The Centre has the facility to perform all ENT Surgeries. Commonly performed are Mastoidectomy, Tympanoplasty, FESS(Endoscopic Sinus Surgery), Septoplasty, Turbinoplasty, Tonsils and Adenoid Surgery, Surgery for Sleep Apnea, Microlaryngeal Surgery etc.
Some surgeries are performed by Dr Bhardwaj and his team at the Sitaram Bhartia Hospital.
Presently, cochlear implant is the only hope for these groups of patients for developing and learning linguistic ability for communication. Cochlear implant is now an accepted and established method of therapy for deafness in children and adults.
Human ear consists of three parts-the external ear, middle ear, and inner ear.The mechanism of hearing involves two components. In the conductive component, sound travels along the external ear canal causing the eardrum to vibrate. Three small bones of the middle earconduct this vibration from the eardrum to the cochlea (hearing organ) of the inner ear.
In the sensor neural component, the vibrations of the bones of the middle ear start waves of fluid in the cochlea, and these waves stimulate delicate hearing cells calledhair cell. The movement of the hair cell generates an electrical current in the auditory nerve and it travels through interconnections to the brain area that recognizes it as sound.
Types of Deafness
There are two types of deafness:-
Conductive deafness: If the patient has disease inexternal or middle ear, it leads to conductive deafness. Medical or surgical treatment can correct this type of deafness.
Sensorineural deafness: Sensorineural impairment ornerve deafnessoccurs if there is an innerear problem. Sensorineural hearing loss cannot be corrected with medicines. Hearing aids help the people with moderate to severe sensorineural hearing loss by amplifying the sound. But if there is bilateral severe or profound sensorineural hearing loss and if there is no benefit with hearing aids, cochlear implant is the only treatment option.
How does a cochlear implant work?
In cases of sensorineural deafness, the hair cells are damaged although many auditory nerve fibers may be intact. These nerve fibers are unresponsive because of hair cell damage. But these fibers can transmit electrical impulses to the brain on stimulation. Cochlear implants bypass damaged hair cells and convert speech and environmental sounds into electrical signals and send these signals through the hearing nerve to the brain.
Evaluation of the candidates for cochlear implant surgery
An implant team consisting of otolaryngologist, audiologist, radiologist, paediatric neurologist, clinical psychologist and speech therapist does the clinical and other laboratory assessment. The otolaryngologist examines the middle and inner ear to ensure that no active infection or other abnormality precludes the implant surgery and assess the patient in detail for fitness of implant surgery.The audiologist performs hearing tests to find out the severity of hearing loss and also does pre-implant assessment and counselling for prospective implant client. High Resolution Computerized Tomography (HRCT) of temporal bone and Magnetic Resonance Imaging (MRI) scans of head with 3D reconstruction for the inner ear and the 7thand 8thnerve complex are done to assess the morphologic status of the ear and the brain. Anaesthetists will do a complete physical examination and analysis of the laboratory investigations to identify any potential problems with the general anaesthesia. We also take opinion from paediatric neurologist and clinical psychologist regarding fitness for cochlear implant surgery.
After the completion of above mentioned evaluation, the patient/parents will be explained what they can reasonably expectafter cochlear implant surgery. The complications of the implant surgery which include wound hematoma, infection, facial weakness etc will also be explained to the individual patient/relative/parent on his/her visit to the hospital.
Cochlear Implant Surgery
Implant surgery is performed under general anaesthesia and lasts from two to three hours. An incision is made behind the ear to open the mastoid bone leading to the middle ear and then the inner ear is opened and implant electrodes are inserted. A well is created in the skull bone for the placement of the receiver-stimulating system. The procedure requires a stay in the hospital for 7 to 10 days. Antibiotics and other supportive medicines are given to such a patient.