In cooperation between ENT Department of Erebouni MC (Head of ENT Department, prof. Artur Shuquryan, MD, PhD) and University of California UCLA in the field of cochlear implantation (Akira Ishiyama - Chief surgeon of UCLA University and founder of Armenian International Medical Fund Salpy Akaragian) founded in 2004, today in Armenia have already been performed about 100 cochlear implant surgeries.
Hearing loss diagnosis and treatment continues to be one of the most actual problems of modern otorhinolaryngology both in medical and social terms. Despite to considerable success in otosurgery, the newest achievements of scientific and technical progress in development of modern diagnostic equipment and new models of hearing aid , a number of people with hearing impairments remain significant, especially among children and teenagers.
Since 2003, according to Mother and Child Protection order, neonatal audiological screening has been carried out both in Erebouni MC and Arabkir MC.
The first years of the child life are critical for speech development, knowledge, social and psychological development; it is therefore important early diagnosis of hearing loss. Up to now members of the family first pay attention to hearing loss in children, most of which have no idea about possible complications, and how to deal with children with detected pathologies. Hearing pathologies, which are not diagnosed or are detected at a later date, lead to intellectual and social - psychological disabilities, deafness (deaf-mutism).
Diagnosis of hearing disorders in children is necessary to begin from the date of birth, which gives opportunity timely reveal pathologic condition and early start rehabilitation and involve the child in speaking environment.
The most productive method of an early diagnosis is a neonatal screening, after which the organization of timely and proper treatment is possible.
In RA wide implementation of audiological screening will allow to examine each newborn and take them under the control in case of necessity. In the maternity clinic within 48-72 hours after the childbirth, UAE examination is carried out, the benefits of which is simplicity, promptness and noninvasiveness.
Early diagnosis of the children with hearing impairment allows organizing the treatment (hearing aids and cochlear implant) and further rehabilitation properly, so that the child can be fully adapted in hearing society. And there are more than a hundred patients of different ages among which a large percentage of children of different age groups. Post-operational period passes satisfactory, rehabilitation sessions are conducted. The results are in accordance with standards.
Cochlear implantation is intended mainly for children whose audio-verbal center hasn`t been formed yet. The operation is possible to perform in the first year of life, which in its own turn, is the main reason for universal audiological screening.
Indications for cochlear implantation:
- Bilateral sensorinueral hearing loss IV degree (90 dB or more)
- Bilateral sensorinueral hearing loss III-IV degree (70 dB and more), if implantation is unsatisfactory and the patient has no positive result.
- Unilateral sensorinueral hearing loss IV degree ( 90 dB and more)
- Insufficient result with a bilateral appropriate hearing aids after 6-12 months of using.
- Psychological stability
- Absence of somatic disorders
- Normal anatomic structure of inner ear
- Child training with the help of surdopedagogs during 6-12 months
- Age pecularities: congenital deafness in children up to 3 years, acquired deafness of any age with preserved speech
- Parental consent
Contraindications for cochlear implantation:
- Complete or partial obliteration of the pinna
- Retrocochlear pathology
- Concomitant severe somatic disorders
- Focal brain pathologies
- Mental retardation
- Satisfactory result when using appropriate hearing aids
- Unstable mental state
- Inconsistency age
- Unsatisfactory result of the surdopedagogs` work
- Underpreparedness of the child (defective work of the surdopedagogs, unsatisfactory result of hearing aid).
If in the first stage of audiological screening were identified infants with suspected hearing impairments, they are included in the group for outpatient observation of the specialist, which should be carried out in the second and third stages.
In the second stage the observation of a three- month baby is carried out in the Cochlear implant Centre of Erebouni MC – for more reliable response.
If at this stage, children with suspected hearing disorders will be diagnosed, they will go for the third phase of the study.
On the third stage six-month babies should pass complete audiology observation (UAE, DPOAE, impedancemetry, ABR) in Republic Pediatric Audiology Centre of Arabkir MC and in the Cochlear implant centre of Erebouni MC for the final identification and detection of degrees of hearing loss.
The children whom cochlear implantation is indicated, should be under observation in the Cochlear implant centre of Erebouni MC, where surgeries and farther rehabilitation are carried out by the specialists. The surgery is indicated for adults in cases when the hearing has been lost during life and the speech has been already formed.
Currently, the cochlear implant surgery is a method of increasing the medical and surdopedagogical rehabilitation. The most important task of cochlear implantation is lowering the age of candidates for cochlear implantation and expansion of indications for its performing.
During the recent decades in ENT department of Erebouni MC were registered thousand patients of different ages, with sensoneural and conductive hearing loss, who were carried out cochlear implant surgery. It is a unique phenomenon, which refers to the high –tech medicine. Cochlear implant is a clinically tested, effective and safe method for hearing recovery in patients.
In Armenia cochlear implant surgery performed only by specialists of Cochlear Implant Centre in Erebouni MC in collaboration with the specialists of UCLA!
