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Cochlear Implants

Written by Arshia Shahrodizadh

What are they?

What are Cochlear Implants?

  • Cochlear implants are small electronic devices that stimulate the cochlear nerve in the ear

The implants consist of:

Parts

  • A microphone
  • A speech processor
  • A transmitter and receiver
  • An electrode array

How do they work?

  • These implants aim to bypass the damaged portions of the ear, and instead directly stimulate the auditory nerve found in the ear

How do they work?

Cochlear implants:

  • Differ from normal hearing
  • Improve hearing loss
  • Allows individuals to recognize warning sounds and speech

Who gets them?

What individuals benefit from them?

  • Individuals who are deaf or severely hard of hearing
  • Both children and adults
  • Those who have lost hearing later in life can also benefit

As of 2019:

  • There are 736,900 registered cochlear implants implanted worldwide
  • In the United States there are 118,100 implanted in adults & 65,000 in children

Who cannot get them?

Who cannot get them?

Those whose deafness is due to injury, and individuals who are born without auditory nerve fibers.

Current Issues

Current Issues

Individuals with cochlear implants may hear sounds differently, as reported by those who could hear before they became deaf.

Meningitis

This is an infection that may occur in the lining of the surface of the brain. Some individuals are at a greater risk, if they have abnormally formed inner ears.

Perilymph leak

There is fluid inside the inner ear, which can leak as a result of the hole that is created to place the cochlear implant.

Cost

By far the most reported issue is cost

  • These implants cost from $30,000 to $50,000 for both ears without insurance
  • Some insurance companies will not cover the cost
  • There are cheaper alternatives that albeit do not work as well, such as hearing aids

How long they last

Cochlear implants are meant to last an entire lifetime, but there have been many cases in which they fail.

About 5-7 percent of children will experience device failure, and 1-3 percent of adults

What can be worked on ?

Looking to the future

Cost, duration of implants, and effectiveness are the main points being worked on by the NIDCD, or the National Institute of Deafness and Other Communication

Surgical error is not common and has become less of a problem as Cochlear implants become more common in those hard of hearing

Effectiveness

Cochlear implants effectiveness at transmitting sound are being improved on several fronts, with researcher Dr. Ruffin stating his big five as:

  • Device size
  • Adapting hearing aid noise reduction algorithms
  • Electrode design
  • Speech processing strategies
  • Patient Selection

Cost

  • Currently, Cochlear implants are labeled as expensive by the hard of hearing community
  • Other options exist such as hearing aids which are much cheaper, ranging from $2000-$6000

Can anything be done?

The main reason for the mass expense is that brain surgery is essentially being done to implant the device.

The surgery is done inside the skull and can be dangerous if not performed correctly (leaks, tears, etc.)

Thus medical professionals, are skeptical of prices going down in the near future

Implant failure

Failure is usually cased by two main reasons:

  • Electrodes not being placed correctly in the skull. This causes shifting which will damage the electrodes.
  • Failure within the device itself

Solution

Electrode placement is advancing at an amazing rate. Researchers have developed interactive models which are used to train surgeons on placement. This has been shown to be an important development

In the case of device failure, Implants are now able to be replaced, allowing a new and functioning piece to be re-implanted

Works Cited

References

1. Center for Devices and Radiological Health. “Benefits and Risks of Cochlear Implants.” U.S. Food and Drug Administration, FDA, https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants.

2. “Cochlear Implants.” National Institute of Deafness and Other Communication Disorders, U.S. Department of Health and Human Services, https://www.nidcd.nih.gov/health/cochlear-implants.

3. “Cochlear Implants 101: Commonly Asked Questions.” Texas Children's Hospital, https://www.texaschildrens.org/blog/2014/09/cochlear-implants-101-commonly-asked-questions.

4. Victory, Joy. “Cochlear Implants: What Are They and How Do They Work?” Healthy Hearing, 28 June 2021, https://www.healthyhearing.com/help/hearing-aids/cochlear-implants.

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