Hearing is believing

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Dr. Nael Shoman, an associate member of the Neurosurgery Division with the Saskatoon Health Region, is now performing cochlear implant surgeries at both Royal University Hospital (pediatric surgeries) and St. Paul's Hospital (adult surgeries). Here, Dr. Shoman holds the internal electrode which is surgically implanted in the cochlea (inner ear).

Since the early 1990s, cochlear implant surgery has transformed the lives of hundreds of Saskatchewan residents who have a profound degree of hearing loss. The Saskatchewan cochlear implant team, which includes physicians, audiologists, speech pathologists and geneticists, has worked with patients of all ages, providing assessments, pre-and post-surgical treatment and rehabilitation.

However, one important element of the program was absent - an Ear Nose Throat (ENT) surgeon to perform the surgical procedures. For over two decades, Saskatchewan patients have had to travel to Edmonton, Alberta for these life-changing surgeries. As many as 45 to 50 Saskatchewan patients a year have received cochlear implants in Edmonton over the past five years.

Recently, these surgeries began to be performed in Saskatoon by Dr. Nael Shoman, a member of the Division of Otolaryngology - Head and Neck Surgery, and an associate member of the Division of Neurosurgery with the Saskatoon Health Region.

Shoman graduated from the University of Saskatchewan's College of Medicine and then completed his residency in otology and neurotology at the University of British Columbia. He went on to practice for two years at the University of Cincinnati Medical Centre.

The doctor's passion for "the ear" and cochlear implantation was ignited during his residency. "The more I learned about it, the more fascinated I became. It became a focal point for me and one of my main interests. I knew at some point I'd like to come back to Saskatoon and help establish this program here," says Shoman.

In 2011, the ENT specialist accepted a position with the Saskatoon Health Region. "When I came back to Saskatoon, we started talking about adding the last piece of the puzzle, which was the surgery," says Shoman.

"The program entails quite a few people, including audiologists, speech pathologists, geneticists, the ENT physician involved in the assessment of the patient and the ENT surgeon who does the cochlear implant. There are also people involved in the rehabilitation phase, which can range from members of the audiology team to social workers. We were fortunate because those parts of the team were already established. We just added the surgical aspect."

Almost two years of planning, budgeting and specialized training followed before the first adult cochlear implant surgery took place in October of 2013 at St. Paul's Hospital. The first pediatric cochlear implant surgery took place in January of 2014 at Royal University Hospital.

Designed to replace the function of a damaged cochlea (inner ear), the electronic medical device provides sound signals to the brain. The cochlear implant consists of two parts: an internal device with an electrode array that is surgically inserted in the inner ear and an external sound processor that is placed behind the ear.

"The internal device has an electrode that is implanted in the cochlea. About a month after that surgery, the patient receives the external device, which captures sound through microphones and sends it to a processor which analyzes the signal and sends it through a magnet to the electrode that has been implanted in the cochlea. The electrode stimulates certain aspects of the hearing nerve and relays those impulses to the brain. The brain analyzes that signal and makes sense of it, restoring the ability to hear in a lot of patients," says Shoman.

Who can benefit from a cochlear implant? Dr. Shoman explains, "A cochlear implant is a device for people who have a profound degree of hearing loss who have not befitted from hearing aids. Most have sensorineural hearing loss, also referred to as nerve deafness. They have lost a lot of the hair cells in the cochlea but the nerve itself, even if it's affected, still has some viable aspects to it."
There are approximately 15,000 hair cells in the cochlea which convey signals to the auditory nerve. Damage from disease, loud noise, certain medications or the aging process can permanently damage the hair cells, leading to severe hearing loss or deafness.

Although the cochlear implant program is based in Saskatoon, patient referrals are accepted from across the province. "It's a province-wide initiative," says Shoman.

He notes that a growing number of young children are being referred to the program as a result of the universal screening program that was implemented by the province of Saskatchewan within the last five years. "It catches more of the newborns. More kids are getting diagnosed with sensorineural hearing loss early on in their lives."

According to research conducted by the Canadian Agency for Drugs and Technologies in Health, the most common age range for children to have cochlear surgical implantation is between 12 and 24 months. "A patient who is born with hearing loss will do better if the implant is received early on, versus when they get older. The same thing applies to adults. If they receive an implant closer to any loss of hearing, as a group, they will do better than someone who receives an implant later on," says Shoman.

The surgery itself takes several hours, requiring a one-to three-day hospital stay, depending on the age of the patients.

Hearing is not achieved instantly after surgery, says Shoman. "There's about a month of post-op healing. During the first post-operative session, when they get their implant turned on, there's a fair amount of 'mapping', which is trying to fine tune the signal to a sequence that is comfortable for the patient - not too loud, not too soft. That may be fine-tuned, over the next few sessions," says Shoman.

"It's important to emphasize that there is a period of time, sometimes six months to a year, or longer, of rehabilitation where we train the brain to use this device."

