Cochlear Implant<\/h2><\/div><\/i><\/i><\/span>What is a cochlear implant?<\/span><\/a><\/h4><\/div>\nThe cochlear implant<\/b> is a device that allows hearing<\/b> for adults and children affected by profound deafness<\/b>. It provides electrical impulses<\/b> directly to the fibers of the auditory nerve<\/b> bypassing the damaged cells of the inner ear <\/b>(hair cells). Once the impulses reach the brain, they are interpreted as sounds<\/b>. Cochlear implants are not hearing aids<\/b><\/a>; they do not amplify sounds <\/b>(as hearing aids do), but capture sound, convert it into signals\/electrical impulses<\/b> (as a cochlea<\/b> would), and transfer the newly generated signals\/electrical impulses to the cochlear nerve<\/b> stimulating it. This stimulation of the cochlear nerve ensures the human perception<\/b> and recognition of sound<\/b>.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div>![\"Book](\"https:\/\/gruppootologico.com\/wp-content\/uploads\/2024\/05\/cover_surgery_for_cochlear_and_other_auditory_implants-1920w.webp\")
<\/a><\/span><\/div><\/div><\/div><\/i><\/i><\/span>What does a cochlear implant look like?<\/span><\/a><\/h4><\/div>\nThe cochlear implant consists of an internal component<\/b> made up of the receiver\/stimulator<\/b> with the electrode array, which is surgically inserted into the ear, and an external component<\/b> made up of the speech processor and the coil, which is usually applied behind the ear (retroauricular region<\/b>).<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Who can benefit from a cochlear implant?<\/span><\/a><\/h4><\/div>\nThe cochlear implant<\/b> is indicated for subjects with bilateral profound deafness<\/b>, either genetic or acquired during life, for whom hearing aids do not provide adequate help in sound perception. In certain subjects, the cochlear implant can significantly improve the quality of life<\/b> (e.g., social, communicative, learning abilities) by enhancing the ability to hear words without the aid of visual signals (e.g., lip reading). Improving the recognition of normal everyday environmental sounds increases the ability to listen<\/b> in a noisy environment and enhances the possibility of hearing during television programs, music, and phone conversations. The cochlear implant can be applied to those subjects<\/b> who have severe or profound sensorineural hearing loss<\/strong> (anacusis) bilaterally, with little or no benefit from using a hearing aid and with strong motivation and expectations. The cochlear implant<\/b> can be applied to both adults and children. A distinction must be made between prelingual<\/b> and postlingual<\/b> deafness: <\/p>\n\n- prelingual<\/b> refers to before the acquisition<\/b> of the ability to produce <\/b>and understand language and speech;<\/b><\/li>\n
- postlingual<\/b> refers to after acquiring the ability to produce<\/b> and understand <\/b>language and speech.<\/li>\n<\/ul>\n
In 60-70% of children, deaf from birth and implanted in the first three years of life, there is normal schooling, this percentage drops to 20-25% if implanted after the 3rd year of life.
\nEven children who are hearing-impaired from birth<\/b> and have postlingual deafness <\/b>can obtain very good results from a cochlear implant; the earlier the implantation procedure is carried out with respect to the onset of deafness, the better the results can be obtained.
\nAdults with <\/b>postlingual deafness<\/b> who have lost their hearing as a result of meningitis, trauma, otosclerosis, or other conditions with progressive hearing loss<\/b> over time can benefit tremendously from cochlear implantation<\/b>.
\nThe concept, as with children, of early intervention also applies to adults.
\nAdults with prelingual deafness<\/b> undergoing cochlear implantation may reap very limited benefits (sound discrimination).<\/p>\n
Although many people are not aware of it, in Italy<\/b> cochlear implantation is totally free of charge as it is paid for by the National Health System<\/b>, and so is the rehabilitation process<\/b> and the pathway<\/b> to its activation<\/b>. Financial assistance from the State can help resolve the discomfort caused by severe forms of sensorineural hearing loss<\/b> by finding the most suitable solution.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>How does a cochlear implant work?<\/span><\/a><\/h4><\/div>\nA generic cochlear implant captures sounds<\/b> from the external environment, converts the captured sounds into electrical impulses\/signals<\/b>, and finally transmits the generated electrical impulses\/signals<\/b> to the cochlear nerve,<\/b> stimulating it.
