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The Scoop on Cochlear Implants
Incredible Technology, but Not a Cure-All
I would say most people — or at least, most people with hearing loss — have heard of cochlear implants. These devices, which are an alternative to traditional hearing aids, are an incredible piece of technology. They allow us to address hearing loss in patients for whom it would be impossible otherwise, increasing the number of patients who can be treated effectively. However, they are not a magic solution akin to flipping a light switch for hearing. It’s important for patients to understand the true nature of cochlear implants rather than expect a miracle. By some quirk of medical terminology, the cells within the cochlea that receive and transmit sound to the brain are called hair cells. These hair cells, which have no relation to the follicular hair, are the conduits from the hearing apparatus to the nerves and brain. When these cells are ruptured and don’t work, traditional hearing aids will not provide the patient with any restoration. We can drive the sound to the cochlea, either acoustically or via electromagnetic conduction, but it’s all for naught if the hairs don’t relay the message. Rather than trying to interact with the hair cells at all, a cochlear implant bypasses them entirely. A cochlear implant sends electrical signals directly to the auditory nerve. Somebody’s hearing organ could be entirely compromised, and
a cochlear implant could still be a viable option to restore sound. These devices come in two parts, an outside component, which is normally worn on the back of the head, and the actual implant itself, which is placed under general anesthesia and has a visible component about half the size of a dime. While the surgery to implant a device is routine and minimally invasive, it is not a cure-all in itself. Like a traditional hearing aids, a cochlear implant requires education At first glance, a cochlear implant can sound like a silver bullet. You mean my hearing loss, no matter how severe, can be treated? You’re telling me we can stimulate the auditory nerve directly, thereby eliminating the need for amplification? Sign me up, right? Well, yes and no. A cochlear implant is a remarkable piece of technology, but it doesn’t work miracles. The doctor providing a cochlear implant needs to educate the candidate on the challenges they will face. When someone first wears a cochlear implant, they have to learn to hear in an entirely new way. They’re going from acoustical hearing, which they’ve done their entire life, to electrical hearing, an entirely new cognitive process. Learning this new process is difficult, causing people new to cochlear implants to complain of disorientation and difficulty comprehending speech. and diligence on the part of the patient in order to be effective.
These difficulties are perfectly normal, but if the patient doesn’t expect them, they can be extremely discouraging. In a process not dissimilar to physical therapy, cochlear implant patients have to “work out” their new hearing system. Cochlear implant candidates should go into the process with complete awareness of the challenges they’ll face after surgery. They are not going to wake up with the volume turned back up and the clarity tuned to perfection. If they expect that, they’re in for a very rude awakening. When patients expect a cochlear implant to do something it cannot, frustration and disillusionment can mount. I like to tell patients that the day they get their implant is akin to their wedding day. The day you become a candidate and decide to go forward, you’re engaged to that implant. Before the wedding day, you should get to know that implant as well as you can. And like a marriage, the success of your relationship doesn’t depend on what happens on your wedding day. Success comes from the work you
put in day in, day out to ensure your relationship lasts.
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