 Today we will have a brief, we will understand how it works and who all are ideal candidates to undergo cochlear implant. So before we right away jump into what is cochlear implant, we need to understand how a normal person hears. So for any person who is wanting to get a cochlear implant done, we need to understand how it works. So normally our ear, this is the external ear, we have something called as a middle ear, then we have the inner ear which is called the cochlear. So now when we hear sounds, the sounds come to the ear, the sounds are collected by the external ear, amplified and then transmitted to the middle ear, the middle ear which further amplifies the sound into the inner ear. Now this inner ear have small hair cells, so now this small hair cells will transduce or basically convert these vibrational energy into electrical energy and send to the cochlear nerve which further goes into our brain. Now this is how a person hears the sound. Now what happens is sometimes in cases where there is cochlear injury that is the inner ear injury or sometimes these hair cells which were responsible to convert this mechanical sounds into energy that is electrical stimuli are damaged when the child is born itself. Now these are the individuals who we categorize into sensory neural hearing loss. Basically the sensory organ itself is damaged. Now these people what we can do is first we need to assess how good the hearing is, how the severity of hearing is. So we run a set of battery of audiological evaluation, we see what type of hearing loss it is, how much is the hearing loss and whether there is any benefit by giving a conventional hearing aid. Now only those candidates who don't benefit with conventional hearing aids are the candidates for cochlear implants. So as I mentioned there are two sets of people who have hearing loss, one is a newborn, a child who is born deaf and those who have acquired this deafness. So in both the categories we have cochlear implant which is going to benefit these people. In children it plays a more crucial role because the same hearing which is damaged or which is not developed is responsible for the delay in the speech as well. Basically if the child is not hearing the child doesn't know what to speak. So now this needs to be addressed at a young age because our brain is shown to have a certain limited time frame before which the language skill develops. Now if we miss this golden opportunity of this particular six years of early childhood we tend to not develop the speech or language. Now that is why now it is implemented a newborn child as soon as the child is born we do the small testing called as autoacoustic emission OAE. Now this will pick up the likely kids who are going to have hearing loss. Now these kids can get further evaluation to confirm the hearing loss and if found to have hearing loss which is not benefited with hearing aid then we can do something that is cochlear implant. For adults as well those who have lost the hearing after some incident like some viral infection some ear infection or some trauma a fall or due to any loud noise exposure. Something which is frequently happening these days the trend of using ear pods and earphone uses. Now people tend to put loud music to the ear for a prolonged duration of time. As per WHO that is the World Health Organization they have set a certain limit for the hearing using the new gadget or the smart gadgets. So they say you can use up to one hour in a limited volume. So the more higher the volume is you have to use it lesser. So that's how the things about the smart devices are but these days we are misusing it and people tend to develop hearing loss at a very early age as compared to our ancestors. Now in these kind of people who are now profoundly deaf or those who are not benefited with hearing aid. Now always the question arises now the hearing aid is not functioning anymore for me. What do I do now? So there is always an option of a further advanced technology which is cochlear implant. Now for both the newborn as well as acquired cases the cochlear implant surgery is the same and it is a safe surgery. So in this surgery basically we perform a small incision behind the ear and we place the internal processor which is the component which is going to sit inside the inner ear the cochlear and there is an external processor which has to be kept over the skin overlying the internal device. Now usually this process is a time consuming process and we need to be patient enough to go through this process. So once the surgery is done we need to give time for the tissues to heal and after the tissues have healed we start or the switch on the device. From the day of switch on the person or the child starts to hear sounds. So after the surgery we give time for the tissues to heal and once the healing has happened we put a external device and we switch on. Now with the switch on we need to understand the person is not going to hear it to the full potential of the device. So for a child we need to give time for the child to adapt to this new sensation which the child has never heard before. So usually we start with a very minimal tone and slowly as the child adapts to the sound we bring the device to its full potential. Now as a child is born we know it usually takes one to one and a half years to child to develop speech in a normal scenario also in the same way the day we switch on I consider the child is born. So from that time we give intensive speech therapies and accordingly the child will develop speech. So it is a process wherein the parents have to be patient and parents have to sit with the child undergo the speech therapies initially it will be more intensive then as the child we find that child is starting to understand the speech it then we can be little lats and we do it once in six months and so on. But this is a continuous learning process for adults it is again the same way but it is slightly bit more easier because the adults have a well developed auditory system and a well developed brain which has already heard the new, already heard the sounds. So now for adult when we switch on although the same previous auditory perception have been there this is something new. Now the person is hearing through this new bionic hearing technology. So it takes time again for the adult to adapt to this new method of hearing. So for them also we need to give hearing training will adjust the machine according to the need for the patient and then after a certain period of time the person can get the full potential of the device. Now there are certain questions which many of the parents or many of the patients are apprehensive about is the surgery safe as I told before it is a very safe surgery which has stood the test of time. So it is being performed over the last 30 years and the technology has been ever growing and benefits also with this device has also improved a lot. Now the speech perception, speech discrimination and the music perception are also made possible with cochlear implants. Now the second thing is how long the device will function. As far as we know even the earliest devices are still functioning there are definitely some glitches with the technology sometimes the device may not function. In those cases we do revision implants and we change the implant and put in new implant. This person can continue to hear with the new implant as well. So there is no worries regarding the safety and the outcomes of the device because it is well proved and something which lot of people are enjoying the benefit of. Now the other questions which frequently they ask is whether it will affect the child's health in any other manner. Of course it is not going to affect it is a proven safe device it is not going to affect your brain or the inner ear itself for the matter of fact that these devices have been shown to be very safe and it does not damage the inner ear or the brain or the general health of the patient in any manner. So it is something which a person can undergo without any fear only thing it is little time consuming and it requires little effort from both the patient or the parents to find the total or the full potential of the device. So I hope it is little informative from our side to all those people who are thinking about cochlear implants with this we will conclude the video. Thank you.