Cochlear Implant, a Reality in Cuba

Havana. -The number of Cuban patients who have benefited from cochlear implants has reached 224. This is an advanced technique carried out free in Cuba to those who need it, mostly children with more than one handicap.Such is the case of the little girl Lianely, who lost her hearing at 7 months as a result of the after-effects of bacterialmeningitis.

However, she was surgically implanted with the device at 11 months old, and today, at five years old, she performs as any other little girl of her age.

She will never remember that a total silence lived in her for some time. There are other stories, such as Wendy�s, a teenage girl from Santiago de Cuba in eastern Cuba, who had to learn to speak and listen after she was surgically implanted with the device.

The cochlear implant is an electronic device which allows improving the auditory perception of people suffering severe and profound deafness, and who do not benefit enough from conventional hearing aids.

The system has internal components, which are placed during the

surgery and which are not visible. The electronic implant or

stimulator is placed underneath the skin, behind the ear, and the bundle of electrodes is placed in the cochlea, inside the internal ear. In other words, a small accessory works as an internal ear.

In order to carry out this implant, the surgeon and his team must have adequate skills and training, as this is a highly complex and specialized surgery.

Each type of cochlear implant requires a specific surgical set of instruments in optimum conditions.

Doctor Antonio Paz, surgeon of the implant group, told Prensa Latina that the technique is very expensive, because it not only requires state-of- the-art technology, but also because just the implant itself costs more than $20,000 USD.

This technique also requires a long period of rehabilitation following surgery, so that the total cost of the treatment in any country of the first world is about $60,000 USD, said Paz. However, in Cuba this is a free service, as are all health services.

Despite the complexity, the high costs, and the US blockade on Cuba, the country has been able to carry out such an important health strategy, said Paz.

The blockade affects us in everything, in technologies and supplies; however, we have overcome these difficulties. The government authorities and the Ministry of Health have supported this program and invested a great deal of money to develop it, stressed Paz.

The National Programa

Great progress has been achieved in cochlear implants in the

developed world in the last few decades. In Cuba, the first surgeries of that type were carried out in 1997, but it was not until late 2004 and early 2005 that the current program was implemented.

Paz acknowledged the importance of the integrated vision of

the program and its multidisciplinary nature, with the participation of professionals from different disciplines, including audiologists, phoniatricians, teachers, psychologists, and with neuroscience as the driving force.

Choosing the Patients

The criterion to choose candidates for the cochlear implant was

changed with the passage of time as a result of the research carried out in relation to perception and production of speaking and development of the language.

New techniques in surgery and in the programming of the devices are also taken into account, as well as advances in the development of the technology, said Doctor Beatriz Bermejo, expert in phoniatrics and logopedics.

Those currently given the implants are children with greater hearing capacity, better levels of hearing perception of speech, minors, with ossified cochleas and with different levels of cochlear deformities, and children with pathologies

associated with hearing loss.

The general criteria used by companies and the different groups that carry out implants in the world to determine the candidacy of an infant to be implanted include the minimum age of 12 months, the presence of a profound sensorial hearing impairment of at least 90 decibels and with minimum benefits from conventional hearing aids, added Bermejo.

She explains further that there is ample proof of the capacity of the implant to improve access to environment sounds, the hearing and understanding of speech, music, or the use of the telephone, thereby improving the quality of life of adults and children with auditory deficiencies.

Although in Cuba some adults have benefited from this technique,

the priority is generally given to minors. Two-hundred and sixteen

children have been surgically implanted so far, among them 27 suffering deafblindness.

The expert made it clear that is impossible to predict the benefit that each patient will obtain from the cochlear implant, because there are many individual factors that contribute to its results.

The age, the previous level of hearing, the duration of the deafness or the number of healthy sensorial cells influence the result of the implant.

Post-operation rehabilitation, the educational support, and the

participation and efforts of the patient and the family are also key factors that determine the results, because the brain is trained depending on how the individual practices hearing and speaking, said doctor Bermejo.(Prensa Latina)