Cochlear implants are small, electronic devices used to correct hearing loss in those who are completely deaf or severely hard-of-hearing. The device is implanted into the inner ear, bypassing the damaged parts of the ear to directly reach the auditory nerve and send sound signals to the brain. Cochlear implants can benefit adults and children over 12 months old. The success of cochlear implants varies depending on how long a person has been deaf, how many nerve fibers remain and their motivation to hear.
A bone anchored hearing aid, or BAHA is an implantable device used to improve hearing by stimulating the inner ear through the bone. BAHAs can improve hearing in patients with less severe cases of conductive or mixed hearing impairment. It is ideal for patients who are not candidates for regular hearing aids because of a physical deformity, frequent ear infections or narrow ear canals.
A bone anchored hearing aid placement procedure takes less than an hour to perform on an outpatient basis, using local anesthesia for adults and general anesthesia for children. Patients can return home the same day. During the initial procedure, only the titanium screw and abutment are placed, while the hearing aid is implanted during a second procedure three to six months later. This ensures that the titanium becomes integrated into the bone for long-lasting correction.
Aural rehabilitation for those with cochlear implants or bone anchored hearing aids generally includes learning strategies to communicate more effectively in conversation as well as how to handle distracting background noise.
Ossiculoplasty is a surgical procedure performed to remove, repair, or replace one or more of the small bones of the middle ear. These three bones, called ossicles, are individually known as the malleus, the incus and the stapes. They normally vibrate in order to transmit sound waves to the eardrum and the auditory nerve. When they are congenitally malformed or damaged by infection or injury, an ossiculoplasty is required to restore hearing. During some surgeries, the damaged bone will be removed and a prosthetic will be implanted in its place.
An ossiculoplasty is performed to restore the hearing process when the
ossicles are damaged due to :
- Anatomical genetic defect
- Middle ear infection
- Traumatic injury
- Barotrauma, a sudden change in ear pressure
- Extremely loud noise, like an explosion
- Scarring of the bones
An ossiculoplasty is frequently performed concurrently with a tympanoplasty to reconstruct the eardrum, or tympanic membrane. Sometimes the surgeon is aware of the need for bone repair in advance and sometimes a fracture is discovered during the repair of the eardrum. In the latter case, the surgeon is usually able to perform the two corrections during the same procedure.
The rate of success for an ossiculoplasty is very high, though it depends to a certain extent on the anatomy of the individual patient's ear and the severity of the damage to the bones. Most patients do very well after this surgery, but, as with any surgical procedure, there are certain risks. The primary risks of ossiculoplasty may include a postoperative balance dysfunction and the possibility that the hearing will be worse after surgery. During the period immediately following an ossiculoplasty, patients should refrain strong nose blowing, swimming and air travel and try to avoid crowds in an effort to avoid respiratory infections.
Hearing loss is the sudden or gradual decrease in hearing. Hearing loss can be mild or severe, reversible, temporary or permanent, and may affect one or both ears. The most common cause of hearing loss is age, affecting up to 25 percent of people between the ages of 65 and 75 and up to 50 percent of those over the age of 75. Age-related hearing loss, known as presbycusis, results from changes in the ear which cause gradual hearing loss. Some individuals are hearing-impaired or deaf as a result of a congenital defect or because of an illness, such as Ménière's disease.
Treatment of hearing loss depends in the cause of the problem. For temporary loss of hearing due to wax buildup, a thorough cleaning of the ear canal, also known as an irrigation or lavage, may be helpful. Hearing loss caused by an ear infection may be treated with antibiotics and decongestants to rid mucus from the ears. For more permanent types of hearing loss resulting from aging, or damage to the inner ear, hearing aids may be helpful, although adjusting to them may take a few weeks.
When the eardrum has been torn or perforated, a surgical procedure known as tympanoplasty, may be necessary to repair the eardrum. Individuals with more profound hearing loss as a result of a congenital defect, injury or disease, may benefit from the surgical implantation of a cochlear implant, a small electronic device that helps to provide a sense of sound. Individuals coping with severe hearing loss may also learn to pay careful attention to gestures and facial expressions, to read lips, or to use sign language in order to improve their communication skills.
