Cochlear Implants: What are they?

Cochlear Implants: What are they?

On the States petitions website, readers may have seen this petition and wondered what it is all about.

Petition: Provide resources for cochlear implanted children to be checked in Jersey

It is difficult for people with medical needs to have to travel to London for the whole day for an hour’s appointment. Many children over here with cochlear implants are in this position. It costs States money for travel expenses and it’s a traumatic experience for the children.

There is also no help if processors become damaged, broken etc, or if equipment needs checking. In addition, cancellations due to travel disruption cause children to miss appointments because of the difficulty of rearranging them.

The States should provide the resources for children with cochlear implants to be checked in the Island.

So what is a Cochlear Implant?

A cochlear implant (CI) is a surgically implanted neuroprosthetic device that provides a sense of sound to a person with severe to profound sensorineural hearing loss.

Cochlear implants bypass the normal acoustic hearing process; instead they replace it with electric hearing. Namely, the sound sensation comes from the sound that is converted to electric signals which directly stimulate the auditory nerve.

The brain adapts to the new mode of hearing, and eventually can interpret the electric signals as sound and speech.

The implant has two main components. The outside component is generally worn behind the ear, but could also be attached to clothing, for example, in young children. This component, the sound processor, contains microphones, electronics that include DSP chips, battery, and a coil which transmits a signal to the implant across the skin.

The inside component, the actual implant, has a coil to receive signals, electronics, and an array of electrodes which is placed into the cochlea, which stimulate the cochlear nerve. The surgical procedure to insert this is performed under general anaesthesia. Surgical risks are minimal but can include tinnitus and dizziness.

From the early days of implants in '70s and '80s, speech perception via an implant has steadily increased. Many users of modern implants gain reasonable to good hearing and speech perception skills post-implantation, especially when combined with lip-reading.

What problems are caused by non-Island support?

Current policy in Jersey is for young children (from as young as six months) who are profoundly deaf to be offered the operation as the sooner sounds can be heard, the better the advantage for the understanding and learning of speech.

At present, while the operation takes place in the UK, so does support. So if something goes wrong and needs diagnosis and fixing, or the equipment needs adjusting, or it needs to be checked over, the only option is to arrange a flight to London with parents and children.

This may be for an hour’s appointment, but is disruptive to the child, who may have to be taken out of school, and if there are travel delays, may have to rebook another appointment with further delay in treatment.

At the moment, islanders who wear the devices have to travel to the UK to have them fitted and checked.

The States of Jersey pays for the travel of children and some vulnerable adults to go to the appointments in London and elsewhere.

However, as BBC Radio Jersey reported: “A health department spokesman said they do basic troubleshooting on island but there are a number of different processors costing about £7,000 each, which need to be programmed using expensive specialist equipment.”

That is probably true - there are 3 brands of cochlear implants, and children in Jersey have a mix between the 3 so it would probably be impossible to request funding as the specialist equipment to fix and check them varies, and it would need constant updating as well as trained staff.

How does it improve hearing? An Insider’s Perspective.

Rosemary Richardson (Mayoress of Verwood) has written about her experience of cochlear implants

“In October I will have had my cochlear implant for four years. I am still hearing new sounds; even today I heard a buzzard in the trees in our Recreation Ground field where we live. I said to my husband, “What bird is that?” as I listened to the short sharp mewing sound nearby. It was lovely to hear as it is a high pitch call. Today I just was wearing my implant and not together as I usually do with my hearing aid in the other ear. (I had forgotten to put it in. But sound came clear to me as I listened.

“Back in May 2013, my husband was elected our Town Mayor and I the Mayoress, here in Verwood, Dorset. Together we go out a lot to venues and meet people. Without the implant I don’t believe I could have done this with my current natural hearing loss being so severe.”

“I am enjoying life again being much more confident meeting people. I am so glad I was able to have this operation, to help me find pleasure in hearing sounds again. At first I was dubious, then eventually decided to have it done.”

References
https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2014/04/d09-ear-surg-coch-0414.pdf
http://www.bcig.org.uk/
https://www.bbc.com/news/live/world-europe-jersey-45029137