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Ear (aetiologic) assessment: Before implantation is performed, the otorhinolaryngologist, analyses the tympanum (the main cavity of the ear; between the eardrum and the inner ear) to establish tympanum and labyrinth (a complex system of interconnecting cavities; concerned with hearing and equilibrium), deviation (damage, disease, infection or obstruction) may endanger the procedure. |
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Hearing (audiology) assessment: The audiologist determines with specialized apparatus the existing, hearing abilities of the patient to establish that no alternative procedure or conventional devices be implemented successfully. |
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X-ray (radiography) assessment: Special X-rays, normally by CT, a method of examining body organs by scanning them with X rays and using a computer to construct a series of cross-sectional scans along a single axis or MRI scans, a method of examining body organs by using nuclear magnetic resonance of protons to produce proton density images, to evaluate the inner ear bone. |
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Psychological assessment: Psychological assessment to establish the mental endurance and adaptability of the patient to manage with the procedure and later the device and if pre-therapy is necessary. |
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Physical assessment: Your otorhinolaryngologist is obliged to establish any allergies relevant to anaesthetic agents and the desirability thereof by a thorough physical examination and to identify any potential problems that might endanger the patient and the successful conclusion of the procedures. |
This procedure takes approximately 1½ to 5 hours and is administered under general anaesthetic where the selected device is implanted surgically. To avoid infections a small area on the scalp, a little bit above and to the rear of the ear lope is shaved and with disinfection, cleaned. A minor incision opened the scull in this area and a small part of the scalp with surrounding tissue is lifted to drill through the outer scull bone, the mastoid bone and into the inner ear to expose the cochlea. The electrodes of the device is then tabularized placed in the cochlea to get the best results possible as earlier assessments have established. The procedure is considered as minor surgery and the receiver, if no complications occur, would go home on the day of the operation and is treated as an outpatient.
Surgical intervention goes together with a calculated probability of being exposed to an infectious agent, as with every medical procedure, and such risks include, harm to the equilibrium, infections to the skin, oncoming of tinnitus (singing in the ear), harm to the seventh cranial nerve that supplies facial muscles its functioning, or, in worst cases, facial disfiguring.
The incidence of mechanical failure of the cochlear implant is about 2%. Successful re-implantations is a possibility and this should not be a deterring factor.
The surgical intervention also may harm any residual hearing quantity that was present before the procedure, resulting in single implantations being mostly advised.
The implant is activated after an appropriate period of healing, but seldom exceeds 4 weeks and because of rehabilitation and the necessary learning experience needed, results are not immediate. As post-implantation therapy progresses, the brain assimilates new stimulation to audible sound and depending on the individual's prognosis and ability, cochlear implants could change the quality of a user's life quality dramatically.
Speech therapy and audiometry training in hereditary and congenitally Deaf children, normally will carry on for a prolonged period, but compared to any learning curve, it is not that much different from any schooling. The ability to use the full potential must come by experience, assimilation, stimulation and interpretation and the family's participation of the child is critical to a successful outcome. It plays a crucial role to enable them to develop spoken language. Babies on the other hand, in a very short period of time, due to the brain organ's natural delayed development will adapt very early to stimulation and the acquisition of sound and language. This is the reason why it is advised to have the procedure as early as possibile if the correct prognosis is made.
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