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Hearing aids, like cochlear implants, are hearing aids. The earliest hearing aids simply amplify the sound. The hearing aids used today can selectively amplify sounds of different frequencies according to the hearing of each frequency and the needs of the patient, which is also called nonlinear amplification. , So that the patient feels that it can be heard in a low voice, and not too loud.

If the hearing aid does not work well, you must first check Hearing aid Is there any problem with its own quality and power; secondly, when the elderly wear hearing aids, evaluate the hearing threshold and speech recognition ability of hearing aids.If the elderly’s hearing reaches severe or severe sensory deafness, the quality and power of the hearing aids are not problematic, but the hearing aids still do not achieve the desired effect, it means that the elderly’s deafness is indeed very severe, and it is necessary at this time. Consider implanting a cochlear implant to improve hearing.
Strictly speaking, presbycusis refers to the decline in hearing caused by the aging of people and the aging of the auditory system, just like machine parts, aging will occur to a certain extent.But in fact, in addition to age factors, many factors such as genetics, drugs, noise, and otitis media can also cause hearing loss in the elderly.

Regardless of the cause of presbycusis, as long as the degree of deafness reaches severe or severe sensory deafness (severe deafness: hearing loss is 71-90 decibels, you can hear loudly in the ear; extreme deafness: hearing loss is 90 If the sound is higher than decibels, you can’t hear it if you shout loudly in the ear), or when the hearing aid is not effective or has no effect at all, you can consider a cochlear implant.Of course, if the old man hasn’t worn it before Hearing aid If you have reached extreme deafness, you can also consider cochlear implants when the benefits of hearing aids are estimated to be limited.
Some people are worried that if their parents are older, can they have cochlear implants?The maximum age of patients with cochlear implants admitted to our department is 91 years old, and foreign literature reports that 93 years old undergo surgery.Whether or not a cochlear implant can be implanted, on the one hand, the results of preoperative assessment of hearing and imaging are required to meet the basic standards of cochlear implants. On the other hand, it also depends on the physical condition of the elderly.

The operation time of cochlear implantation takes 1-1.5 hours. In the past, special patients with otitis media who have undergone radical mastoidectomy, trauma, meningitis, cochlear ossification and fibrosis, the operation time may be longer, and the entire process is under general anesthesia It is completed in the state. If the elderly have basic diseases such as three highs, coronary heart disease, stroke or cervical spondylosis, they need to consult the relevant department before surgery to do a comprehensive examination and preoperative evaluation to determine whether the elderly can tolerate it for about 2 hours General anesthesia to ensure the safety of the operation.
The process of normal people hearing sounds is like this. After the sound comes, it passes through the external auditory canal, tympanic membrane, middle ear, and then to the inner ear. The mechanical stimulation of the sound is converted into electrical signals to stimulate the spiral ganglia and auditory nerves, and then to the auditory sense. The center causes an auditory response.

The principle of cochlear implantation is that the speech processor (the part of the cochlear implant placed outside the body) directly converts sound into electrical signals, which crosses the outer ear, middle ear, and inner ear to directly stimulate the spiral ganglion and auditory nerve, causing Auditory response; and hearing aids basically rely on people’s normal hearing methods, but only amplify the sound.Therefore, due to the different working principles of the two, the comparability in listening to the sound is not very great.http://www.jhhearingaids.com

In some special cases, patients are not suitable for cochlear implants:

1) The patient has severe inner ear malformations, basically no cochlea, and there is no place to put the electrodes, this situation cannot be done;

2) The patient’s cochlear nerve is not developed. In this case, even if a cochlear implant is implanted, it will not work;

3) There are some patients who have a history of trauma, otitis media, and meningitis, resulting in complete ossification or fibrosis of the entire cochlea. In other words, the inside of the cochlea has become solid and there is no way to implant electrodes;

4) For some special patients, such as mental retardation, the cochlear implant cannot cooperate with hearing and speech rehabilitation, so it is not suitable for cochlear implant.
Whether a cochlear implant can be performed is not directly related to the duration of deafness. No matter how long the deafness is, as long as it is deaf after speech (post-lingual deafness) and has a certain foundation in speech and hearing, surgery can be considered.However, the longer the deafness is, the worse the surgical effect may be. Therefore, if the deafness of the elderly is severe, it is best to use it as soon as possible. Hearing aid Once the hearing aid is not effective, the cochlear implant should be implanted as soon as possible. The earlier the operation, the better.
If the patient’s hearing is not good in both ears, it is best to have surgery on both sides to ensure the patient’s hearing on both sides.Bilateral hearing has the following benefits:

1) To help patients judge the direction of the sound source more accurately. For example, if someone calls you behind your right, if only one ear is good for hearing, it is impossible to distinguish whether the sound source is on the left or the right. Yes, it will accurately determine which ear the sound reaches in faster time and higher intensity, so as to know the location of the sound source.

2) In a noisy environment, the ability of single ear hearing to recognize speech is relatively poor, and the sound feels very noisy. Binaural hearing can significantly improve the recognition rate and intelligibility of speech.

3) One ear hearing is prone to hearing fatigue. After listening to sound in an environment for a long time, you will feel very tired, and the fatigue of binaural hearing will be relatively less.

4) Reduce the influence of cephalometric effect. It is more difficult for patients with monaural hearing to listen to the sound from the opposite ear. Hearing sounds from side ears will appear, but binaural hearing will not be affected.
When the patient’s hearing loss in both ears, he needs to restore the hearing in both ears. You can use hearing aids in both ears, or use cochlear implants in both ears, or you can wear hearing aids on one side and cochlear implants on one side. To achieve better hearing effect, the specific method should be determined according to the degree of hearing loss in both ears of the patient.

If one ear has good residual hearing (moderate-severe deafness) and is suitable for hearing aids, and the other ear can not hear at all, consider implanting a cochlear implant; if the residual hearing is very poor (severe-severe deafness) You have to consider bilateral cochlear implants.