\nThe stimulation of the cochlear nerve<\/b> ensures the perception and recognition of sounds.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>How is the surgical procedure for cochlear implantation performed?<\/span><\/a><\/h4><\/div>\nL\u2019intervento chirurgico di \u201cinserzione di impianto cocleare\u201d<\/b> viene eseguito da uno specialista in otorinolaringoiatria in anestesia generale<\/b> ed ha una durata di 2-3 ore.
\nDurante l\u2019intero intervento viene eseguito il monitoraggio del nervo facciale<\/a><\/b>. Viene praticata un\u2019incisione della cute a forma di L<\/b> rovesciata.
\nUna volta scollati i tessuti ed esposto l\u2019osso si effettua una piccola mastoidectomia<\/b>. Si esegue la timpanotomia posteriore<\/b>, che ci permette di accedere alla regione della finestra rotonda. A questo punto si crea l\u2019alloggiamento per il ricevitore-stimolatore con l\u2019ausilio di un modellino metallico fornito nel kit dell\u2019impianto. Si esegue, quindi, l\u2019apertura della coclea<\/b> (cocleostomia) e si inserisce (nella scala timpanica) il filo porta elettrodi<\/b> che viene poi fissato con del tessuto connettivo <\/b>pi\u00f9 eventuale colla. Eseguito ci\u00f2, l\u2019audiologo confermer\u00e0 attraverso opportuni tests la corretta collocazione<\/b>.
\nOccorre, inoltre, valutare eventuali interferenze tra gli elettrodi del filo ed il nervo facciale<\/b>. Infine si esegue un\u2019attenta chiusura dei lembi. <\/p>\nNei casi in cui sia necessario impiantare un orecchio affetto da otiti croniche<\/a><\/b> o precedentemente sottoposto a tecniche aperte \u00e8 opportuno rimuovere tutta la patologia ed eseguire la chiusura del condotto uditivo esterno a cul di sacco con obliterazione della cavit\u00e0 al fine di evitare possibili complicanze (meningite). In presenza di infezioni attive, l\u2019inserzione dell\u2019impianto cocleare \u00e8 posticipata ad un secondo tempo.
\nNei pazienti affetti da malformazioni congenite<\/b> \u00e8 opportuno eseguire un\u2019attenta valutazione radiologica<\/b> attraverso una TC<\/a><\/b> ed una RM<\/a><\/b> ponendo particolare attenzione alla perviet\u00e0 della coclea ed al decorso del nervo facciale<\/a><\/b>. Nei casi di reimpianto bisogna porre particolare attenzione alla fibrosi cicatriziale<\/b> a livello della timpanotomia posteriore<\/b> e della finestra rotonda ed inoltre al lembo cutaneo.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Diagnostic preparation process for cochlear implant<\/span><\/a><\/h4><\/div>\nBefore the installation of a cochlear implant<\/b>, the patient must undergo a series of tests to determine suitability for the procedure<\/b>.
\nDuring these tests, the patient will also receive all the information regarding the installation procedure<\/b> (what it involves, pre-operative guidelines, post-operative course, etc.). Before deciding to apply a cochlear implant, it is advisable to perform assessments<\/b>: <\/p>\n\n- Audiological tests<\/b> (e.g., pure tone audiometry<\/a><\/b> and speech audiometry<\/a><\/b> with and without hearing aids, tympanometry, auditory evoked potentials<\/a><\/b>, promontory test)<\/li>\n
- Clinical tests<\/b> (routine blood tests<\/b> for general anesthesia)<\/li>\n
- CT<\/a><\/b> and MRI<\/a><\/b> (for evaluating the anatomy of the inner ear<\/b>)<\/li>\n
- Consultation and speech therapy visit<\/a><\/b><\/li>\n<\/ul>\n<\/div><\/div><\/div>
<\/i><\/i><\/span>Results after cochlear implant installation<\/span><\/a><\/h4><\/div>\nToday, thanks to the continuous advances<\/b> in medical technology in the audiological field<\/b>, the use of a cochlear implant<\/b> represents an excellent remedy<\/b> for resolving many cases of profound deafness<\/b> and moderate to severe hearing loss<\/b>.
