Neurostimulation devices represent a highly complex and advanced branch of medical devices. Being used for several decades, several neurostimulation devices have led to astonishing results in treating conditions related to the central nervous system, autonomic nervous system, and peripheral nervous system.
Of the variety of neurostimulation devices available in the market, the sector of cochlear implants, till date, represents the most successful and one of the greatest success stories of modern healthcare practices.
Some forty years ago, when cochlear implants were new to the world, these little devices worked only as an aid to lip-reading by providing little more than the sense of sound and sound cadence. Soon enough, cochlear implant systems with multiple processing channels and multiple stimulation sites in the cochlea, allowing significantly higher levels of sound reception than the earlier single-channel devices. From that time onwards, the field of cochlear implants has benefitted from new and better processing capabilities, and through innovative designs such as multielectrode implants.
More than 500 thousand people across the globe, a majority of them being children as young as twelve months, have achieved the ability to hear through the use of cochlear implants. Studies have shown that modern-day cochlear implants can allow users in understanding high context sentences with up to 80% correctness, even without visual indications.
What is a Cochlear Implant?
A cochlear implant is a complex electronic neurostimulation device that can help provide a sense of sound to a person who is completely deaf or severely hard-of-hearing. It consists of an external portion that is fitted behind the ear and second portion that is placed under the skin surgically.
It is an assembly of:
A microphone, for picking up sound from the environment
A speech processor, for selecting and arranging the sounds picked by the microphone
A transmitter and receiver, for receiving signals from the speech processor and converting them to electric impulses
An array of electrodes, for collecting the impulses from simulator and sending them to the auditory nerve
Cochlear Implants in the Developing World:
The WHO states that nearly 5% of the global population has disabling hearing loss. The majority of these people live in low and middle income countries. As such, the developing world presents the most pressing need for technologies like cochlear implants. But there are many limiting factors that not only make cochlear implants out of reach of the general population of the developing world, but also present major challenges in terms of surgeries and post-implantation support.
Listed below are the major challenges ahead leading to lower adoption of cochlear adoption in developing countries:
The high costs of implants: Currently, most cochlear implants in the market are highly expensive, in the range of 30 to 40 thousand dollars. Add to this the expensive surgery for the implantation that is very difficult for the general population in developing countries to afford.
Lack of specialized services: The surgical implantation of cochlear implants requires highly specialized otolaryngology and audiology surgeons, paucity of which in developing countries makes the adoption of cochlear devices even more complex and difficult.
The debate regarding appropriateness of affordable devices: Developing worlds also predominantly use cochlear implants made by world’s topmost medical device makers. As with many other medical devices, there is a chance that the introduction of more affordable cochlear implants will lead to their higher adoption in the developing world. This is, however, a part of an ongoing debate that for making cochlear implants affordable, the developers will have to compromise on the quality and reliability of these devices. As cochlear implants work directly with the nervous system of our bodies, the slightest discrepancy in the device’s mechanism can wreak havoc on other body functions.
Lack of Medical Reimbursement Policies: Mediclaim policies in many developed countries cover the cost of cochlear implants if the receiver of these devices is below a certain level of deafness. Developing nations do not mostly have such policies.