March 3rd World Ear and Hearing Day Medical technology brings hope to millions of hearing-impaired
**THE METHOD THAT PUTS AN END TO THE GREAT SILENCE: COCHLEAR IMPLANT **
It is estimates that there are nearly 3 million hearing impaired people in Turkey. Some are inflicted at birth and some develop symptoms later which cause them to fall into a ‘great silence’. However the advancements in medical technology can end this silence and reintroduce some people to sound. One of these advancements is cochlear implants. Acibadem Bakırköy Hospital ENT Specialist Dr. Engin Çakmakçı, who explained that this method is applied to people whose cochlea in the inner ear have been damaged but the audio nerve is still viable, said that people in this situation are able to hear again which makes them happier in their education and social lives.
How would you feel if you could not hear all of a sudden? A roaring river is directly in front of you with absolutely no sound from the scene or from the people standing all around you opening and closing their mouths with comments about the amazing view! Unfamiliar with the safety warnings of alarms and horns, not to mention being labeled ‘handicapped’ at work and in your social life, millions of hearing impaired people are in this situation in Turkey. But now there are advancements that bring a voice to this silence: one of these is the Cochlear Implant. People who overcome their hearing problems with a Cochlear Implant can eventually even talk on the phone without difficulty. Acibadem Bakırköy Hospital ENT Specialist Dr. Mustafa Engin Çakmakçı, provided information about this method which enables people to hear again.
How is hearing restored?
How does the system work? This method is applied to people whose cochlea in the inner ear has been damaged but the audio nerve is still viable. The cochlea in the inner ear is by-passed and the nerve is stimulated with electrodes placed within the cochlea. There are two main parts to the Cochlear Implant: The first is the internal part which is the implant that is placed with an operation, the other is the external part serving as a kind of computer that captures sound and transmits it to the piece implanted inside by transforming sounds to electrical signals. When these two parts work compatibly the sounds from outside are transmitted to the brain to enable hearing.
Beware of childhood diseases!
In order for the Cochlear Implant to be implemented the chamber in which the electrode will be placed inside the cochlea must be maintained. Some childhood diseases can lead to hearing loss, which Dr. Çakmakçı points out should be something that families are aware of and adds the following information:
“Sometimes when there is hearing loss related to meningitis children can lose hearing in both ears. If a Cochlear Implant is not installed in the early period for children in this situation, the inside of the cochlea becomes ossified and no channel is left to place the implant. Also if a baby with hearing loss in the prelingual period does not get an implant in the first 5 years of its life it becomes very difficult to treat them. Children, whose hearing does not develop, also do not develop speaking skills. It is not possible to develop speech in a child with completely undeveloped speaking skills after five years. There is also 'Post lingual' hearing loss. In this case the child starts out life with hearing intact, learns to speak but after learning to speak loses his hearing due to a number of different causes like meningitis, inflammatory diseases, and incorrect use of antibiotics or head trauma. When hearing loss develops in both sides it is possible to place implants in these patients.”
Patients, who develop hearing loss because of conditions other than childhood diseases, like tumors, where there is damage at the point that the audio nerve exits the brain, are not suitable for implants because even if electrodes are placed in the patient they will not work because it is not possible to stimulate the audio nerve. Dr. Çakmakçı said other treatments are applied to these types of patients.
From a single frequency to 24 frequencies…
It is estimated that there are nearly 3 million hearing impaired people in Turkey. Some have had hearing loss since birth and some are missing this ability due to an inflammatory disease or some kind of trauma that has occurred. However technology that is progressing faster by the minute and the experience of specialists can sometimes remove this disability. In fact it can even be possible for a hearing impaired person to talk and hear the phone without even being able to see the person on the other side. The device that is now giving a ‘voice’ to the lives of hearing impaired people is called a Cochlear Implant. It is actually a method that has been practiced for some time. It became popular in Turkey in the mid 1990s. Now many patients are able to be introduced to sounds and can easily overcome their hearing problems. While many patients overcome hearing loss with the Cochlear Implant, new advancements in this method also enable people to hear better. For example, in the 1990s there was only a single frequency that stimulated the inner ear but now the number of frequencies has reached 24.
The sounds on the telephone are easily heard
Thanks to the advancements in Cochlear Implant technology people are able to hear the other side in telephone communications. So how soon is it possible to talk on the phone after undergoing this operation? In the first month after the operation the first trials to hear sound are done and the external part is attached. The process after the first month depends on the scale of the patient’s hearing loss. Dr. Çakmakçı says that patients who could speak and hear before usually become able to speak on the phone within 6 months but if they have never had these skills the process requires a little more patience because it could take longer.
An experienced staff and the cooperation of the patient increases success
Dr. Çakmakçı, who pointed out that having an experienced staff is vital for treatment said “Experience is vital for an audiologist to make a correct diagnosis, for the surgeon to be successful in the operation that takes about 1.5 hours and the audiologist to apply therapy and speech training. Also audio-visual training should be continuous, therefore the cooperation and compliance of the family comes first. Otherwise there are many patients with a cochlear implant who have been discharged but the desired results have not been achieved”.
Patients who would normally not be able to benefit from a hearing aid and would continue their life as a handicapped person can have a normal life with the help of this system. Pointing out that even telephone conversations are possible with the Cochlear Implant application, Dr. Çakmakçı says "They can even talk on the phone and go to normal school. While they were destined to be handicapped their whole lives these patients are gained to the community as citizens who graduate, learn foreign languages, play instruments and lead a normal life”