\n<\/span><\/p>\nUnfortunately, in Italy, there is still little knowledge and awareness of the positive impact on quality of life<\/b> that the installation of a cochlear implant can bring.
\n<\/span><\/p>\nIn patients with a cochlear implant<\/b>, there is an improvement in<\/b> hearing ability<\/b> and an awareness of sounds<\/b> in daily life.<\/p>\n
Generally, after the activation of the cochlear implant<\/b>, patients can understand speech without lip reading and even talk on the phone. Learning to hear with a cochlear implant<\/b> requires time, practice, determination<\/b>, and patience.
\n<\/span><\/p>\nOn the day of activation<\/b>, many patients can only hear ‘beeps’ or unrecognizable sounds, while others may already be able to understand voices. Fortunately, a great effort<\/b> by the patient can be rewarded, as cochlear implants<\/b> can significantly restore the ability to hear all sounds. <\/span><\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Risks and complications of surgery<\/span><\/a><\/h4><\/div>\nThe installation of a cochlear implant is a procedure that carries some risks and can result in various complications. Among the possible risks and complications following the installation of a cochlear implant are:<\/p>\n
\n- Infections<\/b>: the surgical wound<\/b> could become infected if not properly disinfected, but this is among the common complications<\/b> of all types of surgery. It is essential not to wet the wound with water for a period specified by the doctor; <\/li>\n
- Suffering\/necrosis of the musculo-cutaneous flap<\/b>: a musculo-cutaneous flap<\/b> that is too thin could go into ischemia<\/b> and, therefore, necrosis. In such a case, a surgical revision<\/b> may be necessary; <\/li>\n
- Extrusion of the receiver<\/b>: this can be a consequence of the suffering\/necrosis of the musculo-cutaneous flap<\/b> and will require a revision surgery;<\/li>\n
- Defective functioning of the receiver<\/b>: a revision surgery<\/b> will be necessary to replace it;<\/li>\n
- Episodes of imbalance and tinnitus<\/a><\/b>: a buzzing<\/b> (tinnitus) is often present in patients with hearing loss.
\nAfter surgery, the buzzing generally decreases; occasionally, however, it may arise after the surgery;<\/li>\n- Vertigo<\/a><\/b>: temporary vertigo, usually lasting a few days, can occur in 5% of our patients; very rarely, this disturbance persists over time;<\/li>\n
- Facial nerve paralysis<\/a><\/b>: a possible but rare postoperative complication is temporary facial paralysis<\/b> which generally recovers spontaneously within a few weeks;<\/b><\/li>\n
- taste disturbances<\/b>: the taste of the anterior third of the tongue on the operated side is ensured by a nerve that passes through the middle ear<\/b>, it is often necessary to cut this nerve and this can cause a temporary taste disturbance in about 10% of patients.
\nThis disturbance can last up to a year and only in rare cases remains permanent;<\/li>\n- cerebrospinal fluid leak\/meningitis<\/b>: the loss of cerebrospinal fluid (cerebrospinal fluid leak) can occur from the opening of the cochlea. To avoid this problem, the area where the electrode enters the cochlea is sealed with fascia and fibrin glue. If this complication occurs in the postoperative period, a revision surgery<\/b> will be necessary to prevent meningitis<\/b>.
