Cochlear implant

Cochlear implant (or helix) and the means provided by the development of scientific research in recent years, in order to help the deaf to overcome their disabilities, and to facilitate their integration in society.
In order to identify the subject well not be mentioned the following points:
- The need to start with a brief introduction on the cochlea and its work.
- Find a deal without going into my theoretical research complex.
- Discuss the topic in general, taking into account that each case of lack-of-hearing
Is a state independent, and need a detailed study to take the right decision.
Introduction to anatomical and functional: the ear is composed anatomically of three sections:
External ear middle ear --- ----- the inner ear.
External ears and middle are responsible for transport mechanical vibrations of the sound coming from the external environment.
The inner ear is composed of a device for the hearing and balance. My hearing is in the cochlea
Containing sensitive organ in charge of the transfer hearing to the auditory nerve, the so-called
Corti's organ
This user noble contains hairy sensory nerve cells that convert sound vibrations from the middle ear hyphen to an electrical signal called "Siala nerve." These cells communicate with the auditory nerve fibers which transfers Sayala nerve to the brain centers.
This is a flow diagram of the sound vibrations until it reaches the brain electrical signals
Subject to analysis and interpretation.

Sensorineural hearing loss occurs in most cases due to the infection in these cells sensitive
The reasons for this infection: congenital malformations, infections, genetic factors, bacterial and viral causes of traumatic ,................
When the infection of these cells - and the degree of injury - the snail loses its ability to convert sound vibrations into electrical signals, and thus occurs in the relative lack of ability to hear.
The principle of cochlear implant: implant a small computer (we will explain how later) The function of the cochlea in terms of the transfer of sound vibrations into electrical signals. Who shall pick up the sound vibrations from the middle of the outside and sends it to the computer, which analyzes and amplified, then sent
Reference to the internal segment cultivated by delivering the message by electrical audio
Tiny wires to the auditory nerve fibers, and then follow up roads as usual.

Who are the deaf candidates for cochlear implants?
There are several requirements to run for the cochlear implant:
- The presence of sensorineural hearing deficiency dual varies in intensity between the strong and deep.
- Ensure the integrity of the auditory nerve fibers by special tests. (Because the goal is an alternative to cochlear implants and not for the auditory nerve)
- The failure of the occurrence of any evolution at the level of speech after the experience of hearing aids with appropriate private undergo rehabilitation for a period of at least six months.
- A natural evolution of spiritual activist.
- The absence of contra-indicated (and Snzla in a separate paragraph)
- Age: plays a key role in the success of cochlear implants, and Snfred has a special search.
Important Note:
The assessment of hearing aids depends on a previously heard in the planning arena free, then
Show that this assessment is accurate. Became dependent evaluation - especially when cochlear implants report - on
Speech discrimination tests the existence of hearing aids in the arena free. Because the basis for the evaluation of certain audio is the understanding of speech and not pick up the votes over the net.
What are the contraindications transplant snail?
- Disruption of one of the conditions precedent to run for surgical work.
- Contraindications general anesthesia.
- A disease in advanced.
- A neurological disorder or psychological important.
- Some of the distortions of the Rock (diagnosed with radiographic imaging).
- There is no strong incentive to follow up when the parents of the rehabilitation work following surgery.
The role of age in determining the degree of success of the cochlear implant.
Age interfere to a large extent determine the level of the results of cochlear implants.
It is well known that the greater the age of incidence is smaller clear speech was delayed, so it was divided
People living with hearing into three groups according to age of incidence:
1 - Pre-speech prelingual: and where the infection is very brilliant deaf (congenital or acquired
In the first months of age), prior to the acquisition of any to be uttered.
2 - PERI talk perilingual: and where the injury occurs at the age of slightly larger than the previous group, in a time when the child has exceeded a certain stage in the acquisition of pronunciation.
3 - post-speech postlingual: and where the injury occurs when a large child or an adult, and the acquisition of the speech was full before the injury.
It is clear that the sons of the first group in need of intensive training and rehabilitation after surgery, because of the lack of any stock hearing my words to them, and thus long Vtahillhm
And the results have medium quality.
So whenever there deafness in older age groups were warning of rehabilitation and the acquisition of speech better.
Perhaps the latter group is the group ideal, which gives the best results, because the patient
Has a full stock of words can easily return to it when you make rehabilitation.
The age factor also intervenes in other ways, including: the difficulty of ascertaining the degree of hearing loss
Children fairly young too, development of anatomical conditions of the middle ear cavities they have.
In general, we say that the earliest age can be proposed by the cochlear implant is the age of two, but some of the world's centers conducted a transplant at the age of early (six months) in some cases
Exceptional, as in hearing loss following the deep inflammation of the meninges and the fear of a calcification
Subsequent to meningitis, which reduces the surgical results of the work and aggravated the difficulty.
As for the injuries can be gained proposal cochlear implant after a waiting period within six months
To ensure the stability of the injury.
Important note: You must know that the audio alerts that are passed them on the ear to the brain is responsible for the maturity of the auditory brain centers. Thus, the brain does not receive this
Alerts when children heard the lack of injury leads to severe immaturity of the auditory centers. Hence the need for early intervention to rehabilitation and development of specific audio or an
Cochlear implant, in order to preserve the natural evolution of the brain regions of audio.
What is the outline of the study Almtojb made to see the candidates for cochlear implants?
This study includes the following points:
- The precise interrogation of the patient and family: the date of the hearing loss, its development, the degree of speech development, hearing aids, training, spiritual development motor, psychological, common diseases, the ability to visual (lip reading), family antecedents.
- A study of hearing and include: planning hearing tone net, speech discrimination test with and without
Hearing aids, impedance and reflex Alrkaph audio, broadcast audio auricular OEA, Alkmonat induced hearing ABR.
- Stimulation test auditory nerve fibers to the knowledge of the degree of safety.
- Study of the level of speech by a specialist in this art, so as to know the degree of development of speech, lip reading, sign language.
- A social psychological study of the patient and his family.
- A study of the development of the material of the patient and his family.
- Verification of the existence of a strong motivation and enthusiasm in the family to follow the long rehabilitation following.
- X-ray study of the great rock.
- Development of a test period hearing aids and to subject the patient to an appropriate qualification for
At least six months, and then assess the degree of benefit of this procedure.

