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Singapore General Hospital’s
Cochlear Implant Service is one of the many specialised services available
under the ENT Centre. There is a team of dedicated professional staff and
ENT specialists who work together to provide our patients with the best
possible medical, audiological and habilitative/ rehabilitative care.
The service,
which started in 1998, has seen more than 100 patients (adults and
children) successfully implanted with the device.
Patients under
this programme will also be referred to the Listen and Talk Programme for
therapy sessions.
What
is a Cochlear Implant?
The Cochlear
Implant is a device which when implanted into the inner ear, provides
useful hearing to those with total or severe to profound sensory (inner
ear) hearing loss.
It is not an
ordinary hearing aid, but an electronic device that bypasses the damaged
parts of the inner ear to stimulate the remaining auditory nerve fibres.
Part of the cochlear implant is implanted under the skin in a surgical
procedure.
How
does a Cochlear Implant work?
With reference to the diagram above:
(a) Sounds enter the system through a small microphone
attached behind the ear.
(b) The sound is sent from the microphone to the speech processor through a
tiny cord that connects the two.
(c) The speech processor selects and codes the elements of
sound that are most useful for understanding speech.
(d) These electronic codes are sent back through the cable
to the transmitter.
(e) The transmitting coil, a plastic covered ring about
33mm in diameter, sends the codes across the skin to the
receiver/stimulator.
(f) The receiver/stimulator contains a custom-designed
integrated circuit that converts the codes into special electronic signals
and sends them along the electrode array.
(g) The electrode array is a set of 22 tiny electrode
bands, arranged in a row inside a piece of tapered flexible silicone
tubing. Each electrode has a wire connecting it to the receiver/stimulator.
(h) The coded electronic signals are sent to specific
electrodes, each of which has been separately programmed to deliver sounds
that can vary in loudness and pitch. These electrodes then stimulate the
appropriate hearing nerve fibres, which send the messages to the brain.
Who
should get a Cochlear Implant?
A cochlear implant may be considered for the following:
(a) Adults and children with a severe-to-profound or
profound sensory hearing loss in both ears, who received limited benefit
from hearing aids.
(b) Those who do not have any medical conditions that
would prevent them from undergoing a surgical procedure.
(c) Those who have the support of friends and family.
(d) Those who want to be part of the hearing world.
(e) Children who will be enrolled into an education
programme that stresses auditory and verbal language development.
(f) Children as young as one year of age may be implanted.
It is usually said that the earlier the implantation, the better the
outcome will be.
What
are the benefits of having a Cochlear Implant?
The outcome
varies with each individual and is influenced by:
- The age at which the hearing loss occurred
- How long it's been since the hearing loss
occurred
- The integrity of the auditory nerve
- Motivation and emotional support from family and
friends
- The amount of practice and training in the early
stages of implant
What
are the follow-ups required after surgery?
The implant has
to be programmed by the audiologist before it can work. Programming of the
implant will be carried out 2 to 3 weeks after surgery, after which the
implant needs to be programmed periodically to maximise the speech sounds
that can be heard by the individual.
A period of
(re)habilitation is also required, especially in children, to gain the
maximum benefits from listening through the implant. Implanted children
will be enrolled in therapy sessions in Listen and Talk Programme, where
the Auditory-Verbal approach is adopted to help children develop speech and
language.
What
should my expectations be?
A Cochlear
Implant may not be the right choice for everyone. An evaluation by an
experienced cochlear implant team will help you to decide.
No Cochlear
Implant is able to restore normal hearing completely. However, with the
Cochlear Implant, adults can look forward to hearing sounds that may help
them to carry on a conversation and participate in everyday life.
The outcome in
children varies, but the ultimate objective is that children can develop
speech and language. For further information, please do not hesitate to
contact us for an appointment.
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