Examining the Pros and Cons of the Cochlear Implant

In considering the cochlear implant, it is important to separate the hype that is often associated with this ground-breaking technology from the reality that, despite the wow factor, it does have limitations. Commonly referred to as a bionic ear, it is a device that one cannot deny has changed the lives of many of those affected by severe to profound hearing loss for the better. Unlike the conventional hearing aid which simply amplifies incoming sound to compensate for defects in the conductive or sensory mechanisms of the ear, these devices are actually an attempt to circumvent this normal pathway and, instead, to provide a working alternative.

Firstly, the impulses generated by a cochlear implant and passed to the brain via the auditory nerve are not identical to those experienced by a hearing individual. However, in much the same way that the dots and dashes used in Morse code can be interpreted as a meaningful message by anyone who has been taught to decipher it, those alternative sound sensations may be interpreted just as successfully with sufficient practice. Clearly the slight disadvantage arising from the time needed for a patient to become sufficiently proficient in understanding the new sensations can be more than compensated by the benefits of improved two-way communication.

This learning-curve requirement in no way detracts from the potential of a cochlear implant to transform the life of someone whose hearing is seriously impaired. It can allow those previously considered unemployable to pursue a career, and children that might otherwise have required specialised schooling to attend mainstream schools. Every candidate who is accepted for this procedure will have first been subjected to in-depth aural examination and audiological testing. Only those subjects in which both ears are affected, and for whom a conventional hearing aid has been demonstrated to offer no significant benefits, will ultimately be considered for an implanted device.

Acceptable candidates will typically be aged between 12 months and 69 years although, in children, cochlear implant surgery is not normally performed until they are at least 2 years of age. Interestingly, children and adults deaf from birth tend to adjust more quickly to the modified sound sensations than adults whose hearing has become impaired later in life. The difference lies in the fact that, in the latter subjects, old associations must be unlearned in favour of new ones, whilst those unfamiliar with speech more readily associate the new sounds with the people and situations that are responsible for them.

One cannot overlook the fact that all surgery carries risks and that the overall cost of implantation is high. Nevertheless, the pros of a cochlear implant far outweigh the cons.

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