\nMeningitis, in very rare cases, can also occur as a consequence of the spread of an infection to the inner ear<\/b>: in this case, the therapy consists of administering massive doses of antibiotics. <\/li>\n<\/ul>\n<\/div><\/div><\/div>
<\/i><\/i><\/span>What is a cochlear implant?<\/span><\/a><\/h4><\/div>\nThe cochlear implant<\/b> is a device that allows hearing<\/b> for adults and children affected by profound deafness<\/b>. It provides electrical impulses<\/b> directly to the fibers of the auditory nerve<\/b> bypassing the damaged cells of the inner ear <\/b>(hair cells). Once the impulses reach the brain, they are interpreted as sounds<\/b>. Cochlear implants are not hearing aids<\/b><\/a>; they do not amplify sounds <\/b>(as hearing aids do), but capture sound, convert it into signals\/electrical impulses<\/b> (as a cochlea<\/b> would), and transfer the newly generated signals\/electrical impulses to the cochlear nerve<\/b> stimulating it. This stimulation of the cochlear nerve ensures the human perception<\/b> and recognition of sound<\/b>.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/a><\/span><\/div><\/div><\/div><\/i><\/i><\/span>What does a cochlear implant look like?<\/span><\/a><\/h4><\/div>\nThe cochlear implant consists of an internal component<\/b> made up of the receiver\/stimulator<\/b> with the electrode array, which is surgically inserted into the ear, and an external component<\/b> made up of the speech processor and the coil, which is usually applied behind the ear (retroauricular region<\/b>).<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Who can benefit from a cochlear implant?<\/span><\/a><\/h4><\/div>\nThe cochlear implant<\/b> is indicated for subjects with bilateral profound deafness<\/b>, either genetic or acquired during life, for whom hearing aids do not provide adequate help in sound perception. In certain subjects, the cochlear implant can significantly improve the quality of life<\/b> (e.g., social, communicative, learning abilities) by enhancing the ability to hear words without the aid of visual signals (e.g., lip reading). Improving the recognition of normal everyday environmental sounds increases the ability to listen<\/b> in a noisy environment and enhances the possibility of hearing during television programs, music, and phone conversations. The cochlear implant can be applied to those subjects<\/b> who have severe or profound sensorineural hearing loss<\/strong> (anacusis) bilaterally, with little or no benefit from using a hearing aid and with strong motivation and expectations. The cochlear implant<\/b> can be applied to both adults and children. A distinction must be made between prelingual<\/b> and postlingual<\/b> deafness: <\/p>\n\n- prelingual<\/b> refers to before the acquisition<\/b> of the ability to produce <\/b>and understand language and speech;<\/b><\/li>\n
- postlingual<\/b> refers to after acquiring the ability to produce<\/b> and understand <\/b>language and speech.<\/li>\n<\/ul>\n
In 60-70% of children, deaf from birth and implanted in the first three years of life, there is normal schooling, this percentage drops to 20-25% if implanted after the 3rd year of life.
\nEven children who are hearing-impaired from birth<\/b> and have postlingual deafness <\/b>can obtain very good results from a cochlear implant; the earlier the implantation procedure is carried out with respect to the onset of deafness, the better the results can be obtained.
\nAdults with <\/b>postlingual deafness<\/b> who have lost their hearing as a result of meningitis, trauma, otosclerosis, or other conditions with progressive hearing loss<\/b> over time can benefit tremendously from cochlear implantation<\/b>.
\nThe concept, as with children, of early intervention also applies to adults.
\nAdults with prelingual deafness<\/b> undergoing cochlear implantation may reap very limited benefits (sound discrimination).<\/p>\n
Although many people are not aware of it, in Italy<\/b> cochlear implantation is totally free of charge as it is paid for by the National Health System<\/b>, and so is the rehabilitation process<\/b> and the pathway<\/b> to its activation<\/b>. Financial assistance from the State can help resolve the discomfort caused by severe forms of sensorineural hearing loss<\/b> by finding the most suitable solution.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>How does a cochlear implant work?<\/span><\/a><\/h4><\/div>\nA generic cochlear implant captures sounds<\/b> from the external environment, converts the captured sounds into electrical impulses\/signals<\/b>, and finally transmits the generated electrical impulses\/signals<\/b> to the cochlear nerve,<\/b> stimulating it.
\nThe stimulation of the cochlear nerve<\/b> ensures the perception and recognition of sounds.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>How is the surgical procedure for cochlear implantation performed?<\/span><\/a><\/h4><\/div>\nL\u2019intervento chirurgico di \u201cinserzione di impianto cocleare\u201d<\/b> viene eseguito da uno specialista in otorinolaringoiatria in anestesia generale<\/b> ed ha una durata di 2-3 ore.
