25 July 2022
The cochlear implant first came into being in Melbourne, Australia, in 1982. A collaboration between an audiologist, a professor and two surgeons resulted in the world’s first multichannel cochlear implant. This life-altering technology would go on to become a worldwide solution for those suffering moderately severe to profound hearing loss.
This remarkable device is discretely implanted inside the cochlear and works with a highly compact external speech processor that transmits the sound to the cochlear.
Unlike hearing aids, which amplify sound, a cochlear implant bypasses damaged hair cells in the cochlear and stimulates the hearing nerve directly. A cochlear implant can also be used for patients with acquired single-sided deafness.
There are two main components to a cochlear implant; the implant itself, which is inside the cochlear organ and the highly compact external processor, which can be worn on or off the ear. This processor is connected to the head through a tiny magnet. These tiny processors are technological powerhouses and provide features including Bluetooth connection providing direct and easy access to your mobile phone or iPad at any time.
The device is small, compact and technologically savvy, although you don’t need to be technologically savvy to wear it.
Provided your general health is good, you meet the criteria, have a good support network and are motivated, age is no barrier to receiving a cochlear implant.
While the majority of people with hearing loss can be helped with hearing aids, for some, hearing aids are not enough due to the extent of cochlear damage. For these people, simple everyday situations become stressful and challenging; crossing the street, speaking to co-workers, friends and family, going for a walk outside, speaking on the phone and going to the shops. In many cases, all of this leads you to experience regular anxiety and exclusion. The things you love doing in life can become difficult and unfulfilling.
A cochlear implant has the ability to change this.
A cochlear implant can be an extraordinary alternative that changes your life and alters your state of mind. In many cases, it allows you to get back to doing what you love. For some, it even allows them to start doing things they’ve never done before.
How the ear hears with a cochlear implant:
The benefits depend on the recipient and their lifestyle, but regardless of anything, a cochlear implant has the ability to greatly improve your overall well-being and quality of life.
Step 1: The Cochlear Implant Candidacy Questionnaire
To ensure that cochlear implants are fitted to the right candidates at the right time, the Attune cochlear implant team will need to obtain information about your hearing history, the devices you are using to assist your hearing and to understand your current hearing difficulties. Attune uses this information to advise you and your loved ones of your suitability for a cochlear implant assessment.
Step 2: Referral to Implant Surgeon
Ask your GP for a referral to an Attune cochlear implant surgeon. Cochlear implant surgery is performed by Ear, Nose and Throat (ENT) surgeons with specialist implant training. Your surgeon will advise your medical suitability for implantation.
Step 3: Evaluation and Information Session
When you visit the Attune Cochlear Implant Centre, your audiologist will:
*We recommend you bring a family member or loved one to this appointment as a second person can go through the process with you and learn how they can assist you with your implant.
Step 4: Specialist Tests and Investigations
Attune works closely with a team of Ear, Nose and Throat surgeons, audiologists and psychologists with a wealth of experience in this field so you and your loved ones can have peace of mind knowing you are receiving expert care.
These investigations include:
Step 5: Schedule of Surgery
If the investigations indicate you are eligible for an implant and it would be of benefit to you, and you decide to proceed, your implant surgeon will schedule your surgery.
Cochlear implantation is a routine procedure performed in a hospital by an Ear, Nose and Throat surgeon. The procedure generally takes one to two hours, and most patients stay in the hospital for one night.
What does implant surgery involve?
You are encouraged to discuss the surgery and any potential risks at the pre-operation appointment, where they will provide you with all the information you need before proceeding. Candidates attend a pre-operative appointment before their implant surgery to ensure they are physically well, manage any medications such as blood thinners, explain the implant process and allow you to ask any questions. The surgeon’s secretaries will notify you when to stop eating and drinking before surgery and when and where to present at the hospital.
Most patients are admitted on the day of surgery, and the operations are done under general anaesthetic. The surgery takes between 1-2 hours on average, and most patients stay one night in hospital. A head bandage is applied for the initial period after the surgery. You can continue to wear your hearing aid in the non-implanted ear during your recovery. A post-operative check with the implant surgeon typically occurs one-week post-surgery.
