny hair cells are damaged or missing and do not generate electrical pulses to be sent to the hearing centres of the brain. Therefore, the brain does not perceive the sound.

The cochlear implant attempts to replace the function of the hair cells with electrical stimulation. The device is comprised of an externally worn ‘speech processor’ and an internal ‘implant’ comprising the receiver stimulator and electrode array. Sounds are picked up by the microphone of the speech processor. The speech processor analyses and codes sounds into electrical pulses. These pulses are sent to the surgically implanted receiver/stimulator package and through to the electrode array, which stimulates the residual nerve fibres in the cochlea. The hearing nerve then sends these electrical pulses to the brain and which are finally interpreted as sound.

Who can benefit from Cochlear Implant Surgery in India?

Any adult or child with bilateral (both ears) severe to profound sensorineural (nerve) hearing loss who obtains little or no benefit from hearing aids would be considered a candidate for a Cochlear Implant Surgery in India. Such deafness may be acquired following infection (such as meningitis), toxic effect of ototoxic drugs, trauma or age associated hearing loss. Some children may be born with deafness. Such congenital hearing impairment is not uncommon with 2 to 3 out of every 1000 live births are born with significant hearing loss. Such children need to be identified at the earliest. This ensures that appropriate measures are undertaken to rehabilitate their hearing loss at a time when language skills can most easily be acquired. Many of these children may eventually require a cochlear implant.

Before Cochlear Implant Surgery in India

There are various factors that need to be taken into consideration prior to Cochlear Implant Surgery in India. Patients who may be candidates for cochlear implantation would have met with their audiologist – speech therapist and ENT(Hearing implant) Surgeon. We often ask for input from other professionals in the team such as developmental paediatrician, neurologist, psychologist, education specialist etc. and the team would help decide the best option for the candidate.

1. Complete audiological and speech assessment and trial with hearing aids. We need to know the severity and nature of the hearing loss, level of speech and language and the degree of benefit one gets with current hearing aids.
2. Imaging – CT and MRI scanning of the ears and brain. We need to see the structure of the ears and the condition of the inner ear, hearing nerves and brain.
3. Routine preoperative blood tests for anaesthesia. Patients would also be seen by a physician or paediatrician (in the cases of children) to ensure they are fit for general anaesthesia. All candidates need to be vaccinated (against H.influenza, Pneumococcus and Meningococcus) to reduce the risk of infections.
4. Deciding the choice of implant – We have expertise in implanting all makes and models of implants. The various brands and models are detailed below. There are four companies that manufacture cochlear implants. Some offer different models depending on levels of technology used in the type of internal implant or the external processor.

Cochlear Implants, Auditory Brainstem Implants & Bone Anchored Hearing Aids

Trained at the National Centre for Cochlear Implantation (UK) since 1995 and thus have extensive experience in management of deafness with cochlear implantation.

The above experience has empowered me to set up the cochlear and hearing implant programme (for children and adults) in Delhi NCR. Have a series of over 400 cochlear implant procedures in the last 5 years.

Also provide Bone Anchored Hearing Aids (BAHA) and Vibrant Soundbridge middle ear implants as options for patients with hearing loss. Am one of the first surgeons in India to have independently carried out Auditory Brainstem Implantation, in both child and an adult.

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