\nDurante l\u2019intero intervento viene eseguito il monitoraggio del nervo facciale<\/a><\/b>. Viene praticata un\u2019incisione della cute a forma di L<\/b> rovesciata.
\nUna volta scollati i tessuti ed esposto l\u2019osso si effettua una piccola mastoidectomia<\/b>. Si esegue la timpanotomia posteriore<\/b>, che ci permette di accedere alla regione della finestra rotonda. A questo punto si crea l\u2019alloggiamento per il ricevitore-stimolatore con l\u2019ausilio di un modellino metallico fornito nel kit dell\u2019impianto. Si esegue, quindi, l\u2019apertura della coclea<\/b> (cocleostomia) e si inserisce (nella scala timpanica) il filo porta elettrodi<\/b> che viene poi fissato con del tessuto connettivo <\/b>pi\u00f9 eventuale colla. Eseguito ci\u00f2, l\u2019audiologo confermer\u00e0 attraverso opportuni tests la corretta collocazione<\/b>.
\nOccorre, inoltre, valutare eventuali interferenze tra gli elettrodi del filo ed il nervo facciale<\/b>. Infine si esegue un\u2019attenta chiusura dei lembi. <\/p>\nNei casi in cui sia necessario impiantare un orecchio affetto da otiti croniche<\/a><\/b> o precedentemente sottoposto a tecniche aperte \u00e8 opportuno rimuovere tutta la patologia ed eseguire la chiusura del condotto uditivo esterno a cul di sacco con obliterazione della cavit\u00e0 al fine di evitare possibili complicanze (meningite). In presenza di infezioni attive, l\u2019inserzione dell\u2019impianto cocleare \u00e8 posticipata ad un secondo tempo.
\nNei pazienti affetti da malformazioni congenite<\/b> \u00e8 opportuno eseguire un\u2019attenta valutazione radiologica<\/b> attraverso una TC<\/a><\/b> ed una RM<\/a><\/b> ponendo particolare attenzione alla perviet\u00e0 della coclea ed al decorso del nervo facciale<\/a><\/b>. Nei casi di reimpianto bisogna porre particolare attenzione alla fibrosi cicatriziale<\/b> a livello della timpanotomia posteriore<\/b> e della finestra rotonda ed inoltre al lembo cutaneo.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Diagnostic preparation process for cochlear implant<\/span><\/a><\/h4><\/div>\nBefore the installation of a cochlear implant<\/b>, the patient must undergo a series of tests to determine suitability for the procedure<\/b>.
\nDuring these tests, the patient will also receive all the information regarding the installation procedure<\/b> (what it involves, pre-operative guidelines, post-operative course, etc.). Before deciding to apply a cochlear implant, it is advisable to perform assessments<\/b>: <\/p>\n\n- Audiological tests<\/b> (e.g., pure tone audiometry<\/a><\/b> and speech audiometry<\/a><\/b> with and without hearing aids, tympanometry, auditory evoked potentials<\/a><\/b>, promontory test)<\/li>\n
- Clinical tests<\/b> (routine blood tests<\/b> for general anesthesia)<\/li>\n
- CT<\/a><\/b> and MRI<\/a><\/b> (for evaluating the anatomy of the inner ear<\/b>)<\/li>\n
- Consultation and speech therapy visit<\/a><\/b><\/li>\n<\/ul>\n<\/div><\/div><\/div>
<\/i><\/i><\/span>Results after cochlear implant installation<\/span><\/a><\/h4><\/div>\nToday, thanks to the continuous advances<\/b> in medical technology in the audiological field<\/b>, the use of a cochlear implant<\/b> represents an excellent remedy<\/b> for resolving many cases of profound deafness<\/b> and moderate to severe hearing loss<\/b>.
\n<\/span><\/p>\nUnfortunately, in Italy, there is still little knowledge and awareness of the positive impact on quality of life<\/b> that the installation of a cochlear implant can bring.
