Hearing loss treatments for children

Almost all childrens hearing problems can be treated, even if they have severe or profound hearing loss. As a parent, you are likely to be feeling anxious if your child has a hearing problem. You might be reassured to know that, with the right hearing treatment, even a profoundly deaf child can hear, learn spoken language, be a proficient communicator and live a full life. If your child has been diagnosed with a hearing loss, your hearing health professional can tell you what is the best solution for their unique hearing needs. 1. Cochlear implants : For children with a severe to profound sensorineural hearing loss who receive little or no benefit from hearing aids. 2. Bone conduction implants : For children with conductive hearing loss, mixed hearing loss or single sided deafness. 3. Hearing aids : For children with a mild-to-moderate sensorineural hearing loss.

Cochlear implant
What is a cochlear implant?
A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain Hence, this artificial hearing device is designed to produce hearing sensation by electrical stimulation of nerves inside the inner ear. Also known as Bionic Ear, the implant comprises of two parts: an external portion that sits behind the ear and the internal portion which is surgically planted under the skin. The cochlear implant surgery is of great help to those with impaired hearing.

Essentially, an implant has four major parts:

* a microphone, which picks up sounds and amplifies them * a speech processor, which processes and arranges the sounds * a transmitter, which receives signals from the processor and converts them to electrical impulses

* an electrode array, which collects the impulses and sends them to different regions of the auditory nerve...

Who can they help?

Cochlear implants can help people who: have moderate to profound hearing loss in both ears receive little or no benefit from hearing aids score 50% or less on sentence recognition tests in the ear to be implanted score 60% or less in the non-implanted ear or in both ears with hearing aids Many people have cochlear implants in both ears (bilateral). Listening with two ears can improve your ability to identify the direction of sound and separate the sounds you want to hear from those you dont.

How do they work?

Many people suffer hearing loss because they have damage to hair cells in the inner ear or (or cochlea). If some hearing nerves still work, a cochlear implant can allow you to hear. Heres how

1. A sound processor worn behind the ear or on the body, captures sound and turns it into digital code. The sound processor has a battery that powers the entire system 2. The sound processor transmits the digitally-coded sound through the coil to the implant 3. The implant converts the digitally-coded sound into electrical impulses and sends them along the electrode array placed in the cochlea (the inner ear) 4. The implant's electrodes stimulate the cochlea's hearing nerve, which then sends the impulses to the brain where they are interpreted as sound.

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 implanted receiver/stimulator package with an electrode array.

Who Can Benefit From Cochlear Implants?

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. 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 1 to 2 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.

Limitation
It is important to note that a Cochlear implant does not restore normal hearing. Instead, it provides a deaf person a useful representation of sounds in the environment to help him or her understand them. The Bionic Ear can help young children who are to acquire speech, language and social skills. Most adults who have lost all or most of their hearing can also benefit from the Cochlear implants.

Who Benefits From A Cochlear Implant ?

Cochlear implants can help patients with severe to profound sensorineural hearing loss in both ears who cannot benefit adequately from the use of hearing aids. People of all ages can qualify, from age 1-100. The ideal candidate has hearing loss of short duration. In children born with

deafness, early implantation is preferred, so that they may experience speech sounds in time to begin learning language before the age of 2-3. In special cases, implantation may be performed on patients with long-term deafness.

Procedure of Cochlear Implant Surgery at Hospital in India

The implantation surgery lasts about 2-3 hours and is performed under general anesthesia. The electrode array is fitted into the cochlea while the receiver or stimulator is secured to the skull. The success of operation is tested by checking the functionality of the processor and taking an Xray to ensure that the device is positioned correctly. Typically, patients remain in the hospital for two nights. They have a bandage on their head which is removed after a few days. Patients return to school or work as soon as they feel well enough to do so, usually within a week of surgery.

Follow-Up and Rehabilitation after Cochlear Implant Surgery at Hospital in India

Rehabilitation is essential for those who have undergone Cochlear implants and can be imparted at their hospital and auditory rehabilitation centers. The patient needs to know learning and relearning techniques. Hearing through Cochlear implant is very different from normal hearing or hearing through hearing aids.

Cost
In the United States, medical costs run from US$45,000 to US$125,000; this includes evaluation, the surgery itself, hardware (device), hospitalization and rehabilitation. Some or all of this may be covered by health insurance. In the United Kingdom, the NHS covers cochlear implants in full, as does Medicare in Australia, Seguridad Social in Spain and Israel. According to the US National Institute on Deafness and Other Communication Disorders, the estimated total cost is $60,000 per person implanted. A study by Johns Hopkins University determined that for a three-year-old child who receives cochlear implants can save $30,000 to $50,000 in special-education costs for elementary and secondary schools as they are more likely to be mainstreamed in school and thus use fewer support services than similarly deaf children.

Risks and disadvantages

Some effects of implantation are irreversible; while the device promises to provide new sound information for a recipient, the implantation process inevitably results in shaving of the hair cells within the cochlea,which can result in a permanent loss of some or all residual natural hearing. While recent improvements in implant technology, and implantation techniques, promise to minimize such damage, the risk and extent of damage still varies. Still, the cause of deafness is not always identified before the surgery. It is possible but rare that the surgery does not restore hearing at all.

In addition, while the device can help the recipient better hear and understand sounds in their environment, it is not as robust as the quality of sound processed by a natural cochlea. The main factor in success is with the age of recipient. While cochlear implants restore physical ability to hear, this does not mean the brain can learn to process and distinguish speech if the recipient has passed the critical period of adolescence. As a result, those born profoundly deaf who receive an implant as an adult can only distinguish simple sounds,[citation needed] such as a ringing phone vs. a doorbell, while others who receive implants early can understand speech.The success rate depends on a variety of factors, most critically the age of recipient but also the technology used and the condition of the recipient's cochlea. Rarely, necrosis has been observed in the skin flaps surrounding cochlear implants.Hyperbaric oxygen has been shown to be a useful adjunctive therapy in the management of cochlear implant flap necrosis. As the location of the cochlea is close to the facial nerve, there is a risk that the nerve may be damaged during the operation. The incidence of the damage is infrequent. There are strict protocols in choosing candidates to avoid risks and disadvantages. A battery of tests is performed to make the decision of candidacy easier. For example, some patients suffer from deafness medial to the cochlea - typically vestibular schwannomas. Implantation into the cochlea has a low success rate with these people, as the artificial signal does not have a healthy nerve to travel along. Historically, patients with severe congenital anatomic anomalies of the cochlea were considered poor candidates for cochlear implantation. Many studies since the 1980's have demonstrated successful hearing outcomes after CI in this group.