Otolaryngology and Cochlear Implants

With all of otolaryngology’s many traditions, the field is pioneering work on one of the most advanced neuroprosthetic devices ever devised. Cochlear implants promise to bring the gift hearing to those who are deaf or profoundly hard-of-hearing. Otolaryngology, especially the subspecialty of neuro-otology, is bringing sound to those previous destined to be deaf throughout their lives.

 

In contrast to a hearing aid which simply amplifies sound waves, a cochlear implant is a complex medical device that collects sound waves, converts the information, and presents it to the central nervous system in a form that it can understand. The cochlear implant is comprised of a microphone, a speech processor, a receiver/transmitter, and an electrode array. The speech processor takes the sound collected by the microphone and organizes it. The information is then converted into electric impulses which are sent through the electrode array directly to the auditory nerve. While current versions of the device do not provide perfect hearing, they do provide patients with useable sound information and can allow them to understand speech.

 

 

Children and adults can be implanted with cochlear implants, often by a doctor of otolaryngology. These doctors of the ear, nose, and throat are ideally suited to place these sophisticated devices. Doctors of otolaryngology train in both the medical and surgical aspects of diseases of the ear and related brain structures. Not all otolaryngologists place these cochlear devices so patients seriously considering the surgery should find a specialist that is skilled at evaluating patients for placement, placing the device, and providing training and management of the device. This generally requires the services of a specialist within the field of otolaryngology, such as a neuro-otologist, a pediatric otolaryngologist, or one that specializes in audiology.

 

It is important to remember that for individuals that have never heard sound, training after cochlear implant patient can be extensive. Not only must the person be taught the verbal version of their respective language, but the sounds that are transmitted by the neuroprosthetic device need to deciphered and interpreted. This can take a great deal of time and effort on the part of the patient, the patient’s family and medical professional providing care. Most of this therapy will be provided by an audiologist or speech therapist however, the long term care of the patient should be directed by a doctor of otolaryngology, preferably the one that did the initial evaluation and implant.

 

In the future, research in otolaryngology may make the use of cochlear implants obsolete. Current research efforts are aimed at restoring or replacing damaged hair cells, the sensory structures that harness sounds waves and transmit them to the brain in the normal ear. If otolaryngologist and neuroscientists can develop this treatment, the need for cochlear implants may become a thing of the past because it will provide normal hearing. Until that technology is clearly established, cochlear implants remain a powerful tool for doctors of otolaryngology to restore a form of hearing to the deaf and profoundly hard-of hearing.