|What … for? (Indications)|
Ear implants help, when there is no understanding with speech using hearing aids. They are placed after middle ear operation or malformation. Ear implants help at single-sided deafness.
Global: 219.000, USA 70.000 patients with cochlear implants. (ASHA). 1-3 newborns per 1.000 have a hearing loss that can be treated only with cochlear implants.
The ear implants consist of an external portion that sits behind the ear and a second portion that is surgically placed under the skin.
Swelling around the wound for about 2-3 days.
|Contraindications||behavioral||People who have been deaf for a short period of time do better with cochlear implants than people who have been deaf for long periods of time|
|medical||Minimum age is 18 years. There are special implants for 12-24 month old children. Middle ear infection. Perforation of the membrane tympanique due to an infection. Aplasia of the cochlea.|
|Risks||during surgery||Nerv injury may lead to change of taste, rarely permanent.|
Injury to the facial nerv (temporary or permament weakening or full paralysis on the same side of the face occurs in <1 in 1000 cases.
Leakage of brain fluid (~1%).
2-3% of patients will require their implant removed due to device malfunction or infection.
General anesthesia necessary – relating risks.
|short term||Skin wound infection, cerebrospinal fluid leakage, numbness around the operation area,|
|long term||Exposed implant, Meningitis (biofilm after microorganisms colonize boundary surfaces), perilymph fluid leak, chronic localized inflammation, reparative granuloma, tinnitus, vertigo or dizziness. Few reports on allergic reactions to silicone.|
|restrictions||MRI scan not possible. Risk with ionic radiation therapy, electroconvulsive therapy, electrical surgery, and neuro-stimulation.|
|Possible interaction with theft detection systems, metal detectors or other security systems.|
Possible affection by cell phones or radio transmitters.
Possible Interaction in unpredictable ways with computer systems.
CI-patients have to be careful of static electricity, something that can damage their implant.
Skin irritation (rubbing of the external part).
Strange sounds may be heard.
Different hearing outcomes: A person might not hear as well as other people who experience successful outcomes with their implants.
Potential loss of residual hearing: Cochlear implants might destroy any remaining hearing in the ear that has the implant.
|Failures||Implant failures may happen and the person would have to undergo additional surgery|
|Material||External part||Microphone, sound processor, and transmitter system. They receive the sound, process it and send it to the internal part. This advice is necessary for the different types of ear implants.|
|Cochlear||Internal part||Implanted receiver and electrode system; something that contains electronic circuits that receive signals from the external system, and send electrical currents to the person’s inner ear. They activate the person’s nerve, sending a signal to their brain. The person’s brain learns to recognize the signal and the person experiences the signal as, ‘hearing.’|
|Inner parts differentiating||Transmitter||Coil in a silicone sheath|
|Cochlea Implant||Electronics||Enclosed in a titanium casing|
|Electrode||Platinum contacts in a silicone array|
|Electroacustic Stimulation||A cochlear implant combined with a hearing aid. For people to restore their hearing in the high frequencies, and acoustic amplification for the low frequencies|
|Middle Ear Implant||Vibrant soundbridge||Mechanical vibrations transmit the signals to the middle ear.||No cables to the inner ear necessary|
|Bonebridge Implant||Mechanical vibrations in the temporal bone transmit the signals to the inner ear.||No cables to the inner ear necessary|
|Statistics||USA: 36 million have hearing loss (one in every ten). Sudden sensoneural hearing loss 5-20 people per 100.000 persons |
16% of Europeans require treatment. 50% over 65 have hearing loss. (MHH)
|Literature||– Basic||Advanced Bionics|
|– Problems||Wilson-Clark S: Bacterial Meningitis among cochlear implant recipients – Canada 2002|
|– Science/Future||Stöver T, Lenz T: Biomaterials in cochlear implants (also for basics on material)|
|Medical societies||see here|
|Selected Informations||– Cochlear Implants: Facts, Benefits & Risks (2012)|
|Register for patients||USA: Cochlear® Register |
Register my cochlear implant
|News||Amplify Sounds Using iPhone with SoundAMP Hearing Assistant App – Ian Langtree – (2011-03-07)|
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