With the implementation of the National Deafness Program, hearing loss treatment in India has finally come of age and the Indian Association of Otolargyngologists is taking an active part in not only creating an awareness about loss of hearing among the Indian masses but are also taking active steps to alleviate the problem.
Hearing loss treatment in India depends fundamentally on the main cause of the problem. For instance, if there is earwax build-up which leads to blockage and loss of hearing, medication, flushing out using an aural syringe and suction are the most commonly used methods. Temporary deafness due to bacterial infections are manageable with antibiotics while surgery is done to drain intra-aural fluid, ruptured eardrums, or maladies of the stapes and cochlea – the bones for hearing.
The main sphere of hearing loss treatment in India, however, is hearing loss due to inner ear damage, also called sensorineural loss of hearing and which is unfortunately permanent. This can be treated by high-powered hearing aids which by way of a microphone, amplifier, loudspeaker and battery increases the sound volume to improve hearing and can distinguish between traffic noises and normal conversation. These are also discreet and small and may fit in snugly inside the ear. State-of-the-art digital hearing aids have a tiny computer that may be programmed for different environments like a quiet room or even a noisy workshop. These are of the BTE or behind-the-ear, open fit, RITE or Receiver in-the-ear, ITE or In-the-ear, ITC or In-the-canal, CIC or Completely in-the-canal, BW or Body-worn and the BiCROS / CROS types.
Recent advances in the treatment of progressive deafness have borne fruit in the Indian sub-continent. Hearing aids based on the bone conduction principle have led to the use of BAHA or Bone Anchored Hearing Aids which are screwed on to the skull through a minor surgical procure and the hearing aid can be switched on and off also as desired. It may be removed also when the patient swims or showers. Implants may also be inserted on the middle ear hearing bones that make them vibrate and transmit sounds to the brain.
Cochlear implants are a more elaborate and intricate procedure and require a micro-surgical process to fit tiny hearing devices under the skin behind the ear. An external sound processor, receiver coil, electronics package & electrode array go into the making of the implant. A small incision is made behind the ear and the middle ear is accessed and the implant is put in.
The external processor absorbs the sound, analyzing and converts it into signals which get transmitted to the internal receiver-stimulator relaying the same on the electrode array to the cochlea. This signal moves on to the brain through the auditory nerve normally. However, cochlear implants work in those cases only where the patient’s hearing nerves function normally. Cochlear implants have worked wonders for Indian children with acute bilateral sensorineural hearing loss which cannot be tackled by hearing aids. The operation yields the best results in children under the age of six and implants are put in both ears.