In the Russian Federation, according to statistics, live about 12 million people with different hearing impairments.Hard of hearing and people with profound hearing loss experience a number of difficulties in the normal daily life.This limits their opportunities and participation in public life.A particularly negative impact on the person manifests in those people who are born with normal hearing, and later due to some circumstances completely deaf, or hearing fell sharply.
designed for the hearing impaired hearing aids.Most patients use them, but sometimes they use gives very little effect.In the case of patients with sensorineural hearing loss may help cochlear implant.To understand how it works, to begin with a look at how the ear works and why we hear, as well as briefly the kinds of hearing loss.
Why do we hear?
Sound is conducted through the outer and middle ear.The sound wave vibration leads to the eardrum.Then it transmits this vibration to a chain of auditory ossicles - a hammer, anvil and stirrup.
From stapes, which is in the end of the chain of the middle ear ossicles, fluctuations take place in the cavity of the inner ear.It is shaped like a snail and is filled with liquid.In this cavity are sensitive hair cells that convert mechanical vibrations into nerve impulses.These pulses are delivered to the brain by the auditory nerve, there is the formation and perception of sound images, which we hear.
Why is hearing loss?
Hearing problems occur, if at some stage of the sound disturbances occurred.So if irreversibly damaged sensory hair cells of the inner ear as a result of any injury or illness that develops complete deafness.It can be postlingvalnoy, if at the time of deaf children have learned to speak, or prelingvalnoy - if the speech he has not yet mastered.
Types of hearing loss
Features hearing loss have their own classification, which is determined by the degree of localization and the occurrence of deafness.
According to the degree of hearing loss are divided into total deafness and hearing loss, if the perception of sound occurs, but it is difficult.Hearing loss is:
- sensorineural;
- conductive;
- mixed.
Sensorineural is due to hearing problems resulting from disorders of the inner ear or auditory nerve conduction.The extent of such violations range from mild to total deafness.
Conductive hearing loss occurs due to problems encountered in the outer or middle ear because of which the conductivity of sound vibrations is broken and they are distorted, or not come at all conducted to the inner ear.This may damage the eardrum, sulfuric lid, etc.
By age onset of these problems can be:
- birth;
- prelingvalnye;
- postlingvalnye.
Localization deafness may be distributed in one ear or both, then, it is called binaural hearing loss.
Indications for cochlear implant cochlear implants
shown in the following cases:
- With profound sensorineural bilateral deafness.
- At low threshold of perception in the case of audio devices in the binaural hearing aids.
- In the absence of speech perception in the case of optimally selected hearing aids for three months, with bilateral profound sensorineural hearing loss.
- If there is no cognitive problems (disorders of mental activity of different character).
- In the absence of mental problems.
- In the absence of different kinds of physical illnesses.
Contraindications and limitations
This type of implant is ineffective in the case of hearing loss, which occurred as a result of neuritis of the auditory nerve or bleeding in the temple or lobe of the brain stem.Cochlear implants in these cases will not bring the desired results.
makes no sense to carry out the operation in cases of cochlear calcification (deposition of calcium salts) or ossification (bone germination).
cochlear implantation does not make sense if the patients with hearing loss for a long time (years) live in absolute silence.In this case, the operation will not bring the desired effect due to the fact that the long absence of sprigs of stimulation of the auditory nerve atrophy and can not be reversed.
In addition, contraindications are:
- Inflammation of the middle ear.
- presence of perforation of the eardrum.
- Safety and function of the hair cells, which is determined by otoacoustic emissions.
- prelingvalnoy At deafness - the age of the child more than 6 years.
- postlingvalnoy At deafness - deafness period lasting over a period of normal hearing.
What is a cochlear implant?
system consists of two parts which are interconnected by any physical methods are not connected.One part is attached behind the outer ear and consists of a microphone, and a processor (in contemporary models are combined), and a transmitter, which is mounted on the skin, like a magnet.The second portion - the internal and is a receiver.It is fixed in the temporal bone.Actually, to install the receiver and is the operation - cochlear implantation.
