6.2 Cochlear implants and auditory brainstem implants

Hearing implants like cochlear implants and auditory brainstem implants are game-changers for people with severe hearing loss. They work by bypassing damaged parts of the ear and directly stimulating nerves to restore hearing. It's like giving someone a brand new way to experience sound.

These implants aren't for everyone, though. Doctors look at factors like the type and severity of hearing loss, as well as the person's motivation and support system. Once implanted, the devices need careful programming and lots of practice to get the best results.

Cochlear Implants

Functioning of hearing implants

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Top images from around the web for Functioning of hearing implants

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  Frontiers | Auditory Brainstem Implants: Recent Progress and Future Perspectives View original

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• 

  Auditory Pathways to the Brain – Introduction to Sensation and Perception View original

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• 

  Adaptive Pitch Transposition: Smart Auditory Spectral Shifts in Cochlear Implants View original

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  Frontiers | Auditory Brainstem Implants: Recent Progress and Future Perspectives View original

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  Auditory Pathways to the Brain – Introduction to Sensation and Perception View original

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• Cochlear implants bypass damaged or non-functional hair cells in the cochlea directly stimulate the auditory nerve
  • External components include a microphone, speech processor, and transmitter capture sound, convert it into digital signals, and transmit to the internal components
  • Internal components consist of a receiver/stimulator and electrode array that convert digital signals into electrical impulses and stimulate auditory nerve fibers in the cochlea
• Auditory brainstem implants (ABIs) used when the auditory nerve is damaged or absent bypass both the cochlea and auditory nerve
  • ABIs directly stimulate the cochlear nucleus in the brainstem
  • External components (microphone, speech processor, transmitter) capture sound, convert it into digital signals, and transmit to internal components (receiver/stimulator, electrode array)
  • Internal components convert digital signals into electrical impulses and stimulate the cochlear nucleus, bypassing the damaged or absent auditory nerve

Candidates for hearing implants

• Cochlear implant candidates have severe to profound sensorineural hearing loss in both ears, limited benefit from hearing aids, no medical contraindications for surgery, realistic expectations and motivation for rehabilitation, and adequate support system and access to post-implantation therapy
• Auditory brainstem implant candidates have neurofibromatosis type 2 (NF2) with bilateral vestibular schwannomas, complete or near-complete destruction of auditory nerves due to tumor growth or surgical removal, severe to profound hearing loss not amenable to cochlear implantation, no medical contraindications for surgery, realistic expectations and motivation for rehabilitation, and adequate support system and access to post-implantation therapy

Programming of hearing implants

• Cochlear implant programming involves mapping (setting threshold and comfort levels for each electrode), adjusting speech processor settings to optimize speech perception and sound quality, regular follow-up sessions to fine-tune settings based on patient feedback and performance, and auditory training and rehabilitation to help patients adapt to new auditory input
• Auditory brainstem implant programming is similar to cochlear implant programming but with fewer electrodes and more complex stimulation patterns
  • Involves mapping, adjusting speech processor settings, regular follow-up sessions, and intensive auditory training and rehabilitation to help patients interpret new auditory sensations

Psychosocial impact of implants

• Improved communication and social interaction lead to increased ability to understand speech and participate in conversations, enhanced social confidence, reduced feelings of isolation, and better integration into the hearing world
• Educational and occupational opportunities expand with increased access to mainstream education, improved academic performance, and broader career options and job prospects
• Emotional well-being and self-esteem improve through reduced stress and anxiety related to communication difficulties, increased independence and autonomy, and enhanced overall psychological well-being
• Family dynamics and relationships benefit from reduced stress and frustration due to improved communication, enhanced bonding and emotional connection, and increased participation in family activities and decision-making
• Challenges and adaptations include adjusting to new auditory input, learning to interpret signals, dealing with unrealistic expectations and potential disappointment, coping with stigma and social attitudes towards implants and deafness, and balancing deaf identity with newfound connection to the hearing world