\n<\/span><\/p>\nIn patients with a cochlear implant<\/b>, there is an improvement in<\/b> hearing ability<\/b> and an awareness of sounds<\/b> in daily life.<\/p>\n
Generally, after the activation of the cochlear implant<\/b>, patients can understand speech without lip reading and even talk on the phone. Learning to hear with a cochlear implant<\/b> requires time, practice, determination<\/b>, and patience.
\n<\/span><\/p>\nOn the day of activation<\/b>, many patients can only hear ‘beeps’ or unrecognizable sounds, while others may already be able to understand voices. Fortunately, a great effort<\/b> by the patient can be rewarded, as cochlear implants<\/b> can significantly restore the ability to hear all sounds. <\/span><\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Risks and complications of surgery<\/span><\/a><\/h4><\/div>\nThe installation of a cochlear implant is a procedure that carries some risks and can result in various complications. Among the possible risks and complications following the installation of a cochlear implant are:<\/p>\n
\n- Infections<\/b>: the surgical wound<\/b> could become infected if not properly disinfected, but this is among the common complications<\/b> of all types of surgery. It is essential not to wet the wound with water for a period specified by the doctor; <\/li>\n
- Suffering\/necrosis of the musculo-cutaneous flap<\/b>: a musculo-cutaneous flap<\/b> that is too thin could go into ischemia<\/b> and, therefore, necrosis. In such a case, a surgical revision<\/b> may be necessary; <\/li>\n
- Extrusion of the receiver<\/b>: this can be a consequence of the suffering\/necrosis of the musculo-cutaneous flap<\/b> and will require a revision surgery;<\/li>\n
- Defective functioning of the receiver<\/b>: a revision surgery<\/b> will be necessary to replace it;<\/li>\n
- Episodes of imbalance and tinnitus<\/a><\/b>: a buzzing<\/b> (tinnitus) is often present in patients with hearing loss.
\nAfter surgery, the buzzing generally decreases; occasionally, however, it may arise after the surgery;<\/li>\n- Vertigo<\/a><\/b>: temporary vertigo, usually lasting a few days, can occur in 5% of our patients; very rarely, this disturbance persists over time;<\/li>\n
- Facial nerve paralysis<\/a><\/b>: a possible but rare postoperative complication is temporary facial paralysis<\/b> which generally recovers spontaneously within a few weeks;<\/b><\/li>\n
- taste disturbances<\/b>: the taste of the anterior third of the tongue on the operated side is ensured by a nerve that passes through the middle ear<\/b>, it is often necessary to cut this nerve and this can cause a temporary taste disturbance in about 10% of patients.
\nThis disturbance can last up to a year and only in rare cases remains permanent;<\/li>\n- cerebrospinal fluid leak\/meningitis<\/b>: the loss of cerebrospinal fluid (cerebrospinal fluid leak) can occur from the opening of the cochlea. To avoid this problem, the area where the electrode enters the cochlea is sealed with fascia and fibrin glue. If this complication occurs in the postoperative period, a revision surgery<\/b> will be necessary to prevent meningitis<\/b>.