How does the system work?
microphone mounted behind the outer ear, picks up sound and transmits it to the speech processor, located in the same place.The processor received sounds are encoded and converted into electrical impulses.They further through a transmitter attached on the skin, arrive at the receiver, located in the temporal bone.From there they go on the electrode into the cochlea and spiral ganglion affect the auditory nerve.Thus the patient is able to perceive sounds.
cost
total cost of a cochlear implant, a survey carried out by surgery and postoperative correction is determined specifically for each patient.The number of required inspections depends on the history and general condition of the patient.So, for example, for patients with a history of who had meningitis, necessarily appointed by magnetic resonance imaging, which will determine the status of the temporal bones.Other patients, such an examination may be dispensed with.Also, sometimes (not all) require consultation geneticist or neurologist.It all affects how much it will cost cochlear implants.Its cost is of the order of about 1 million 300 rubles.But for citizens of the Russian Federation such an operation can be performed free quota.
cost of hospitalization and hospital stay is paid separately and depends on the prices of the selected institutions.
necessary examinations and surgery
- Inspection ENT doctor.
- Consultation otonevrologa.
- Consultation surdopedagogs.
- audiometry.
- impedance.
- Promontorialny test.
- otoacoustic emission.
- auditory evoked potentials.
- Computed tomography of the temporal bones.
- standard laboratory tests as for any surgical procedure (common blood and urine tests, blood glucose, biochemical blood).
The operation itself takes about 1.5 hours.The implant is fixed in the area of the temporal bone behind the ear and the electrodes are introduced into the cochlea.During the next 7-10 days held dressings and sutures are removed.
Enable system can be 3-5 weeks.The first setting can be made no earlier than one month after surgery.It is very important to her carefully and not to cause the patient's negative emotions at returning him to the world of sounds.
Available-stage cochlear implants in both ears at once.This is placed on each side of a separate independent cochlear system.Surveys and rehabilitation period are the same as for unilateral implantation.
Rehabilitation After surgery, "cochlear implants" Rehabilitation is an essential step.After the speech processor is connected, it must be properly set up and teach the patient to perceive the sounds and recognize these feelings, so that he could use the information for the development of speech.Rehabilitation takes the most important, difficult and long stage.
undergo a period of rehabilitation the patient helps a team of experts, which includes otohirurgi, surdopedagogs, audiologists, psychologists.Classes on special techniques and long-tuning session, as well as consultation of all these specialists.In the future, they must be monitored throughout the life of the patient.In addition, the speech processor must periodically be reprogrammed.
Hearing.Prices
For people with a low level of sound perception developed many devices - hearing aids that can help adapt to the social environment.Hearing aids are BTE, which are mounted behind the ear and in-the-- they are placed in the patient's ear canal and are made to order.Currently, there are commercially available digital models.
In addition, there are a CIC hearing aids.They are located in the ear canal, very small size and practically invisible to others.But such devices are contraindicated for children under 12 years.
cost of hearing aids is different, but it is relatively small.This enables a large number of patients to use hearing aids.Prices are quite affordable.So, you can buy a BTE models from 4.5 to 17 thousand. Rubles.In-the devices are more expensive.
Treatment for hearing loss
If you have a hearing loss, treatment will depend on the reasons why he had been summoned.Among the possible choices:
- Removing cerumen - this is done by means of washing, sometimes using a special tool.
- use of hearing aids.Further BTE, ITE and glubokokanal'nykh, hearing aids may be used, mounted in an eyeglass frame or pocket, as well as a headband, and even in the form of earrings.Which one will suit a particular patient, consult an audiologist.
- Cochlear implants - they are mentioned in this article.
prevention of hearing loss
Hearing loss can be caused by a disease, work in noisy environments or long stay in a noisy place.Hearing may be reduced and in view of age-related changes.
If the work is connected with the production of noisy, it is recommended in the workplace using headphones or other devices to protect against loud noises, such as special earplugs.
should be checked regularly listening to all the people associated with prolonged stay in a noisy place.This will help identify hearing loss early on and in time to take action, thereby preventing further loss of hearing and hearing loss or deafness.
Avoid too loud noises during the holidays and do not listen to very loud music, or at least periodically take breaks.
