Hearing impairment surgery: Difference between revisions
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*Reconstructive middle ear surgery (including [[stapedectomy]] and [[tympanoplasty]]) | *Reconstructive middle ear surgery (including [[stapedectomy]] and [[tympanoplasty]]) | ||
== [[Hearing aids]] == | ==[[Hearing aids]]== | ||
* They are the foremost recommended devices for persons with deafness. They vary in features, cost, efficacy, simple use, and style . | |||
* They can be programmed for various frequencies and loudness. This adjustment can optimize listening comfort for patients. | Hearing devices which are either implantable or non-implantable. These devices include: | ||
* It contains Bluetooth capabilities, which permit to regulate through a smartphone and may enhance telephone use | |||
* .It is rechargeable. This feature requires limited dexterity, vision impairment, or limited financial resources because it is straightforward to use and save money from buying expensive batteries again and again. | * Conventional air-conduction hearing aids: The conventional air-conduction hearing aids are used with a microphone that converts sounds into electrical signals, returned to the ear as amplified sound. They are useful for patients with mild-to-severe hearing loss. | ||
* It can adjust volume and listening settings through buttons on the device and/or a mobile app on a smartphone. | * Bone-anchored hearing aids (BAHAs): BAHA devices incorporate a titanium plate that is surgically anchored to the skull on the hearing-impaired side, to directly stimulate the inner ear by conducting sound vibrations through the bone. Some of the indications for BAHA include severe conductive hearing loss, congenital ear canal atresia, SNHL, and difficulty wearing a conventional air-conduction aid with an ear fungal infection, due to recurrent ear infections. | ||
* One hearing aid provides gain in decibels perceived; the second helps with speech discrimination and localizing the source of the sound. So bilateral hearing aid is best if there's no financial constrain for patients. | |||
*They are the foremost recommended devices for persons with deafness. They vary in features, cost, efficacy, simple use, and style . | |||
*They can be programmed for various frequencies and loudness. This adjustment can optimize listening comfort for patients. | |||
*It contains Bluetooth capabilities, which permit to regulate through a smartphone and may enhance telephone use | |||
*.It is rechargeable. This feature requires limited dexterity, vision impairment, or limited financial resources because it is straightforward to use and save money from buying expensive batteries again and again. | |||
*It can adjust volume and listening settings through buttons on the device and/or a mobile app on a smartphone. | |||
*One hearing aid provides gain in decibels perceived; the second helps with speech discrimination and localizing the source of the sound. So bilateral hearing aid is best if there's no financial constrain for patients. | |||
{| class="wikitable" | {| class="wikitable" | ||
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====Mechanism of Action==== | ====Mechanism of Action==== | ||
Cochlear implants send sound signals directly to the auditory nerve, bypassing cochlear hair cells. A receiver unit and an intracochlear electrode that is surgically implanted, typically under anesthesia. Once the device is activated, a speech processor is worn behind the ear.<br /> | |||
* Cochlear implants: The cochlear implant is a biomedical device that is surgically placed into the cochlea. It converts sound energy into an electrical signal, which is then conducted to the ganglion cells in the cochlea via electrodes. This conduction ultimately produces an auditory sensation to the individual that allows the detection of sounds, especially speech sounds. | |||
* Cochlear implants send sound signals directly to the auditory nerve, bypassing cochlear hair cells. A receiver unit and an intracochlear electrode that is surgically implanted, typically under anesthesia. Once the device is activated, a speech processor is worn behind the ear.<br /> | |||
===<u>Risks associated with surgery:</u> <ref name="pmid332536102">{{cite journal| author=Nieman CL, Oh ES| title=Hearing Loss. | journal=Ann Intern Med | year= 2020 | volume= 173 | issue= 11 | pages= ITC81-ITC96 | pmid=33253610 | doi=10.7326/AITC202012010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33253610 }}</ref>=== | ===<u>Risks associated with surgery:</u> <ref name="pmid332536102">{{cite journal| author=Nieman CL, Oh ES| title=Hearing Loss. | journal=Ann Intern Med | year= 2020 | volume= 173 | issue= 11 | pages= ITC81-ITC96 | pmid=33253610 | doi=10.7326/AITC202012010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33253610 }}</ref>=== | ||
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Surgery and Device Based Therapies[1]
A surgical candidate is the patients with conductive hearing loss due to mechanical problems, such as perforation of ear drum, ossicular disease, or a cholesteatoma in middle ear.
