Cochlear Implant
<i>Bringing hearing to the deaf</i>
A child with a cochlear implant device.
A cochlear implant (also called Bionic Ear) is an electronic hearing device, designed to produce useful hearing sensations to a person with severe to profound deafness. It is surgically implanted in the inner ear and activated by a device worn outside the ear. Unlike a hearing aid, it does not make sound louder or clearer. Instead, the device bypasses non functioning parts of the hearing system and directly stimulates the nerve of hearing, allowing deaf individuals to receive sound. Cochlear implant surgery has brought a revolution in the treatment of deafness and it is performed in many countries of the world. Three years ago, the surgery started at a very small scale in our country. People are becoming interested to this surgery day by day. Cochlear implant brings the profoundly deaf patients to a new world overcoming the disability and this new technology can make their life like other normal individuals. Children who are born deaf are the suitable candidates for cochlear implant. It is generally agreed that surgery should be performed within 1-5 years of age. When a baby is born deaf, his hearing area in the brain starts getting deleted if there is no input. The area is are occupied by other programmes. This process continues up to 5 years of age. So before that time if cochlear implant is used, the result is better and the babies can learn normal language and they can go to a normal school. There is another group who learnt the language and speech but suddenly became deaf. They can also be candidates for cochlear implant. In this case, best time for the operation is within 6 months of the incidence. There are many causes of deafness. Women during pregnancy can be infected by rubella, measles, mumps and some other viruses that damage the cochlea (the auditory portion of the inner ear). Some drugs like Frusamide, Gentamicin also affect the cochlea. Babies of consanguine couples may be affected due to genetic abnormality. If the delivery of baby is prolonged and obstructed, the cochlea may be damaged. Some harmful viruses, sever diarrhoea, meningitis, convulsion may facilitate cochlear damage in baby. So everyone should take preventive measures against it. Marriage between 1st degree relatives may be avoided. Babies and mothers should get vaccinated against harmful viruses. However, one can be affected at any time of his/her life. This is known as sudden sensory neural hearing loss. It happens suddenly. It is an emergency condition that needs immediate hospitalisation. If it is not treated immediately the cochlea will be damaged permanently. The exact cause is difficult to detect but viruses have been identified as main culprit. Impaired blood supply to the cochlea due to hypertension or occluded vessel lumen may lead to cochlea damage. The outcome of cochlear implant is excellent. After implantation, patients hear like normal individual. When deaf babies talk and sing, the joy of the parents knows no bounds. They forget all the previous sufferings and sorrows and can dream with a new hope about the baby. One thing is very important after the surgery. Family members should give more time to the patient and should be committed. They should have a realistic expectation as all the babies will not react in same manner. A child born deaf or a man became deaf suddenly have to accept it as their fate though cochlear implant could restore the gift of sound. Most of our 3 million profoundly deaf people can think about the costlier cochlear implant surgery. But we should consider the benefit more than the cost. If a baby is born deaf, s/he cannot speak. S/he becomes the burden of the family and in long run there is none to take care of these people. Their lives become very miserable. The expense of maintaining a deaf baby throughout the whole life is about 5 times more than the cost of cochlear implant. On the other hand if the baby can hear and learn speech, s/he can lead a normal life and can contribute to the family and the nation. A good number of patients really need cochlear implant in our country. We need support from government and non-government level for them. The government can allocate a small amount in the budget for this purpose; as 50 core per year, at a implant cost about 8 lakh. Then 600 patients could be implanted per year which will be a revolution for the nation. The rich people and the biggest institutes can donate some cochlear implant. National and international donor agencies can donate a few number of cochlear implants every year. Renowned banks can give loan with very low rate interest like 1 to 2 percent to the patients. Very small contribution from them will make a big contribution to the nation. Moreover, we need a center of excellence for this cochlear implant and a group of trained medical professionals. Some leading ENT specialists are working hard to make the treatment available and popular in our country in collaboration with internationally renowned ENT surgeons. There was one cochlear implant at the Department of ENT of Mitford Hospital, Dhaka and four more patients are expected to be operated. Once bypass surgery was a dream in our country, but now a days it has become available and affordable. There is a hope that in near future, cochlear implant will be available in Bangladesh. The writer is an Associate Professor of Department of ENT of Sir Salimullah Medical College and Mitford Hospital, Dhaka.
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