A HOPE FOR PEOPLE WITH HEARING LOSS
Hearing loss is a high-income disorder in society. According to the Directorate-General for Children's Health and Family Planning, the rate of hearing loss at birth is 30 per 10,000 births, which is much higher than the rate of other birth defects such as fracture, down syndrome, and organ abnormalities. That's why in 2004, the Ministry of Health, in partnership with some universities, launched a national newborn hearing screening protocol, which is planned for all newborns nationwide. Turgut Ozal Medical Center of the Faculty of Medicine of the Inonu University initially started the program of neonatal hearing screening as an individual practice across our hospital with the support of the Children's Health and Diseases and Women's Diseases and Birth Anabiology Branch. In 2009, a faculty member from the Anabiology Branch of KBB completed the Neonatal Hearing Scanning Educational Training organized by the Ministry of Health.
With the rise and spread of the use of cochlear implants in recent years, there has been hope for people with developmental disabilities who are born with a very advanced degree of hearing loss and as a result cannot acquire the ability to speak.
A Cochlear Implant is an electronic device designed to assist those with advanced and very advanced hearing loss who cannot benefit from hearing aids. The Cochlear Implant system converts everyday sounds into encrypted electrical cues. Alerts stimulate the auditory nerve, and the brain perceives them as sounds.
The cochlear implant system consists of two parts:
- Internal implant implant implanted by operation,
- It's the outer part called the speech processor.
In a person who has had a cochlear implant, sounds are converted into electrical signals by the microphone in the receiver of the implant. These signals are encoded here by being transmitted to the speech processor. These alerts are sent to the electrodes that are surgically placed in the cavity. The auditory nerve receives these alerts and sends them to the brain. The brain also perceives these signals as sounds.
Children with congenital hearing loss, children with later hearing loss, and adults may benefit from a cochlear implant. A cochlear implant is suitable if there is a hearing loss due to an inner ear and sufficient speech information cannot be obtained with the hearing aid. It is difficult to predict exactly how much a person might benefit from this practice. However, children with congenital hearing loss can benefit greatly if they can be implanted as early as possible. After 5 years, the benefit rate drops significantly. Therefore, people with congenital hearing loss prefer to have a cochlear implant before the age of 5, preferably under the age of 3. However, if a person is able to hear and understand enough with a well-equipped hearing aid, there is no need for a cochlear implant. If the primary cause of hearing loss is not the inner ear, or if there are various inner ear anomalies, the use of a cochlear implant may not benefit these patients. In such cases, different approaches may sometimes arise.
People who have lost their hearing for any reason at any age after learning to speak also benefit from cochlear implants. However, the longer the patient has advanced hearing loss, the less likely they are to benefit from a cochlear implant. That's why early implant training can be more helpful.
Considering the benefits of using a cochlear implant, almost all users benefit from the Implant because they will have the ability to hear more environmental sounds. This makes it possible for a person to have a closer relationship with his environment. People will be safer than they will be when they hear sounds like traffic, alarms, sirens. They'll also hear the sounds of speech through a near-permanent olfactory implant. However, it must be remembered that it will take a certain amount of time, especially in children, to understand speech sounds and that this will require special training for children. After implantation, it makes it much easier for most users to transmit in their daily lives. After being able to understand speech without having to read lips over time, some users also gain the ability to make phone calls. Speech also develops as a result of hearing and stimulation of related areas in the brain, and after implantation, these children are able to avoid eating the deaf and mute mark.
In order to decide on the use of a cochlear implant, it is necessary for the patient to be carefully evaluated by a team composed of experts such as an experienced KBB doctor, audiologist, psychologist, radiologist, appropriate patient selection and successful outcome. In these assessments, hearing thresholds with devices and devices must be determined, the function of the auditory nerve evaluated, additional barriers and needs identified, the causes of hearing loss investigated, the general health status and the condition of the ears revealed, the inner ear and auditory nerve with CT and MRI imaged, speech and language development evaluated, and educational needs identified.
All assessments are made and the patient who is given the decision to apply a cochlear implant is operated under general anesthesia by an experienced KBB specialist. The operation will take about two to four hours. Once the receiver receives an appropriate space behind the ear, electrodes from the opening hole in the inner ear are inserted into the ear canal. The function of the once installed electrodes is tested without closing the operating area. Patients will be discharged in a few days. Four to six weeks after the operation, the speech processor is fitted with a normal hearing aid and the sounds are adjusted so that the patient is not disturbed. After that, the person will need to be trained and rearranged when necessary by checking the device settings during the term. Specifically, regular speech and language therapy is needed for children. The family's interest and enthusiasm are very important here. At the end of the education process, a child from a caring and diligent family may be able to attend the same schools as his or her hearing-impaired peers.
Children with congenital hearing loss who are also deaf and cannot speak are able to hear and talk and become part of the community, as well as adults who have lost their hearing for any reason. Our surgical team has successfully implemented a total of 12 patients with congenital hearing loss between December 2008 and 2010, including 9 children with congenital hearing loss and 3 adults with subsequent hearing loss.