Spain: Young Deaf Children Achieve Optimum Results After Cochlear Implants
Edited by Luis Fernando Astorga Gatjens, IID (lferag@racsa.co.cr), UIT information from Portal Tecnociencia
Young deaf children of less than two years of age are now achieving optimum results, at understanding and expressing language, after being treated with cochlear implants. Their school and social integration is reported as a success thanks to this program started by the University Clinic of Navarra, Spain (Clínica Universitaria de Navarra, CUN) in 1989.
This Clinic, the pioneer in the implantation of an electric device which stimulates the auditory nerve, has just published the results of a technique resulting in a greatly improved integration of children with severe hearing impairments.
History of the program
The dictionary of the Spanish Academy defines cochlear implant as "an electronic device which captures environmental sound (noise, sound, words) and transforms them into electric energy to directly stimulate (using electrodes inserted in the cochlea) auditory nerve endings for signalling to the brain."
The program was started in 1989 and one year later the first implant was performed on an eleven-year old girl. In 1992 the first two-year old boy received his implant. Since then, the Department of Ear, Nose, and Throat of the University Clinic of Navarra has performed 356 implants on people between nine months and 82 years; two thirds of the people treated were children. Among deaf persons in Spain, hearing disabilities are present at birth in 80% of the case. Of these 356 patients with cochlear implants, 36 have been children of less than two-years of age. All the persons treated underwent a five-year follow-up study.
Manuel Manrique, of the Department of Ear, Nose, and Throat Department and the author of the first cochlear implant in Spain, told us that "the results have been excellent and stable, for post-linguistic deaf, those who lose hearing after having acquired language. These people achieved 80% of word recognition, without lip reading. And, in the case of post-linguistic children, without any deafness associated damage, as neurological disease."
"Children with cochlear implants have achieved complete integration into society, to such extent that for those children participating in our program, it is virtually impossible to tell they once were not able to hear. Their language expression is completely normal and the implant lasts life long.
"On the other hand, said Manuel Manrique, with children younger than two-years of age, their anatomical organs are smaller. So surgery is more specific. We hope that as electronic devices become smaller these interventions will be easier. The failure index is 0.8%. In children, the tissue is very soft, and we are able to perform the cochlear implant in 45 minutes."
Early detection programs essential
Deafness early detection programs are essential for positive results of cochlear implant intervention. The fact that no implants have been performed on children younger than nine months old, is not because of lack of technical or surgical means, but because of the time required for correct diagnostic of source and extension of the hearing difficulties.
This Center has extended the use of implant techniques to persons with hearing loss who do not obtain adequate results from their hearing aids. At the beginning, the cochlear implant was placed in one ear and the traditional hearing aid was kept on the other ear. Since last year, the Department of Ear, Nose, and Throat started a program of bilateral implants: "Complete hearing is performed by both ears. We use both ears to detect sounds. The bilateral implant technique achieves the same results, improving audition in both ears and eliminates the shadow effect of the head. There are other conditions associated with auditory neuron plasticity where cochlear implants are very effective."
Severe deafness is defined as a condition in which the person needs an auditory stimulation above 90 decibels to perceive the sound. When there is a condition called Severe Deafness Class II, the amount of stimulation required to perceive sound is 80 decibels.
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