The Eye and ENT care wing is a well-developed end of Dr Shroff’s Charity Eye Hospital providing services for eye, nose and throat related problems to the population. While all three are well equipped to handle and manage simple to complicated cases, one of the most sophisticated service is cochlear implant. High-quality work and clinical excellence have been the strength of ENT at SCEH, apart, from the fact that there is a large human relationship quotient, a very high degree of personalized care that combines the benefits of an individual as well as institutional practice.
A cochlear implant is a device that is can be surgically implanted in the ear of people with neural deafness. It works by stimulating the hearing nerve with electrical signals. In neural hearing loss, the hair cells of the cochlea are damaged. The cochlear implant bypasses these non-functional hair cells. The implant consists of an external processor that fits behind the ear and an internal portion that is surgically fixed under the skin.
Parts of a Cochlear Implant are as follows-
A microphone that receives sound from the environment.
A speech processor, that processes the sound received by the microphone
A transmitter and receiver/stimulator, which receives signals from the speech processor and converts them into electric impulses.
An electrode array, that collects the impulses from the stimulator and sends them to different parts of the auditory nerve.
According to U.S. Food and Drug Administration [FDA], as of December 2012, approximately 324,200 registered devices have been implanted worldwide. In the United States, roughly 58,000 devices have been implanted in adults and 38,000 in children. In India, too, this technology is rapidly gaining ground. However, the prohibitive cost of the Implant still makes it a surgery that has had less penetration than its actual need. Even though approximately 7% of our population suffers from profound hearing loss the penetration of the surgery has been around 10,000 only.
The FDA first approved cochlear implants in the mid-1980s to treat hearing loss in adults. Since 2000, cochlear implants have been FDA-approved for use in eligible children beginning at the age of 12 months. With experience and observation/ validation of the procedure and the technology, this age is constantly being revised downward. All other factors being safe, children as young as three to six months have been implanted in countries like Australia. The best results were found among children who received the cochlear implant at 0-3 years of age. They achieved 90 to 95 % hearing and language improvement. 80-90 % of these children develop a hearing and speech equal to those of children with normal hearing. (National Institution Deafness and Other Communication Discords (NIDCD)
In India first surgery was carried out in 1994. Although transplantation in India has been available for a long time due to high costs it is beyond the reach of the majority of people. The cost of cochlear implant surgery procedure in India ranges upwards of INR 7,00,000 depending upon the cost of the implant chosen by a particular centre, which is comparatively lesser than the western countries (Indian Journal of Medical Science March 2011)
We, at Shroff’s have been catering to the section of society that has as yet not had access to this procedure. With our fundraising and cross-subsidy efforts, we presently do a few implants with equal surgical and technical skill like any other centre. These numbers, have, however, so far been few. Our children are doing excellently, the youngest is now 5- three years post-implant.
Further research is likely to add many new dimensions to the hearing restoration making a difference not just to the lives of the implantees but also of the families of profoundly hearing impaired. The way forward is to make the procedure affordable and post-operative care accessible to even the weakest sections of society. This, particularly, is an area of absolute strength for our institution. More than a hundred years in the service of the community has made us uniquely able to fulfil this gap in the need of our country.