What are the forms of the device implanted? What are the main piece?
Devices are divided in to:
- Devices within the cochlea: the intervention of electrodes (electrodes) into the cochlea through the round window. They are most effective.
- Devices outside the cochlea: applied electrodes on the surface of the bone called the (Alkhrashwm)
Without entering into the cochlea. Their effectiveness is limited, and decreasing with time. Prices
Much lower than the previous.
- Single-channel devices: an electrode containing an electric one. Ineffective.
- Devices many channels: by the number of different manufacturers. They are most effective.
Now is the perfect device many channels within the cochlea.
The major parts that make up the device, there is a piece of Interior that are placed surgically
In a hole in the mastoid bone, and this piece has the end of the electrodes bear entering the cochlea through the
Round window.
There is a piece consisting of external microphone is placed behind the ear picks up sounds and sends
To your Pocket (placed in the pocket) or to a device behind the ear, which analyzes the votes
And converted into an electrical signal transmitted to the own coded another piece placed on the surface of the mastoid bone and corroborating with the magnetic field of the internal piece mentioned above.
Is the device implanted is expensive?
The fact that the price of the core obstacle to the spread of cochlear implants.
When calculating the costs must be taken into account: the price of the system + wage-operative
And treatment + long-term rehabilitation, which may amount to years, and Maystlzim that sometimes change to the residential area and the disruption of work and wages of the movements.
The average cost of a computer many channels between twenty and thirty thousand dollars.
The single channels (and virtually disappear from the market) Fetmenh within seven thousand dollars.
What are the possibilities available in the Arab countries?
There has been a constant evolution in this area in Arab countries. The fundamental problems are manifested in: the high cost price, the lack of rehabilitation centers are prevalent in each country, leading to a
Significant changes on the level of family, physical and professional.
What are the long-term outcomes?
We will discuss several points in this context:
- The cochlear implant is a serious attempt to partially compensate for lost hearing, so you must not waiting for impressive results, believing that the child will become deaf to the owner heard normally. The implant will owner of a new attempt to enter the world of the votes after the other usual means fail.
- As mentioned earlier, to obtain good results both in the field of hearing or speech depends
(Postoperative masterly hand expert) on the rehabilitation, which should continue for a period of
Longer or shorter, depending on the patient's age, the age of injury, time elapsed since
Incidence, the degree of speech development ,..........
The rehabilitation period of up to several years.
As a surgical work and the neglect of rehabilitation is not only a result of his exposure to the work of surgeons and physical burdens of cumbersome, we will not reach any positive result in terms of hearing
And pronunciation.
- Must take into account when rehabilitation of these cases, the natural evolution of pronunciation in children
Natural, these children spend the first period of their lives in storing audio words to turn later to the words gradually. Must Tnoqa - at least -
The same development after cochlear implant.
- The results at the level of hearing and speech in general can be summed up as follows:
If we consider the surgery has been properly and that the rehabilitation has been in excellent conditions
The results vary depending on the level of pronunciation in the event of injury and hearing loss as well as by
The time lag between infection and the patient to undergo surgical and rehabilitation work.
In general, whenever the level of speech when the incidence of more advanced rehabilitation after the results of transplantation better and clearer.
In fact, for the patient after the surgery be able to hear sounds, but
Are distorted and unclear. And function of rehabilitation to help the patient understand the implications of these sounds with the occasion. And facilitate this process, the existence of a previous stock of words.
So give excellent results in the rehabilitation injuries acquired hearing loss due to late
Comparability between the new sounds and old stocks.
At the level of pronunciation, the sound becomes deaf after a transplant observer intensity
Not speak screaming as is usually the case when the owners of severe hearing loss. It is also
Up after a period of rehabilitation is similar to the pronunciation Maitkelm by someone who has heard the lack of moderate intensity. In short, training is good after transplantation brings us to the botched pronunciation acceptable, allowing
Useful follow-up social life. The results remain subject to many factors.
Thus I have attempted to cover the main points of the subject, and I hope that I
Have managed it, and I'm ready for any question or to add.