Depending on the type of work you do, some patients return to work one to two weeks post-surgery: rest and avoidance of strenuous activities and sudden movement are important.
Step 6: Activation of your implant
About 10 to 14 days after your surgery, your speech processor will be turned on by your Attune audiologist. This is probably the most exciting and joyful moment of the whole process, so we like to make sure you have your loved ones there to experience this with you!
At this appointment, your Attune audiologist will:
Brain plasticity is a crucial part of maximising the incredible benefits a cochlear implant can provide. This is why we incorporate auditory and communication training as part of the rehabilitation program. This allows you to maximise your device’s potential and helps you adjust to your new implant at home.
Speech sounds very different when the cochlear implant is first activated. Structured listening practice helps you to learn to listen to the implant sound and become more proficient in hearing with your new device. A short period of daily training helps you to see that you are making progress, and It helps your frequent communication partner (often a spouse or family member) to understand how to adjust their own speech to make it easier for you. Auditory Training helps recipients and their families to understand the limitations of the implant. For example, how far away can I talk with someone? Many recipients report that listening practice helped to build their confidence with the new device, especially if they had not heard in the implanted ear for a long period of time.
Auditory training takes place at home usually and can take many forms. These include exercises given by the clinic to do at home with a family member, programs that can be downloaded onto their home computer or tablet, apps, recorded books and other sources that can be accessed by phones direct to the implant.
Communication training explores the broader context by answering questions such as the following:
Your Attune audiologist will work through these with you and help you understand and establish tactics to feel as comfortable and confident as possible in every scenario.
Throughout the whole implant process, our implant audiologist works closely to support you and ensure your comfort and well-being every step of the way.
The Attune cochlear implant program has no waiting lists, giving you and your loved ones immediate access to expert help when you need it most.
If you have moderately severe to profound hearing loss and find hearing aids are not of great benefit, you could be a candidate for a cochlear implant. It is always best to seek advice from a medical professional who can assess your current hearing and advise whether a cochlear implant would be the best solution for you.
The choice of implant system is made collaboratively between the audiologist and the patient. This is dependent upon a number of factors, including dexterity, familiarity and comfort with technology, medical status and work or social environment.
There is a wide range of features and benefits available in each type of implant system, which is why we like to get an understanding of your lifestyle so we are able to best advise you on which products and features would benefit you the most. Some of the available features include dual microphones, waterproof options, iPhone control, processor-off-the-ear, wireless accessories, dust and smash-proof and disposable and rechargeable batteries. For example, if you are a professional who requires Bluetooth and relies heavily on your smartphone, we would ensure you get a product with a high level of connectivity. Following your investigation and assessment phase, your audiologist will go through the features and benefits of what is available to you and determine the best possible solution for you.
In bone conduction implants, such as the Bone Anchored Hearing Aid (BAHA) and Bonebridge implants, external sounds are converted into mechanical vibrations, which are sent to the inner ear through the bone.
Patients with the following health conditions may be assessed for a BAHA or Bonebridge implant.
Which type of implant is recommended as the right solution for you is assessed based on your hearing condition. Cochlear implants are for severe to profound hearing loss, whereas bone conduction implants are for mild to severe hearing loss, conductive hearing loss, single-sided deafness or mixed hearing loss.
Those with mixed hearing loss and conductive hearing loss have a functioning cochlea. Due to a multitude of reasons, the middle ear is not functioning normally, which prevents sound from travelling from the outer ear to the cochlear. The bone conduction implants are designed to help the external sounds travel to the cochlear through vibrations and are especially suitable for those who cannot tolerate conventional hearing aids for medical reasons.
Bone induction implants can also be fitted for single-sided deafness, provided that the ear has had hearing in the past.
Those suffering from single-sided deafness typically have one ear with normal hearing and one ‘dead ear’. These patients can wear an external sound processor on the side with hearing loss. This picks up the sound on the dead side and travels it to the side with a functioning cochlea, which allows them to hear sounds from both sides.
Implant care and management are provided by a highly experienced team of Ear, Nose and Throat surgeons and Audiologists. The management program involves:
In middle ear implants such as the Vibrant Soundbridge (VSB), the implant itself is used to convert external signals into vibrations. These vibrations are then picked up by the small bones in the middle ear.