\nMeningitis, in very rare cases, can also occur as a consequence of the spread of an infection to the inner ear<\/b>: in this case, the therapy consists of administering massive doses of antibiotics. <\/li>\n<\/ul>\n<\/div><\/div><\/div>
The cochlear implant<\/b> is a device that allows hearing<\/b> for adults and children affected by profound deafness<\/b>. It provides electrical impulses<\/b> directly to the fibers of the auditory nerve<\/b> bypassing the damaged cells of the inner ear <\/b>(hair cells). Once the impulses reach the brain, they are interpreted as sounds<\/b>. Cochlear implants are not hearing aids<\/b><\/a>; they do not amplify sounds <\/b>(as hearing aids do), but capture sound, convert it into signals\/electrical impulses<\/b> (as a cochlea<\/b> would), and transfer the newly generated signals\/electrical impulses to the cochlear nerve<\/b> stimulating it. This stimulation of the cochlear nerve ensures the human perception<\/b> and recognition of sound<\/b>.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div> The cochlear implant consists of an internal component<\/b> made up of the receiver\/stimulator<\/b> with the electrode array, which is surgically inserted into the ear, and an external component<\/b> made up of the speech processor and the coil, which is usually applied behind the ear (retroauricular region<\/b>).<\/p>\n<\/div><\/div><\/div> The cochlear implant<\/b> is indicated for subjects with bilateral profound deafness<\/b>, either genetic or acquired during life, for whom hearing aids do not provide adequate help in sound perception. In certain subjects, the cochlear implant can significantly improve the quality of life<\/b> (e.g., social, communicative, learning abilities) by enhancing the ability to hear words without the aid of visual signals (e.g., lip reading). Improving the recognition of normal everyday environmental sounds increases the ability to listen<\/b> in a noisy environment and enhances the possibility of hearing during television programs, music, and phone conversations. The cochlear implant can be applied to those subjects<\/b> who have severe or profound sensorineural hearing loss<\/strong> (anacusis) bilaterally, with little or no benefit from using a hearing aid and with strong motivation and expectations. The cochlear implant<\/b> can be applied to both adults and children. A distinction must be made between prelingual<\/b> and postlingual<\/b> deafness: <\/p>\n In 60-70% of children, deaf from birth and implanted in the first three years of life, there is normal schooling, this percentage drops to 20-25% if implanted after the 3rd year of life. Although many people are not aware of it, in Italy<\/b> cochlear implantation is totally free of charge as it is paid for by the National Health System<\/b>, and so is the rehabilitation process<\/b> and the pathway<\/b> to its activation<\/b>. Financial assistance from the State can help resolve the discomfort caused by severe forms of sensorineural hearing loss<\/b> by finding the most suitable solution.<\/p>\n<\/div><\/div><\/div> A generic cochlear implant captures sounds<\/b> from the external environment, converts the captured sounds into electrical impulses\/signals<\/b>, and finally transmits the generated electrical impulses\/signals<\/b> to the cochlear nerve,<\/b> stimulating it. L\u2019intervento chirurgico di \u201cinserzione di impianto cocleare\u201d<\/b> viene eseguito da uno specialista in otorinolaringoiatria in anestesia generale<\/b> ed ha una durata di 2-3 ore. Nei casi in cui sia necessario impiantare un orecchio affetto da otiti croniche<\/a><\/b> o precedentemente sottoposto a tecniche aperte \u00e8 opportuno rimuovere tutta la patologia ed eseguire la chiusura del condotto uditivo esterno a cul di sacco con obliterazione della cavit\u00e0 al fine di evitare possibili complicanze (meningite). In presenza di infezioni attive, l\u2019inserzione dell\u2019impianto cocleare \u00e8 posticipata ad un secondo tempo. Before the installation of a cochlear implant<\/b>, the patient must undergo a series of tests to determine suitability for the procedure<\/b>. Today, thanks to the continuous advances<\/b> in medical technology in the audiological field<\/b>, the use of a cochlear implant<\/b> represents an excellent remedy<\/b> for resolving many cases of profound deafness<\/b> and moderate to severe hearing loss<\/b>. Unfortunately, in Italy, there is still little knowledge and awareness of the positive impact on quality of life<\/b> that the installation of a cochlear implant can bring. In patients with a cochlear implant<\/b>, there is an improvement in<\/b> hearing ability<\/b> and an awareness of sounds<\/b> in daily life.<\/p>\n Generally, after the activation of the cochlear implant<\/b>, patients can understand speech without lip reading and even talk on the phone. Learning to hear with a cochlear implant<\/b> requires time, practice, determination<\/b>, and patience. On the day of activation<\/b>, many patients can only hear ‘beeps’ or unrecognizable sounds, while others may already be able to understand voices. Fortunately, a great effort<\/b> by the patient can be rewarded, as cochlear implants<\/b> can significantly restore the ability to hear all sounds. <\/span><\/p>\n<\/div><\/div><\/div> The installation of a cochlear implant is a procedure that carries some risks and can result in various complications. Among the possible risks and complications following the installation of a cochlear implant are:<\/p>\n<\/a><\/span><\/div><\/div><\/div><\/i><\/i><\/span>What does a cochlear implant look like?<\/span><\/a><\/h4><\/div>
<\/i><\/i><\/span>Who can benefit from a cochlear implant?<\/span><\/a><\/h4><\/div>
\n
\nEven children who are hearing-impaired from birth<\/b> and have postlingual deafness <\/b>can obtain very good results from a cochlear implant; the earlier the implantation procedure is carried out with respect to the onset of deafness, the better the results can be obtained.
