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Writer's picturemarianeratsimor

What’s the Deal with Cochlear Implants?

This might be a familiar Youtube thumbnail to you:


A few years back, this video about a woman turning on implants for the first time made quite the circulation around the internet. However, after taking a closer look, you’ll see this at the bottom of the video:


The topic of cochlear implants is often rather taboo within the Deaf community—think of how uncomfortable the atmosphere gets when someone brings up a heated political issue with your family at the Thanksgiving dinner table. Many online Deaf forums & groups often have a ‘no cochlear implant discussion‘ rule, to avoid bringing up any sore points.


So, why is there such a split over a little device?


The Biology Behind Hearing


Here’s a massive oversimplification: sound waves (in the form of vibrations in the air) travel through the auditory canal (the part where we totally shouldn’t be sticking Q-tips into), until it hits the eardrum. The eardrum moves with the sound vibrations, causing tiny bones in the middle ear to move as well (which are actually the smallest bones in your body). The movement of these bones pass the signal to the spiral-shaped cochlea, which has hair cells inside. It’s the movement of these hair cells that convert sound into signals that the brain can interpret.



[Anatomy of the Ear] —http://www2.needham.k12.ma.us/eliot/technology/lessons/sense/hearing.htm


For Deaf and Hard-of-Hearing people, or anyone with any form of hearing loss, this pathway is interrupted. This could occur at any part of the ear; but, so long as the cochlea doesn’t receive or is unable to convert sound signals, ‘noise’ won’t be perceived by the person.


So What are Cochlear Implants, Anyways?


A cochlear implant (CI) is a device that, in a nutshell, restores hearing if it is lost. The entire device is made of two components: a surgically implanted part, and an external part.


Essentially, the implant allows auditory signals to bypass the auditory canals altogether, to deliver these signals directly to the auditory nerve. An external sound processor, as the name suggests, processes auditory signals from a connected microphone and guides them to a transmitter. These three components make up the part of the CI device that you can see.


However, there’s more going on on the inside—the transmitter sends the signal to a surgically implanted receiver, which passes the signal along to electrodes on the cochlea (that’s the snail shell-shaped part of the ear; a bit of a tongue twister!). Take a look at the diagram below for a visual of these components:

[CI & Ear Anatomy]—https://www.attune.com.au/2020/08/21/what-are-cochlear-implants/


As mentioned before, for a hearing person, the cochlea is the part of the ear where sound waves get converted into an electrical impulse that can be interpreted by the brain into perceivable “noise.” Between the brain and the cochlea, we have the cochlear nerve (which carries auditory sensory signals from the ear to the sound processing areas of the brain). Since this pathway is interrupted for people who have lost their hearing at any point in life, the cochlear nerve doesn’t receive any input, and the brain interprets no sound.


With a CI, the implanted electrodes along the cochlea stimulate the cochlear nerve from the signal picked up by the external sound processor. The brain now receives auditory input, albeit a different kind than organic hearing.


Since the input isn’t the same, it takes time to learn how to interpret signals from a CI. Some residual hearing may be lost after the surgery and the types of sounds that an individual can hear are a bit different—however, the end result is that generally, a form of hearing is accessible to the implantee.


CIs & The Deaf & Hard-of-Hearing Community


The Deaf & HoH community has a long and arduous history with oralism—the view that Deaf children shouldn’t be taught sign language and be taught using auditory methods, to integrate children into the “hearing world.” Cochlear implants can further validate some hearing parents’ choice to take this route and make them more likely to choose an oralistic option when raising their Deaf children, rather than exploring the opportunities that sign language offers.


The Deaf community strongly advocates that Deafness/Hard-of-Hearing is not something that needs to be 'fixed,' while hearing people often make the false assumption that it should be. This led to the invention of one of the most controversial technologies: the Cochlear Implant.

[A young boy wearing a CI]—https://www.medgadget.com/2019/04/2019-cochlear-implants-market-structure-by-size-share-and-prominent-players-are-advanced-bionics-ag-med-el-cochlear-ltd-gaes-medica-william-demant-holding-group-etc.html


Essentially, the trouble with CIs begin when young children—who have this choice made for them by parents or guardians—receive implants, and are subsequently taught using oral methods instead of sign language (such as ASL). When a Deaf child is faced with learning their very first language, the consensus within the Deaf/HoH community is that teaching children their local sign language FIRST is the way to go. Avoiding teaching children sign language due to their CIs and having the desire to ‘integrate them into the hearing world’ both hinders the child’s language development, and diminishes a central aspect of their Deaf identity.