Implants za cochlear ni vifaa vidogo vya elektroniki vinavyotumiwa kurekebisha upotezaji wa kusikia kwa wale ambao ni viziwi kabisa au wenye shida sana ya kusikia. Kifaa hicho huingizwa ndani ya sikio la ndani, na kwa kuepuka sehemu zilizoharibiwa za sikio, kinaweza kufikia moja kwa moja neva ya kusikia na kutuma ishara za sauti kwenye ubongo. Implants ya cochlear inaweza kuwa na faida kwa watu wazima na watoto zaidi ya miezi 12. Ufanisi wa implants ya cochlear hutofautiana kulingana na muda mrefu mtu amekuwa kiziwi, ni nyuzi ngapi za neva zilizobaki na motisha yao ya kusikia. Msaada wa kusikia wa mfupa (BHEA) ni kifaa cha kupandikiza kinachotumiwa kuboresha kusikia kwa kuchochea sikio la ndani kupitia mfupa. BAHAs inaweza kuboresha kusikia kwa wagonjwa wenye visa visivyo vikali vya kupooza kwa kusikia au mchanganyiko. Ni bora kwa wagonjwa ambao si wagombea kwa ajili ya masikio ya kawaida kwa sababu ya deformity kimwili, mara kwa mara maambukizo ya sikio au narrow ear canals. Utaratibu wa kuweka kifaa cha kusikia cha mifupa huchukua chini ya saa moja kufanya kwa msingi wa mgonjwa wa nje, kwa kutumia anesthesia ya mahali kwa watu wazima na anesthesia ya jumla kwa watoto. Wagonjwa wanaweza kurudi nyumbani siku hiyohiyo. Katika utaratibu wa kwanza, ni screws ya titanium na abutment tu ambazo huwekwa, wakati vifaa vya kusikia huingizwa wakati wa utaratibu wa pili miezi mitatu hadi sita baadaye. Hii inahakikisha kwamba titani huingizwa ndani ya mfupa kwa ajili ya marekebisho ya muda mrefu. Urekebishaji wa sauti kwa wale walio na implants cochlear au mifupa ya kusikia ya mifupa kwa ujumla inajumuisha mikakati ya kujifunza kuwasiliana kwa ufanisi zaidi katika mazungumzo, pamoja na jinsi ya kushughulikia kelele za nyuma. Upasuaji wa kuondoa mifupa ya kati (Ossiculoplasty) ni upasuaji unaofanywa ili kuondoa, kurekebisha, au kubadilisha mfupa mmoja au zaidi wa mifupa midogo ya sikio la kati. Mifupa hii mitatu, inayoitwa ossicles, inajulikana kwa kibinafsi kama malleus, incus na stapes. Kwa kawaida wao hutetemeka ili kupeleka mawimbi ya sauti kwenye utando wa sikio na neva ya kusikia. Wakati wao ni congenitally malformed au kuharibiwa na maambukizo au jeraha, osculoplasty inahitajika kurudisha kusikia. Wakati wa upasuaji fulani, mfupa ulioharibiwa huondolewa na kiungo cha ziada kiingizwe mahali pake. Upasuaji wa viungo vya sikio (Osculoplasty) ni utaratibu wa kurekebisha uwezo wa kusikia wa mtu kwa sababu ya kasoro ya chembe za urithi (anatomical genetic defect) au majeraha ya uchochezi (traumatic injury) au barotrauma (barotrauma) ambayo ni mabadiliko ya ghafla ya shinikizo la sikio (eardrum) au membrane ya tympanic (eardrum membrane). Wakati mwingine daktari wa upasuaji anajua mapema kwamba kuna haja ya kurekebisha mifupa, na nyakati nyingine kuvunjika kwa utando hutambuliwa wakati wa kurekebisha utando wa sikio. Katika kisa cha mwisho, daktari-mpasuaji kwa kawaida anaweza kufanya marekebisho hayo mawili wakati wa utaratibu uleule. Uwezekano wa mafanikio ya upasuaji wa mifupa ni mkubwa, ingawa inategemea kwa kiasi fulani anatomia ya sikio la mgonjwa na uzito wa uharibifu wa mifupa. Wagonjwa wengi hufanya vizuri sana baada ya upasuaji huu, lakini, kama ilivyo na utaratibu wowote wa upasuaji, kuna hatari fulani. Hatari za msingi za upasuaji wa mifupa yaweza kutia ndani tatizo la usawa baada ya upasuaji na uwezekano wa kusikia kuwa mbaya zaidi baada ya upasuaji. Katika kipindi cha baada ya upasuaji wa mifupa, wagonjwa wanapaswa kuepuka kupiga pua, kuogelea, na kusafiri kwa ndege, na pia kuepuka makundi ya watu ili kuepuka maambukizo ya njia za kupumua. Kupoteza uwezo wa kusikia ni kupungua kwa kusikia kwa ghafula au hatua kwa hatua. Kupoteza kusikia kunaweza kuwa kwa kiasi kidogo au kikubwa, kwa muda mfupi au kudumu, na kunaweza kuathiri sikio moja au zote mbili. Kwa kawaida, tatizo la kusikia hutokana na uzee, na huathiri asilimia 25 ya watu wenye umri wa miaka 65 hadi 75 na asilimia 50 ya watu wenye umri wa miaka 75 na zaidi. Kupoteza kusikia kunakohusiana na umri, au presbycusis, ni ugonjwa unaosababishwa na mabadiliko ya sauti katika sikio na kusababisha upotezaji wa kusikia. Watu wengine ni viziwi kwa sababu ya kasoro ya kuzaliwa au kwa sababu ya ugonjwa kama vile ugonjwa wa Ménière. Matibabu ya upotezaji wa kusikia hutegemea kisababishi cha tatizo hilo. Kwa ajili ya kupoteza kusikia kwa muda kwa sababu ya kuunganishwa kwa nta, kusafisha kabisa mfereji wa sikio, pia inajulikana kama umwagiliaji maji au kuosha, inaweza kuwa na msaada. Kupoteza kusikia kunakosababishwa na maambukizo ya sikio kwaweza kutibiwa kwa kutumia viuavijasumu na dawa za kuondoa mshipa kutoka masikioni. Kwa aina za kudumu za upotezaji wa kusikia kutokana na uzee, au uharibifu wa sikio la ndani, vifaa vya kusikia vinaweza kusaidia, ingawa kurekebisha kwa hizo inaweza kuchukua wiki chache. Wakati utando wa sikio umevunjika au kupasuka, upasuaji unaojulikana kama tympanoplasty, waweza kuhitajiwa kurekebisha utando wa sikio. Watu walio na upotezaji mkubwa wa kusikia kutokana na kasoro ya kuzaliwa, majeraha au magonjwa, wanaweza kufaidika na upasuaji wa kupandikiza cochlear, kifaa kidogo cha elektroniki ambacho husaidia kutoa hisia ya sauti. Watu walio na matatizo makubwa ya kusikia wanaweza kujifunza pia kusikiliza ishara za mwili na nyuso, kusoma midomo, au kutumia lugha ya ishara ili kuboresha uwezo wao wa kuwasiliana.