Vandita's Audiogram Before and After Cochlear Implant

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This is Vandita's unaided audiogram recorded on 20.04.2009. It is showing more than 100 dB loss at higher frequencies. At lower frequencies, loss is not less than 95 dB either. Right ear is slightly better, but not enough to hear even some useful louder sounds, therefore, it was not an encouraging result of pure tone audiometry of both the ears.

Here is aided audiogram of her, taken on 8-04-10 at Hinduja hospital prior to the CI surgery to determine the candidacy. At lower frequencies, loss is 40 dB to 45 dB at mid frequencies, 50 dB to 60 dB and at higher frequencies more than 80 dB. From this audiogram, it is clear, that most of the sounds not only at higher but also at lower frequencies are missed. Vandita found difficulties in listening sounds like z and v at lower frequencies; p, h and g at mid frequencies and f, s and th at higher frequencies. Although she could speak most of these sounds by articulation practice through speech therapy given to her.

Audiogram after CI and four mappings shows her hearing levels; 25 dB at 250 Hz; 20 dB at 500 Hz and 1000 Hz; 15dB at 2000 Hz and 4000 Hz; and at 8000 Hz, it is 25 dB. So, the findings are good enough because now she is able to hear all sounds falling in speech banana. However, it does not mean that she start listening as a normal child from now on, she should be given a lot of listening practice through her Cochlear Implant. An intensive auditory verbal therapy is a key of success. I already mentioned that she is experienced of listening with Hearing Aids and there was an auditory connection to sounds so it is bit easier for her to connect to those sounds.

Sound and Fury: An Oscar nominated documentary

Sound and Fury

Few days back I got a chance to watch a documentary film about two brothers Peter and Chris, sons of hearing parents. Peter and his wife, Nita, are both deaf and they have three deaf children. Heather is the eldest and a very sharp and intelligent child of the couple. Chris and his wife are hearing parents of a newborn deaf child. Chris's wife has deaf parents. Chris and his wife have already decided for CI surgery of their child.

The documentary is about choosing an option of language and communication for the young deaf children of the family. Peter, his wife Nita and deaf parents of Chris's wife advocate deaf culture with ASL for the young children and strongly opposed cochlear implant surgery as an option for them. They have a fear that their children will not communicate with them if CI is successful and will lose their identity as a deaf.

On the other hand hearing parents of the brothers strongly encouraged Peter and his wife to give CI to their deaf children especially heather because she has a very strong desire to hear sounds. But they opt for a deaf culture and enroll all three children in a school for deaf.

The film has a very good, healthy and sometimes very intense discussions between family members on choosing between CI and deaf culture. The documentary was nominated for Oscar award and has been shown in many film festivals.

Sound and Fury Six Years Later

After watching sound and fury, which was released in the year 2000, I was very curious to know about the progress of Peter Jr. ( son of Chris), who underwent CI surgery and about Heather, daughter of Peter, who opted for ASL. I searched on internet and surprisingly found that not only Heather but also her two deaf siblings, mother and members of her extended family had CI surgery in the year 2002 or later. And producer of the sound and Fury made the second part of the documentary as Sound and Fury: Six Years Later, released in 2006.

Official Website: http://www.soundandfuryfilm.com/

A deaf champion: Matt "The Hammer" Hamill

Matt Hamill is an American wrestler. He was born on October 5, 1976, in Loveland, Ohio. He is profoundly deaf since birth.

Hamill is a three time NCAA (National Collegiate Athletic Association, which organize the athletic events for students of colleges and universities of U.S.) division lll national champion in wrestling.

Hamill won the gold and silver medals in 1997 and 2001 deaflympics. Hamill is also a UFC (ultimate fighting championship) winner.

It is said that his stepfather, who was the wrestling coach at Loveland High School introduced him to the world of wrestling.

Hamill was married to a deaf woman who he divorced. He has a hearing daughter from that marriage.

The Movie 'Hamill (2011)' is based on his life, his struggle as a wrestler, who is deaf. A deaf actor Russell Harvard played Hamill in the movie. Movie won the Audience Award in Miami and Florida Film Festivals.

He has proved by his achievements that he is a real champion.

Source: Wikipedia, IMDB, hamillthemovie.com
P.S.- in theaters, on Oct 27th 2011. Name of the film changed to "The Hammer" previously titled "Hamill"

Risks Associated With Cochlear Implant

These are some risks associated with Cochlear Implant

Injury to the facial nerve: facial nerve goes through the middle ear to give movement to the muscles of the face. An injury during surgery can cause a temporary or permanent facial paralysis on the side of the implant.

Meningitis: cases found of meningitis after cochlear implant. People who have abnormally formed inner ear structure are at greater risk.

Tinnitus: ringing or buzzing sound in the ear.

Taste disturbance: the nerve that gives taste sensation to the tongue also goes through middle ear and might be injured during the surgery.

Loss of residual hearing: permanent loss of residual/remaining hearing in implanted ear.

Failure of the internal equipment: contact sport, accident, slips and falls near the ear can damage the implant.

May not be able to have MRI: MRI and some other medical examinations and treatments can not be done due to the presence of magnetic field.

Recipient will have to be careful of electrostatic field and devices.

Source:FDA

How Does a Cochlear Implant work?

Like hearing aids cochlear implant alone is not a total solution, the child will understand the meaning of sounds only with special training. Speech and language therapy from a trained therapist is very important. If the child is benefiting from hearing aids, then he may not be a candidate for a cochlear implant.

Cochlear Implants send electric signals directly to the inner ear and auditory nerve bypassing the outer and middle ear. Implant has two part (1) external part, which are worn outside of the body, and (2) internal parts, which are surgically implanted. The external parts consist of a microphone to pick up sounds, a speech processor who converts sounds into coded signals and sends them to the external transmitter. Which sends the signals to an internal receiver through the skin, internal receiver code these signals into electrical energy and sends them to an electrode array to stimulate the auditory nerve fibers in the cochlea and the sound is transmitted to the brain.

How We Hear?

The ear is divided into three sections:

• The outer ear, which have the pinna and the ear canal,
• The middle ear, which includes the eardrum and the ossicles (three linked, moveable bones),
• Inner ear, where the cochlea is located.

Sound is entered/funneled into the ear canal, where sound waves cause the eardrum to vibrate. The vibrations are passed to the small bones of the middle ear, which ultimately leads to the hair cells within the cochlea. The movement of the cochlear hair cells converts the vibrations into the nerve impulses/current. The nerve impulses travel over the cochlear nerve to the auditory cortex of the brain, which interprets the impulses as sound. It means we hear from our brain the ears are just a medium, or as an input device for the brain. The ear’s job is to sense vibrations in the air and pass the sensory data to those parts of the brain who interpret the meaning of the sound. This process of making sense of airways is what we called hearing. And scientists say that entire auditory system is in fully developed state in a new born baby or even before birth it is in fully developed state. He or she can hear the sound but cannot make sense of it that is why exposure to meaningful sounds, speech, music are essential for healthy auditory development even in case of an infant diagnosed with hearing loss.