Cost of cochlear implant in India

1. Cochlear Implant Hearing Loss Treatment

2. What is Cochlear Implant? • It is a combination of external and internal devices that aim to restore hearing to sensorineural hearing loss patients • It corrects both pre- and post-lingual hearing loss • It does not restore functionality to natural cochlea; only stimulates auditory nerve directly • Restored hearing after the device being installed is not exactly like natural hearing

3. Problem being solved with the help of Cochlear Implant • Sensorineural hearing loss • It is found to be the most common form of hearing loss • Damage caused to either brain or auditory nerve, but most commonly sensory cells of cochlea (cochlear implant used for patients with this type) • More than 1.2 million people are affected by hearing loss; sensorineural being the most common form • Functioning cochlea: vibrations cause fluid movement, which is sensed by hair cells of cochlea causing action potential firing to auditory nerve • These cells don’t function in those with cochlear implants

4. Current Technology • 5 major components • External devices: • Microphone-wraps around front of ear • Speech processor-behind ear; attached to microphone • Transmitter-above processor • Internal devices: • Receiver/stimulator-across from transmitter • Electrode array-placed on natural cochlea; wired to receiver

5. How Cochlear Implant works • Microphone picks up sound, and further sends it to speech processor • Speech processor filters sound, converts to electrical signals through fast Fourier Transforms • Transmitter wirelessly sends signals to receiver/stimulator • Receiver/stimulator sends electrical current according to received signal to electrodes • Electrodes stimulate auditory nerve

6. Who is a Candidate for a cochlear implant? • Children • Have profound hearing loss in both ears. • Get little or no benefit through the use of hearing aids. • Are healthy and any medical conditions would not compromise surgery. • Understand (when able), along with their parents, their role in the successful use of cochlear implants. • Have support from an educational program that will emphasize the development of auditory skills.

7. Continue • Adults • Have severe or profound hearing loss in both ears. • Get little or no benefit from hearing aids. • Have no medical problems that could put them at risk during surgery. • Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading.

8. Risks and Complications • During surgery remaining hearing in the implanted ear may be lost permanently. • Because the surgery is done in the vicinity of the nerve that moves the face, there is a remote possibility that temporary or permanent facial paralysis may occur after surgery. • There is a slight risk that the patient may experience taste disturbances, such as a metallic taste, following cochlear implant surgery. • There is the risk that the surgical site may become infected, which might require removal of the device.

9. Effectiveness of the Procedure • One study shows ability of cochlear implant recipients to identify sentences over telephone with 82 % success rate (pre-lingual) and 70% success rate (post-lingual) • With an adaptor, the success rate increases to 93% and 88%, respectively • Speech development in children • For each 6 month period over first 30 months after receiving implant, subjects’ increase in “language age” was about double that of subjects without implants • Some performed at around same level as non-impaired

10. Limitations of Cochlear Implant • The procedure requires intense therapy post-implantation to achieve high level of speech comprehension (especially for post-lingual patients) • Device has trouble processing late echoing effects that go unnoticed by non-impaired ears • Cochlear Implant costs between $45,000 and $125,000 • Surgical complications of the procedure include infection, facial muscle weakness, facial paralysis, damaged vestibular system, loss of all residual hearing

11. Future Direction • Improvement in surgical techniques to keep residual hearing intact • If cure came about, patients would want what natural hearing still remained • Different electrode arrangements • Longer electrode arrays have shown potential to increase pitch range • Variations in electrode spacing at different points on the cochlea could improve sound quality

12. Best hospitals available for Cochlear Implant in India? • Apollo Spectra Hospital, Bangalore • Apollo Spectra Hospital, New Delhi • Columbia Asia Hospital, Bangalore • Columbia Asia Hospital, Gurgaon • Apollo Hospital, Chennai • Sevenhills Hospital, Mumbai • Fortis VasantKunj, New Delhi • Medanta - The Medicity, Gurgaon • BLK Super Specialty Hospital, New Delhi • MoolchandMedcity, New Delhi • Indraprastha Apollo Hospital, New Delhi • Apollo Gleneagles Hospital, Kolkata • Wockhardt Hospital, Bangalore • Manipal Hospital, Bangalore • Artemis Hospital, Gurgaon • BGS Global Hospital, Chennai • Max Super specialty Hospital • Fortis Hospital, Shalimar Bagh, New Delhi • Rockland Hospital, New Delhi

13. Cost of Cochlear Implant in India? • The average cost of cochlear implant in India will cost around Rs. 20 lakhs. • The average cost of Cochlear Implant in India is very low as compared to the other countries.

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