Cochlear Implant Cost
What is Included in the Cost of a Cochlear Implant?As is the case with any elective surgery, one aspect to be considered will invariably be the cost. However, while fitting a cochlear implant may not be the cheapest of procedures, the alternative of continuing to experience the difficulties that accompany severe to profound hearing loss in a predominately audio-visual society, could prove to be a false economy.
For those whose auditory impairment is less marked, the option of a conventional hearing aid is one that will be far cheaper. For those who may find it difficult to understand the apparent price disparity, the explanation is relatively simple. Firstly, one must take into account that no surgery is involved. Just a routine hearing test is sufficient to confirm the need, and to identify the most appropriate hearing aid for a patient’s needs. Thereafter, unlike the cochlear implant, there should be no additional cost, as there will be no need for further intervention beyond that of fine-tuning the device in order to ensure optimal performance.
While both of these are assisted hearing devices, they employ very different principles. A hearing aid is essentially a miniature amplifier. It collects external sounds via a microphone and selectively amplifies those frequencies that were identified as problematical during the audiological examination. This type of device works because when the balanced mix of sounds is conducted to the inner ear, normal sensory activity then relays the appropriate nerve impulses to the brain for interpretation.
By contrast, the cochlear implant is far from being a simple amplifier. Its higher cost can easily be explained by the fact that it is designed to act as a substitute for the sensorineural activity of the inner ear in patients where the delicate hair cells responsible for this activity are either severely damaged or absent. In such cases, simply amplifying incoming sounds would be of no value, given the lack of any means to convert them into nerve impulses, so a more complex form of technology is required.
Because of the invasive nature of the procedure employed to fit a cochlear implant and the associated cost, it is not a course that an ENT specialist will undertake blindly. Before proceeding, he or she will first wish to conduct a thorough evaluation of each patient who is referred as a possible candidate for implantation. For a patient to have arrived at the referral stage, an audiologist will already have confirmed the presence of severe to profound sensorineural hearing loss, and also that the patient is unable to gain any significant benefit from the use of a conventional hearing aid.
Once the need has been established, the surgeon will want to be sure that there are no problems that could complicate the surgery when attempting to position the cochlear implant, which might therefore fail to justify the cost of proceeding. In addition to establishing that the patient’s general health is sound enough to cope with the anaesthetic, a full ENT examination, and X-rays, a CT scan may also be required to locate any possible anatomical anomaly that might need to be considered when performing the surgery.
In the absence of any contraindications, the surgery will normally be conducted under a general anaesthetic, and should probably take between three and four hours. An incision made behind the ear exposes the mastoid bone, to which the receiver/stimulator component is anchored. Via the middle ear space, an opening is then made in the cochlea through which the electrode array from the receiver is inserted. With the internal components of the cochlear implant in place, the external microphone, transmitter, and speech processor can then be positioned. However, the cost doesn’t end there.
The sound sensation experienced by the brain differs from that produced by normal sensorineural stimulation. It is usually necessary to assist the patient to be accustomed to the new sensation, and may even require the support of a speech therapist. During the process, adjustments to the device will need to be made in order to produce the best possible performance.
Given this insight into the evaluation of candidates, the nature of the surgery, the complexity of the device, the post-surgical support, and the life-changing benefits of a cochlear implant, it is not hard to justify the cost. More importantly, the bulk will be covered by most of the medical aids in South Africa, so don’t be afraid to discuss the possibilities with an expert audiologist at your nearest Ear Institute.