As it is surgically replaced, the patient has to go through a detailed audiological investigation to learn the functionality of the ear using hearing aids and a CT / MRI scan to find out if the ear is structurally developed or not. The delicate surgery done most meticulously lasts for about 3 to 4 hours under anaesthesia without any risk to the nerves. The implant is for life. The inner part is permanent and the outer part should be replaced once in seven years.

Apart from the ENT surgeons, audiologists, speech therapists, auditory verbal therapists, social workers and counselors are part of the ``habilitation'' programme. It must be noted that the surgical implant is only a part of the programme. Equally important is the counseling, to the parents, in case of implants in children. While adults need the therapy for a few months, the children will have to undergo counseling, training and therapy for about two years; a hugely expensive proposition!

Among the 40 odd hospitals involved in cochlear implant, very few are supported by state or central governments. Besides, the banks are reluctant to come forward to advance loans towards cochlear implants. The father of a child who underwent implant at SRMC is a senior bank official. Still, he could not get loans for the purpose and had to go for personal loans, Dr Ravi Kumar recalled.

Dr. Ravi kumar suggests that the National Programme for Deafness fund the cochlear implants. At present it is oriented only towards preventive measures. He wanted the Government to evolve a policy that would induce banks to reach out to the hearing-impaired, especially children. He also wanted the government to focus on the need to vaccinate girls against rubella, commonly known as German measles, a disease caused by the rubella virus. The vaccination is crucial for girls getting married.

Rubella in the first three months of pregnancy could result in hearing, vision and even cardiac problems in the child. Unfortunately the rubella attack could pass unnoticed - the dangers inherent in such a situation are obvious then. According to studies carried out in the African continent, vaccination against rubella could reduce hearing loss in children by as much as 40 percent.

Better maternal health care and post-natal care are also important. Children born with higher billirubin count would have to be closely watched. Billirubin is a chemical formed during red blood cells metabolisis.It is excreted from the liver through the bile. When the liver cells are damaged, a build-up of billirubin in the blood and extra-cellular fluid results which in turn may damage the nerves that control hearing.

Parents should be sensitized to test the sensory perceptions of the newborn, Ravikumar insists. Early detection is the key. Solid studies have revealed that children identified with the problem and accorded treatment early do well enough to live like normal children. It is possible to treat deafness very early in life (before three years). Specialists in the field also talk about the need to train thousands of audiologists and audio-therapists as there is a huge shortage of manpower.

Unlike the case of other surgeries, the ENT segment depends equally on experts in allied field for continued treatment, training and counseling. Prof. Roopa Nagarajan of the Department of Speech, Language and Hearing Sciences, SRMC is one such expert. She points to another area of serious concern - that of unabated noise pollution in modern life. She regrets that there is very little public awareness of this growing menace.

Earlier, noise pollution was restricted to industrial environment. Now youngsters plug in to i-Pods all the time, whose decibel levels could be as much as two times higher than what emanates from a factory in normal circumstances. Noise-induced hearing loss would not manifest itself immediately but would be known only after 5 to 10 years, Dr Roopa says and calls for sustained campaigns to make youngsters aware of the dangers they are courting.

Source-Medindia
GPL /J