Deaf & HoH individuals who have had CIs implanted as children are still an absolutely important part of the Deaf community, and their participation within it only strengthens it. CIs simply bring a large aspect of Deaf culture into question as these ties are being formed for children; so naturally, the Deaf community is apprehensive about this technology.


The increasing prevalence of childhood CI implantations has lead many to the conclusion that cochlear implants are the keystone of a Deaf cultural ‘genocide,’ as hearing parents are given the excuse to lead Deaf children away from the Deaf community, in favour of integration with those who are hearing.


Furthermore, a child’s self-image can also be impacted. As a child with a CI is raised with an oralist focus, a part of their identity becomes focused on the speech therapy and CI at the expense of a proud Deaf identity and ease of communication using ASL (which uses their primary modality of vision, rather than sound).


Take a look at the ASL sign for “cochlear implant” — it looks a little...invasive, right?


When we boil everything down, suggesting cochlear implants to a Deaf/HoH person implies that Deafness is “something to be fixed.” This view isn’t right at all—being Deaf is a different, but absolutely no less fulfilling, way to live. Videos like “29 years old and hearing myself for the first time!” sensationalize CIs and imply that Deafness is something to ‘recover from.’


Here’s a short video (CCs included) about CIs from Cobi Sewell, an 8th generation member of a large Deaf family, talking about cochlear implants:


It’s a bit different when an older Deaf/HoH person makes the choice to receive a CI themselves, since it’s an educated and informed decision made on their own behalf. However, many Deaf and HoH people will refuse to have a CI due to both the costs of the surgery (it’s not cheap—the device itself costs $24,000 in Canada, not including the cost of surgery itself and speech therapy afterwards), as well as the implications the CI has within the Deaf community.


It’s Not All Bad with CIs


That said, CIs can be great tools for those that lose their hearing later in life. This is especially true for people who used to rely on hearing aids, but no longer can as hearing loss progressed through the point where hearing aids aren’t useful anymore.


This population includes those who profoundly lose their hearing with old age, or even those on the frontlines of battles who’ve suddenly lost their hearing after an explosion. In these cases, among others, cochlear implants can restore a certain level of hearing and allow the recipient to use sound once again.

[Older Man with CI]—https://www.verywellhealth.com/cochlear-implant-failure-reimplantation-1046199


The Bottom Line


There’s a reason why cochlear implants are controversial—on one hand, they can give people who lost their hearing a chance to experience it again. On the other, they have the dangerous impact of diminishing Deaf culture when given to young children. Cochlear implants aren’t a “cure” for Deafness, as many hearing people want to believe.


After all, being Deaf isn’t a problem to be fixed.



 

References


https://time.com/76154/deaf-culture-cochlear-implants/


https://www.youtube.com/watch?v=LsOo3jzkhYA


https://www.gallaudet.edu/history-through-deaf-eyes/online-exhibition/awareness-access-and-change/cochlear-implant/


https://www.youtube.com/watch?v=VPt9mGxnL20


https://web.archive.org/web/20070220131900/http://www.nad.org/site/pp.asp?c=foINKQMBF&b=138140


http://cad.ca/issues-positions/cochlear-implants/


https://www.signasl.org/sign/cochlearimplant


https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants


https://www.mayoclinic.org/tests-procedures/cochlear-implants/about/pac-20385021


https://www.mayoclinic.org/diseases-conditions/hearing-loss/symptoms-causes/syc-20373072


https://www.cbsnews.com/news/the-cochlear-implant-controversy/


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913847/


https://time.com/76154/deaf-culture-cochlear-implants/


https://www.insider.com/why-deaf-people-turn-down-cochlear-implants-2016-12


https://www.cbc.ca/news/health/cochlear-implants-a-world-of-sound-for-the-deaf-1.1058362#:~:text=The%20devices%20cost%20about%20%2424%2C000,administration%20and%20philanthropy%2Fgrant%20support.

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