- Myringotomy and tube placement (middle ear effusions)
- Hearing aids ( There are different styles hearing aid depending upon their location behind the ear, in the ear, in the canal, completely in the canal. Devices worn in the canal are difficult to use.)
- Middle ear implantable devices
- Cochlear implants (Patients with a range of hearing who no longer benefit from hearing aids may benefit from cochlear implantation)
- Reconstructive middle ear surgery (including stapedectomy and tympanoplasty)
Hearing aids
Hearing devices which are either implantable or non-implantable. These devices include:
- Conventional air-conduction hearing aids: The conventional air-conduction hearing aids are used with a microphone that converts sounds into electrical signals, returned to the ear as amplified sound. They are useful for patients with mild-to-severe hearing loss.
- Bone-anchored hearing aids (BAHAs): BAHA devices incorporate a titanium plate that is surgically anchored to the skull on the hearing-impaired side, to directly stimulate the inner ear by conducting sound vibrations through the bone. Some of the indications for BAHA include severe conductive hearing loss, congenital ear canal atresia, SNHL, and difficulty wearing a conventional air-conduction aid with an ear fungal infection, due to recurrent ear infections.
- They are the foremost recommended devices for persons with deafness. They vary in features, cost, efficacy, simple use, and style .
- They can be programmed for various frequencies and loudness. This adjustment can optimize listening comfort for patients.
- It contains Bluetooth capabilities, which permit to regulate through a smartphone and may enhance telephone use
- .It is rechargeable. This feature requires limited dexterity, vision impairment, or limited financial resources because it is straightforward to use and save money from buying expensive batteries again and again.
- It can adjust volume and listening settings through buttons on the device and/or a mobile app on a smartphone.
- One hearing aid provides gain in decibels perceived; the second helps with speech discrimination and localizing the source of the sound. So bilateral hearing aid is best if there's no financial constrain for patients.
| Behind the ear | In the ear | In the canal | Completely within the canal | |
|---|---|---|---|---|
| Indication | All ranges | All ranges | Moderate | Moderate |
| Ease of Use | Easy | Easy | Difficult | Difficult |
| Description | Receiver worn behind the ear | Earpiece sits inside pinna | Most of device in external canal | Entire device within external canal |
| Adverse effects | Difficult to adjust | Will not fit ear canals;
High dexterity required. |
Cochlear implants
Patients who no longer benefit from hearing aids may benefit from cochlear implantation. Cochlear implantation technology and surgical techniques have advanced significantly since its approval for commercial use in 1985. [2]
Mechanism of Action
- Cochlear implants: The cochlear implant is a biomedical device that is surgically placed into the cochlea. It converts sound energy into an electrical signal, which is then conducted to the ganglion cells in the cochlea via electrodes. This conduction ultimately produces an auditory sensation to the individual that allows the detection of sounds, especially speech sounds.
- Cochlear implants send sound signals directly to the auditory nerve, bypassing cochlear hair cells. A receiver unit and an intracochlear electrode that is surgically implanted, typically under anesthesia. Once the device is activated, a speech processor is worn behind the ear.
Risks associated with surgery: [3]
- Facial nerve injury
- Dizziness
- Cerebrospinal fluid leak
- Infection
- Chorda tympani lesion causing loss of taste
References
- ↑ Nieman CL, Oh ES (2020). "Hearing Loss". Ann Intern Med. 173 (11): ITC81–ITC96. doi:10.7326/AITC202012010. PMID 33253610 Check
|pmid=value (help). - ↑ Carlson ML (2020). "Cochlear Implantation in Adults". N Engl J Med. 382 (16): 1531–1542. doi:10.1056/NEJMra1904407. PMID 32294347 Check
|pmid=value (help). - ↑ Nieman CL, Oh ES (2020). "Hearing Loss". Ann Intern Med. 173 (11): ITC81–ITC96. doi:10.7326/AITC202012010. PMID 33253610 Check
|pmid=value (help).