Showing posts with label cochlear implant. Show all posts
Showing posts with label cochlear implant. Show all posts

Sunday, 30 July 2017

When to consult an ENT Doctor for my child?

"Your child's Pediatrician is the primary care provider and incharge of your child's health."

Parents should consult a Pediatric ENT only if the child's Pediatrician has suggested them to do so.

Pediatric otolaryngologists are concerned with treatment of medical and surgical ENT disorders in children. They have been trained to take care of children from newborn period to teenage years.

Children are not just small adults.The disease presentations and management can differ from adults.Right from the clinical approach for diagnosis differs in children.It needs specialised training and experience in working with children to keep them comfortable while examining them.

A child will not always be cooperative and will not be able to answer medical questions or express their problems. Sometimes they have their own ways of expressing concerns. I cannot forget a 3 year old telling me her ears are "singing" and we did go ahead and found a cause.

If we learn to interact with kids, they are also capable of giving information.They may not answer direct questions or get overwhelmed with questioning.

Interaction with the child is a must for a pediatric otolaryngologists as child is the one who needs attention.This is especially useful in diagnosing social and communication disabilities.Many times parents are in denial or do not know age appropriate behaviours,in these situations direct interaction with the child is a must.

All of the above requires experience,skill and judgement with the team including the primary treating pediatrician.

Finally be a child with the child....and the doctor for the family.

Tuesday, 19 January 2016

External Speech Processor Upgrade for Cochlear Implants: What are the criteria for upgrade?

The Cochlear Implant system consists of an internal part which is surgically inserted  and an external Processor.
Internal component 

intraoperative snapshot of internal part





The external component is switched on 2-4 weeks after surgery


external procesor

The magnet (beige) of external processor is seen 


The external processor has to be maintained and cared for so that the child is always listening to sounds.

The processor care can be categorised in two groups:

I. Providing repairs,replacements and batteries.Some components are covered in warranty and we always prepare parents to keep aside an amount for these regular maintainance in our pre operative councelling.

II.To provide access to newer technology which can provide improved perception of speech to the implantee.
Usually the external processor is changed anywhere between 3-10 years (on an average of 5 years,child may need a new speech processor).

Newer technologies may provide better access to spoken language and ease/comfort of use.

Following links provide information on processor upgrade criteria in Australia and Canada where upgrades are government sponsored.

www.hearing.com.au

Sharing the Canadian Guidelines for Processor upgrades  for Pediatric Cochlear Implant users

https://www.cadth.ca/speech-processor-upgrades-pediatric-patients-cochlear-implants-clinical-evidence-and-guidelines



Tuesday, 11 August 2015

Hearing loss and deafness treatment-Role of Cochlear Implants

Hearing loss can be classified as conductive or Sensorineural or mixed.
It can also be temporary or permanent or progressive.

How do we hear?

The sounds are collected by outer ear pinna and carried through the ear canal.This vibrates the eardrum and the tiny bones of hearing in turn.These vibrations are carried to the inner ear or Cochlea where it is converted to electrical impulses and finally carried to brain through nerve of hearing.The auditory area of brain interprets the sound.

Image result for how we hear sound through our ears
If there is a disease or problem in outer or middle ear,usually its conductive hearing loss.For example ear wax or middle ear fluid.
If the disease spreads from middle ear to inner ear,it causes mixed hearing loss.
Image result for ear diseases
Sensorineural hearing loss occurs if the infection involves inner ear or deafness from birth due to various causes.
Clinical examination and audiological tests helps us to diagnose.Sometimes we may need scans-HRCT/MRI.

Depending on the diagnosis,treatment is planned.
For infection-medical treatment.
Middle ear fluid may need drainage.Chronic ear  diseases may need surgery.

The treatment of Sensorineural hearing loss also depends on diagnosis.If its Sudden Sensorineural Hearing Loss,it may need oral steroids as the cause is usually Viral.
However manytimes an MRI Scan is ordered to rule out other pathology.

Finally Sensorineural Hearing loss-Progressive or from birth

This may need fitting of hearing aids with auditory,speech and language therapy.
Most of the times children welcome the world of sound.Few take time to keep the hearing aids on for the daytime.The therapist and mother work on auditory and language training.
Cochlear Implants are for those children who do not do well with hearing aids.There are various audiological,radiological and social criterias for Cochlear Implantation.
A cochlear implantee attending auditory verbal therapy with mother.


Trust real doctors sitting in front of you, not internet....

  On Doctors day 1st July 2022, we can only wish for a healthy life and relationship for both patients and doctor. The first practical class...