Thursday, July 10, 2014

Cochlear Implants

I recently started the #CochlearImplant programs at #BangaloreMedicalCollege and at #NovaSpecialtySurgery
Was surprised that in spite of so many materials available online many patients were not aware of the process or whether they are an ideal candidate.
In fact I have seen patients who have not had hearing aids at all or have not been tried on hearing aids getting an implant and not using it/benefitting from it
Also most of them are also not aware that there have been two new companies and especially the Chinese implant.
More so the criteria are changing and my mentor and Director of the fellowship program and Director of Cochlear Implant program at University of Cincinnati is spearheading the Hybrid Cochlear Implant. But in all of these patients the underlying criteria is that hearing aids SHOULD NOT BE BENEFITING THEM.
I just recently submitted an article to an International Publication about the Challenges in Starting a Program in India
My readers will probably be the first to know that the Indian Implant is almost ready. Also for the first time the entire country and the International community would come to know about the specifics of our implant, including indigenous impedance and speech processors.
I had a detailed discussion with the designer and inverter of the implant Dr. Bhujanga Rao who is the
Distinguished Scientist & Director General (Naval Systems & Materials), DRDO,(Min of Defence) regarding this and he shared his thoughts.
Thought I will give a brief about who is an ideal candidate and also about the Indian implant.

As per American Speech Language Hearing Association:


Who is best suited for a cochlear implant?
It is generally agreed that the best adult candidates are those who:
  • Have severe to profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Have no other medical problems that would make the surgery risky
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading
  • Have lost their hearing after speech and language development
Children can be considered for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
It is generally agreed that the best child candidates are those who:
  • Have profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Are healthy and have no medical conditions that would make the surgery risky
  • Are involved (when able), along with their parents, in all the steps in the process
  • Understand (when able), along with their parents, their role in the successful use of cochlear implants
  • Have (when able), along with their parents, realistic expectations for cochlear implant use
  • Are willing to be actively involved in their habilitation/rehabilitation
  • Have support from their educational program to emphasize the development of auditory skills
Some Specifics of the Indian Implant:


Speech Processor: Relatively simple type of body worn 8 channel processor. The prototype weighs 200 gm but will be made more elegant and reduced weight when goes for production. To overcome the recurring cost it has rechargeable lithium batteries.
The material used for the internal electrode is Teflon coated platinum-iridium alloy. It is a monopolar implant with 12 active electrodes spaced at 0.7mm with an overall length of 23 mm achieving an insertional depth of 16mm.
Multicentric clinical trials are poised to start in late 2014 soon after clearance by the regulating authorities for Medical devices. It is likely to be priced at about 1.3-1.8 lakh, when compared to current ones which range from 5.68-11.5 lakhs, this will be a boon for all users.

The other implant which is already in the market is Chinese Nurotron, studies done have shown that speech after using this implant is comparable to that of the market leaders, this implant is priced between 6-6.5 lakhs. The specifics can be found here
The other implant which has proved its efficacy is Digisonic, information about it can be obtained here.

As you see patients have a choice to choose from. 
Herewith attaching a video of my #CochlearImplantSurgery
 



Who is best suited for a cochlear implant?
It is generally agreed that the best adult candidates are those who:
  • Have severe to profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Have no other medical problems that would make the surgery risky
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading
  • Have lost their hearing after speech and language development
Children can be considered for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
It is generally agreed that the best child candidates are those who:
  • Have profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Are healthy and have no medical conditions that would make the surgery risky
  • Are involved (when able), along with their parents, in all the steps in the process
  • Understand (when able), along with their parents, their role in the successful use of cochlear implants
  • Have (when able), along with their parents, realistic expectations for cochlear implant use
  • Are willing to be actively involved in their habilitation/rehabilitation
  • Have support from their educational program to emphasize the development of auditory skills
- See more at: http://www.asha.org/public/hearing/Cochlear-Implant/#sthash.wEmQPOQN.dpuf

Who is best suited for a cochlear implant?
It is generally agreed that the best adult candidates are those who:
  • Have severe to profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Have no other medical problems that would make the surgery risky
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading
  • Have lost their hearing after speech and language development
Children can be considered for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
It is generally agreed that the best child candidates are those who:
  • Have profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Are healthy and have no medical conditions that would make the surgery risky
  • Are involved (when able), along with their parents, in all the steps in the process
  • Understand (when able), along with their parents, their role in the successful use of cochlear implants
  • Have (when able), along with their parents, realistic expectations for cochlear implant use
  • Are willing to be actively involved in their habilitation/rehabilitation
  • Have support from their educational program to emphasize the development of auditory skills
- See more at: http://www.asha.org/public/hearing/Cochlear-Implant/#sthash.wEmQPOQN.dpuf
Who is best suited for a cochlear implant?
It is generally agreed that the best adult candidates are those who:
  • Have severe to profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Have no other medical problems that would make the surgery risky
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading
  • Have lost their hearing after speech and language development
Children can be considered for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
It is generally agreed that the best child candidates are those who:
  • Have profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Are healthy and have no medical conditions that would make the surgery risky
  • Are involved (when able), along with their parents, in all the steps in the process
  • Understand (when able), along with their parents, their role in the successful use of cochlear implants
  • Have (when able), along with their parents, realistic expectations for cochlear implant use
  • Are willing to be actively involved in their habilitation/rehabilitation
  • Have support from their educational program to emphasize the development of auditory skills
- See more at: http://www.asha.org/public/hearing/Cochlear-Implant/#sthash.N3HJM5XT.dpuf

Who is best suited for a cochlear implant?
It is generally agreed that the best adult candidates are those who:
  • Have severe to profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Have no other medical problems that would make the surgery risky
  • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speechreading
  • Have lost their hearing after speech and language development
Children can be considered for cochlear implants. Children as young as 14 months of age have received cochlear implants, and the potential exists for successful implantation at younger ages.
It is generally agreed that the best child candidates are those who:
  • Have profound hearing loss in both ears
  • Have had limited benefit from hearing aids
  • Are healthy and have no medical conditions that would make the surgery risky
  • Are involved (when able), along with their parents, in all the steps in the process
  • Understand (when able), along with their parents, their role in the successful use of cochlear implants
  • Have (when able), along with their parents, realistic expectations for cochlear implant use
  • Are willing to be actively involved in their habilitation/rehabilitation
  • Have support from their educational program to emphasize the development of auditory skills
- See more at: http://www.asha.org/public/hearing/Cochlear-Implant/#sthash.N3HJM5XT.dpuf



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