Cochlear implants

¿Cómo se oye con el implante?

Implanted people hear very much like a hearing person, as shown by the results of some tests and the manifestations of our already implanted patients.

It is not a question of new codes, but rather of sound information that keeps a structure similar to that which we listen to.

Therefore, when a post-lingual deaf person is implanted, who has heard before becoming deaf and who has a good auditory memory, a few days after using the implant he or she is able to recognize the words of a conversation.

Ventajas de un segundo implante coclear 

The placement of a second cochlear implant has important advantages:

• Improved auditory hearing capture
  When an implantation is to be carried out in only one ear, the choice is made based on anatomical-surgical criteria, audiological criteria and the duration of the hearing loss in each of the two ears. Therefore, to restore this function, it is necessary to have two sources of auditory information, in this case with two cochlear implants.
• Location of sound
  The two mechanisms involved in the localization of sounds located in the horizontal plane are: the analysis that the central auditory system makes of the differences in the time that a sound takes to reach the two ears and the differences in intensity that a sound produces in each of the two ears. Therefore, to restore this function, it is necessary to have two sources of auditory information, in this case two cochlear implants.
• Avoiding the "shadowing" effect of the head
  When voice (signal) and noise come from different locations, the signal-to-noise ratio is different in both ears because of the "shadowing" effect produced by the head. People with normal hearing usually use the ear with the best signal-to-noise ratio. People with bilateral implants reportedly get this benefit from bilaterality as well.
• Improving speech perception in noise
  The brain could achieve an optimal representation of noise and voice, being able to differentiate them better.
• Neural auditory plasticity
  Unilateral stimulation exerts irreversible modifications on the development of the higher sectors of the auditory pathway. Just as there is a critical auditory period in children with bilateral deafness of congenital origin, there is also a critical auditory period in the congenital absence of stimulation by one of the two ears.

Programa de seguimiento y rehabilitación

Programming
A correct programming of the cochlear implant is essential to obtain good results.

For the implanted patient to start hearing, the cochlear implant must be activated and the speech processor programmed. This is done with the help of a computer, with a special program that adjusts each of the electrodes to each person's hearing needs. This is essential for clear sound recognition.

Follow up

A correct follow-up is very important to detect possible complications.

It will also serve to evaluate the results and optimize them with a new programming or with the updating of the stimulation strategies.

The Clinica Universidad de Navarra has specialized personnel to carry out this follow-up of the implanted patient. In addition, we make available to the patient a telephone number and an e-mail address to resolve, in collaboration with the technical service of the manufacturer of the implant, those problems which affect the implanted device.

Phases of auditory rehabilitation

• Detection. Exercises in which the patient has to signal the presence or absence of sound.
• Discrimination. To acquire the ability to distinguish if two or more sounds are the same or different.
• Identification. The patient has to point out, among several options, that word, phrase or environmental sound that he/she has heard.
• Recognition and understanding. In these, the patient must gradually acquire fluent language recognition by repeating words and phrases and having an interactive conversation, along with the use of media such as television, telephone and radio.