\nAdults with <\/b>postlingual deafness<\/b> who have lost their hearing as a result of meningitis, trauma, otosclerosis, or other conditions with progressive hearing loss<\/b> over time can benefit tremendously from cochlear implantation<\/b>.
\nThe concept, as with children, of early intervention also applies to adults.
\nAdults with prelingual deafness<\/b> undergoing cochlear implantation may reap very limited benefits (sound discrimination).<\/p>\n<\/i><\/i><\/span>How does a cochlear implant work?<\/span><\/a><\/h4><\/div>
\nThe stimulation of the cochlear nerve<\/b> ensures the perception and recognition of sounds.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>How is the surgical procedure for cochlear implantation performed?<\/span><\/a><\/h4><\/div>
\nDurante l\u2019intero intervento viene eseguito il monitoraggio del nervo facciale<\/a><\/b>. Viene praticata un\u2019incisione della cute a forma di L<\/b> rovesciata.
\nUna volta scollati i tessuti ed esposto l\u2019osso si effettua una piccola mastoidectomia<\/b>. Si esegue la timpanotomia posteriore<\/b>, che ci permette di accedere alla regione della finestra rotonda. A questo punto si crea l\u2019alloggiamento per il ricevitore-stimolatore con l\u2019ausilio di un modellino metallico fornito nel kit dell\u2019impianto. Si esegue, quindi, l\u2019apertura della coclea<\/b> (cocleostomia) e si inserisce (nella scala timpanica) il filo porta elettrodi<\/b> che viene poi fissato con del tessuto connettivo <\/b>pi\u00f9 eventuale colla. Eseguito ci\u00f2, l\u2019audiologo confermer\u00e0 attraverso opportuni tests la corretta collocazione<\/b>.
\nOccorre, inoltre, valutare eventuali interferenze tra gli elettrodi del filo ed il nervo facciale<\/b>. Infine si esegue un\u2019attenta chiusura dei lembi. <\/p>\n
\nNei pazienti affetti da malformazioni congenite<\/b> \u00e8 opportuno eseguire un\u2019attenta valutazione radiologica<\/b> attraverso una TC<\/a><\/b> ed una RM<\/a><\/b> ponendo particolare attenzione alla perviet\u00e0 della coclea ed al decorso del nervo facciale<\/a><\/b>. Nei casi di reimpianto bisogna porre particolare attenzione alla fibrosi cicatriziale<\/b> a livello della timpanotomia posteriore<\/b> e della finestra rotonda ed inoltre al lembo cutaneo.<\/p>\n<\/div><\/div><\/div><\/i><\/i><\/span>Diagnostic preparation process for cochlear implant<\/span><\/a><\/h4><\/div>
\nDuring these tests, the patient will also receive all the information regarding the installation procedure<\/b> (what it involves, pre-operative guidelines, post-operative course, etc.). Before deciding to apply a cochlear implant, it is advisable to perform assessments<\/b>: <\/p>\n\n
<\/i><\/i><\/span>Results after cochlear implant installation<\/span><\/a><\/h4><\/div>
\n<\/span><\/p>\n
\n<\/span><\/p>\n
\n<\/span><\/p>\n<\/i><\/i><\/span>Risks and complications of surgery<\/span><\/a><\/h4><\/div>
\n
\nAfter surgery, the buzzing generally decreases; occasionally, however, it may arise after the surgery;<\/li>\n
\nThis disturbance can last up to a year and only in rare cases remains permanent;<\/li>\n
\nMeningitis, in very rare cases, can also occur as a consequence of the spread of an infection to the inner ear<\/b>: in this case, the therapy consists of administering massive doses of antibiotics. <\/li>\n<\/ul>\n<\/div><\/div><\/div>