"Teamwork of well qualified professionals is essential when choosing and applying the most appropriate form of treatment".
DR. RAQUEL MANRIQUE HUARTE SPECIALIST. OTORHINOLARYNGOLOGY DEPARTMENT
What are hearing implants?
In many cases, hearing implants can solve the patient's hearing problem and significantly improve their quality of life.
The Clinica Universidad de Navarra is a center of national and international reference in hearing implants. We have the exclusive dedication of a multidisciplinary team, composed of medical specialists, nurses, audioprotection technicians and speech therapists.
In addition, we collaborate with other departments, such as the Neurosurgery Department, for the performance of some implants. We have advanced technical means for performing surgery and specific lines of research, both clinical and experimental.
The Cochlear Implant Program of the University of Navarra Clinic began in 1989 and has the experience of more than 1,200 implants, approximately half of which are for children.
We also have extensive experience in auditory brainstem and bone conduction implants for the treatment of deafness where cochlear implantation is not feasible.
When are hearing implants indicated?
Hearing implants are indicated for the following hearing losses:
People who suffer from profound or severe deafness of cochlear origin in both ears
With little or no effectiveness of hearing aids and who are also motivated towards cochlear implantation.
People with unilateral deafness
It is especially indicated when high intensity tinnitus is perceived in the deaf ear, which significantly alters the quality of life.
People with hearing impairments
Able to perceive low-pitched sounds, with low hearing for mid-pitched and high-pitched sounds In addition, they have great difficulty understanding the spoken word even with the use of appropriately adapted hearing aids.
Learn about hearing loss and its different treatments (available in spanish)
Most frequent indications:
- Profound deafness in both ears.
- Unilateral deafness.
- Severe hearing loss with auditory remains.
Do you have any of these problems?
You may need a hearing implant
Types of hearing implants
The Clinica Universidad de Navarra is a center of reference in the placement of cochlear implants, both in children and in adults, since, in its more than twenty years of experience in this technique, it has performed more than 1,200 implants.
A cochlear implant is an electronic device that replaces the external, middle and inner ear, capable of collecting sounds, transforming them into electrical stimuli in order to transmit them to the auditory nerve and restore the flow of auditory information that reaches the brain.
It is indicated for severe or deep deafness and improves significantly the quality of life of the patient.
Active middle ear implant
Active middle ear implants are surgically implanted prostheses that stimulate the ossicular chain or inner ear fluids through the oval or round window. These implants are effective in the treatment of certain patients with sensorineural hearing loss, as well as for conductive or mixed hearing loss.
They are an alternative to hearing aids, classic middle ear reconstructive surgery or bone conduction devices, and are intended for those who cannot use these conventional solutions or who do not derive sufficient benefit from them.
In terms of results, patients report better intelligibility, better sound quality and a more natural perception of their own voice than that obtained with other devices such as hearing aids.
Brain stem implant
The Departments of Otolaryngology and Neurosurgery perform the placement of this type of hearing implant.
It is indicated for:
- Patients suffering from a congenital disease that prevents the development of the inner ear and the auditory nerve.
- Patients with diseases that damage the auditory nerve.
Electrodes are implanted on the cochlear nuclei, in the brain stem, to restore the continuity of the auditory pathway. In this way, the electrical impulse reaches the auditory cortex (in the brain), where it is interpreted and meaning is given to the stimulus that arrives.
The results obtained with the auditory brainstem implant are very encouraging. The levels of hearing that are achieved and the low rate of complications, make it an excellent alternative in the indicated cases. In the case of children, the sooner the implant and the necessary stimulation are carried out, the treatment is more effective.
Bone conduction implant
A subcutaneous device is placed that transmits vibrations to the skull bone. These are perceived by the inner ear as sound.
It is indicated for patients with conductive hearing loss.
How are hearing implants placed?
The surgery lasts approximately one and a half hours and must be performed under general anesthesia.
This operation carries with it the risks inherent in any other surgical act directed at the middle ear. During the operation, it is checked that the implant is correctly placed. For this purpose, radiology is used and neurophysiological studies (telemetry) are performed, which analyze the functioning of the electrodes of the implant and provide useful information for the subsequent programming of the implant.
After the operation, the patient remains hospitalized for approximately 48 hours. Generally, the postoperative period passes without significant discomfort. The following day, patients can eat, get out of bed and walk normally. When the patient is discharged from the hospital, he or she may travel by any means of transportation. You do not start to hear immediately after the operation.
It is necessary to wait about four weeks for the wound to heal completely so that the external components of the cochlear implant can be placed. This will be done in the first programming session.
Minimally invasive or atraumatic techniques
The insertion of a cochlear implant does not necessarily imply the loss of existing hearing in the target ear. These techniques are important in order to keep the cochlea in optimal conditions for new implants or for the prescription of future treatments.
Interventions in one or two stages
In the case of bilateral cochlear implants, it is preferable to place them in a single surgical intervention. However, in those cases where the patient is already a carrier of a cochlear implant, the second one can be implanted in another surgery.
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.
As a general rule, one should try to restore hearing in both ears, as there are a number of important advantages:
- Ability to locate the origin of sounds.
- Avoiding the shadow effect of the head (inability to hear when someone speaks to us through the deaf ear).
- Improve language discrimination, especially in noisy environments.
- Reduce the level of listening fatigue and provide a sum effect of approximately 3 dB, which gives us greater hearing sensitivity.
- Binaural hearing stimulation can be restored through the placement of cochlear implants in both ears in those who suffer from bilateral profound hearing loss.
In patients who have a profound hearing loss in one ear and minor hearing dysfunction in the other ear, binaurality will be restored through a cochlear implant in one ear and a hearing aid in the opposite ear.
These forms of stimulation are well tolerated by patients and provide them with highly satisfactory results.
Bilateral hearing in childhood
It is convenient to stimulate bilaterally, especially in childhood, the auditory pathways and centers of both brain hemispheres.
On this bilateral stimulation, obtained early in life, depends that the brain learns to process normally the auditory information that comes to it through our two ears.
Delays in this model of binaural stimulation will have consequences, which are currently irreversible, when it comes to achieving a complete development of auditory processing at a cerebral level.
Implant users must take a number of precautions in their daily activities:
- The external parts of the device should not get wet.
- Protect yourself from static electricity.
- Avoid sports or activities that can cause strong blows to the head or use adequate protection (helmet).
- In some users, radiofrequency sources (e.g., cell phones) may cause interference with the sound received through the implant. These interferences do not damage the implant or cause injury to the wearer.
- Patients with an implant should warn their general practitioners or pediatricians of this fact, as special precautions should be taken in the event that they require surgery or an MRI scan.
Where do we perform them?
IN NAVARRE AND MADRID
The Department of Otolaryngology
of the Clínica Universidad de Navarra
The Department of Otorhinolaryngology of the University of Navarra Clinic is a national and world reference in numerous highly specialized surgical procedures.
We have the latest technology and we perform all diagnostic tests in less than 48 hours in order to offer our patients the best solution in the shortest time possible.
We were one of the first centers in Spain to use robotic surgery in the surgical treatment with the Da Vinci® System.
Organized in specialized units:
- Otology - Hearing.
- Rhinology - Nose.
- Pharyngology - Throat.
- Laryngology - Voice.
- Balance disorders.
- Head and neck problems.
Why at the Clinica?
- Experts in the treatment of hearing problems.
- Pioneers in axillary surgery to avoid scarring.
- National reference center in tissue sealing for tonsil removal.