Cochlear implant – Patient information

PATIENT CARE

The Department provided a state of the art ENT Service and is equipped with the entire range of diagnostic and therapeutic equipments including a Cochlear Implant Lab, audiological facilities, Electronystagmographic facilities, Electrodiagnostic Audiometry, Hearing Aid Analyzer, ear mould lab, play therapy, stroboscopy & computer aided speech analysis and nasal and laryngeal endoscopes. The Rehabilitation Unit of Audiology and Speech Therapy functions with the clinical department to provide supportive diagnostic and rehabilitative services for the Hearing Impairment, Speech problems and post-laryngectomy speech disabled.

Besides the continuing post-lingual Cochlear implant programme in adults and adolescents, the Department has now also started the implant programme in early onset Prelingual deafened young children

ENT OPD ATTENDENCE

New 39629
Old 26511
Total 66137

SPECIAL CLINICS:

THE REHABILITATION UNIT OF AUDIOLOGY AND SPEECH THERAPY(RUAS)

The Clinical work undertaken by the unit included-

Outreach Rural Services- The department provides a comprehensive ENT service at the Primary Health Centre at Ballabgarh, Haryana. In addition two rural ENT diagnostic camps were organised at Haryana.

COCHLEAR IMPLANT PROGRAM (an overview)

The cochlear implantation (CI) program was started in All India Institute of Medical Sciences in 1996 under the chairmanship of Prof.RC Deka and the first adult patient was successfully operated upon in February in 1997. Soon, the department started the Children Program in 1998. Till now (July, 2008), we have performed 216 cochlear implant surgeries in adults and children. 169 cases were prelingually deaf children and 47 patients were postlingually deaf adults. Prof. RC Deka has also done the country’s first bilateral Cochlear implant successfully in an adult patient. The department has provided support in starting cochlear implant program in R.R. Hospital, Central Railway Hospital in New Delhi and also PGIMER in Chandigarh.

What is a cochlear implant?

A cochlear implant is an electronic device that restores partial hearing to the deaf. It is the only treatment option available for patients with bilateral profound sensorineural hearing loss, if there is no benefit with hearing aids.

How does a cochlear implant work?

Cochlear implant is surgically implanted in the ear and activated by a device worn behind the ear. It converts sound to electrical impulses. These impulses are then transmitted via hearing nerve to the brain. The device bypasses damaged parts of the auditory system (hair cells of cochlea) and directly stimulates the nerve of hearing, allowing individuals who are profoundly hearing impaired to perceive sound.

What are the components of Cochlear Implant?

Cochlear implants have two parts-

1. external (outside) parts that include a microphone, a speech processor, and a transmitter.
2. internal (surgically implanted) parts - a receiver-stimulating system fixed to the skull bone behind the ear and electrodes which are inserted into the cochlea.

The microphone picks up sounds and sends them to the speech processor. The speech processor analyzes and digitizes the sound signals and sends them to a transmitter worn on the side of head just behind the ear. The transmitter sends the coded signals to an implanted receiver. The receiver in turn delivers them to the array of electrodes that stimulate the fibers of the auditory nerve directly. The auditory nerve transmits this information to the brain where it is interpreted as meaningful sound and thus the implanted person starts learning language and speech communication skills.

Cochlear Implant surgery in AIIMS

An implant team consisting of otolaryngologist, audiologist, radiologist, pediatric neurologist, clinical psychologist and speech therapist does the clinical and other laboratory assessment before planning for surgery. Implant surgery is performed under general anesthesia and lasts from two to three hours. The procedure requires a stay in the hospital for 7 to 10 days.

Postoperative rehabilitation

The postoperative rehabilitation will be done by the rehabilitation team consisting of otolaryngologist, audiologist and speech therapist. Parents’ participation in the training is of paramount importance and one of the parents has to learn the therapy to train the child at home. When the surgical wound is well healed (usually 3 to 4 weeks after surgery) the cochlear implant is activated (switch-on) and a MAP is created using computer based software. The subsequent mapping sessions are individually tailored as per the progress made by the patient. The short and long term goals are set for listening and then language and speech. The therapist teaches the child to listen to the sound that is received from the cochlear implant and helps them in developing effective spoken communication, leading to development of language and speech.

When my child/ the patient start hearing and speaking ?

Cochlear implants do not restore normal hearing, and benefits vary from one individual to another. The implantees are expected to hear and/or recognize sounds/speech and learn language through the auditory input with the help of cochlear implant. In children, 4-5 years of intensive training is needed.

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REHABILITATION UNIT OF AUDIOLOGY AND SPEECH THEARPY

This unit provides comprehensive diagnostic and rehabilitative services in various speech and hearing disorders. It is started by clinical experts who provide for diagnostic audiology services, hearing therapy & hearing aid fitting & rehabilitation & speech therapy & training.

The unit is equipped with state of the art equipment and houses facilities for diagnostic audiometry, tympanometry, evoked response testing, hearing aid calibration, ear mould lab, play therapy, stroboscopy & computer aided speech analysis with VAGHMI & vocal-2, speech analysis with software.

Consultations with clinical experts in the unit are available every working day morning. All patients seen in the unit should however have had a previous consultation with the ENT medical staff. The unit has developed expertise in detection & evaluates of paediatric hearing impairment & with its rehabilitation & therapy. The facility for cochlear implant programming has recently become available. The speech therapy services provides therapy for stammering, misarticulation, voice disorder, post laryngectomy aphonia, cleft palate, and patients with hearing impairment.

A 3 year graduate course ( B.Sc (Hons) Speech & Hearing is available in the Unit & train students in the areas of diagnostic audiology, rehabilitation of the hearing impaired and speech therapy. The intake is 3 students per year.