During rehabilitation, the patient will work with an audiologist trained in cochlear implantation. "It may also involve working with a speech pathologist. The family plays a big role as well, as far as being supportive and providing encouragement," says Shoman.

"It's interesting to follow these patients through training and see how their lives change."

Since the devices were first approved by Health Canada in 1990, cochlear implant technology has improved dramatically, notes Shoman. Advances in integrated circuit and electrode technologies and sound coding strategies have improved performance and outcomes for a wider range of patients.

"Wireless technology has expanded the potential benefit of the cochlear implant," says Shoman, adding that the introduction of waterproof processors means the device can now be worn while swimming or bathing.

Having completed its first "trial year," Shoman says the cochlear implantation program "is going quite well."

He anticipates the number of cochlear implant surgeries performed in Saskatoon will continue to increase. "The answer comes down to demand. The hope is that every patient who qualifies for a cochlear implant receives a cochlear implant. We're working towards that goal."

http://www.thestarphoenix.com/health/Hearing+believing/10766621/story.html
 
I hate the idea of having cochlear implants on babies. This is not wise on having surgery.

I was born deaf and I had lived a good life as a deaf happy child for the 8 years before I received my first hearing aid. When I heard only environment sounds, I was not that happy to have hearing aid at all. But I seem to be forced to wear it.

My left ear was severe hearing loss while my right ear was profound hearing loss which I could not hear at all with the second hearing aid. I don't want to have CI and that is my decision and my business not to have someone interfere my decision whether I want to have CI or not have CI. That is what concern me about the babies starting to have CI. They could not be able to defend themselves if they can not use the voice to let the parents know that they don't want to have CI or decide they want to have CI. That is suppose to be the child's decision, not the parents or any other authorities.

I don't like to have parents making the decision of trying to fix the deaf child or any other disabilities as far as I am concern that the parents who want to use surgery to fix the deaf child as normal as possible. Bah! :(

Beside it is too young for the babies to have CI so early. **shaking my head** :(
 
I hate the idea of having cochlear implants on babies. This is not wise on having surgery.

I was born deaf and I had lived a good life as a deaf happy child for the 8 years before I received my first hearing aid. When I heard only environment sounds, I was not that happy to have hearing aid at all. But I seem to be forced to wear it.

My left ear was severe hearing loss while my right ear was profound hearing loss which I could not hear at all with the second hearing aid. I don't want to have CI and that is my decision and my business not to have someone interfere my decision whether I want to have CI or not have CI. That is what concern me about the babies starting to have CI. They could not be able to defend themselves if they can not use the voice to let the parents know that they don't want to have CI or decide they want to have CI. That is suppose to be the child's decision, not the parents or any other authorities.

I don't like to have parents making the decision of trying to fix the deaf child or any other disabilities as far as I am concern that the parents who want to use surgery to fix the deaf child as normal as possible. Bah! :(

Beside it is too young for the babies to have CI so early. **shaking my head** :(

I totally agree
 
I hate the idea of having cochlear implants on babies. This is not wise on having surgery.

I was born deaf and I had lived a good life as a deaf happy child for the 8 years before I received my first hearing aid. When I heard only environment sounds, I was not that happy to have hearing aid at all. But I seem to be forced to wear it.

My left ear was severe hearing loss while my right ear was profound hearing loss which I could not hear at all with the second hearing aid. I don't want to have CI and that is my decision and my business not to have someone interfere my decision whether I want to have CI or not have CI. That is what concern me about the babies starting to have CI. They could not be able to defend themselves if they can not use the voice to let the parents know that they don't want to have CI or decide they want to have CI. That is suppose to be the child's decision, not the parents or any other authorities.

I don't like to have parents making the decision of trying to fix the deaf child or any other disabilities as far as I am concern that the parents who want to use surgery to fix the deaf child as normal as possible. Bah! :(

Beside it is too young for the babies to have CI so early. **shaking my head** :(


yes it is scary seriously. I don't understand why children is want or not accept possible risk for cochlear implant. it is not good.

how allow ASL?. It is very make sure Saskatchewan is under government pay cover costly. it is very pretty expensive health.
it is alots of costly. it is bit increase grow people.. I don't understand why perceptive to cochlear implant.

it really scary.
 
What is the success rate of having a family of five to all learn sign? Of the people who go to school to learn sign(in general or within families), how man become proficient at it? What is the cost of learning sign for each family member to a level of proficient use?
 
What is the success rate of having a family of five to all learn sign? Of the people who go to school to learn sign(in general or within families), how man become proficient at it? What is the cost of learning sign for each family member to a level of proficient use?

:dizzy:
 
It has been discussed in DVTV all the time. A few people said that it's the parents' decision since the baby is their own. IMO, we can't control those parents. If they decide that CI is good for their babies, let them be. Maybe their children will thank them or not. I oppose it but it's not my problem since it's not my child.
 
More and more babies got bilateral CI. I have nothing to say about it. Oh well
 
More and more babies got bilateral CI. I have nothing to say about it. Oh well
Yeah, really people are fantasied to any new technology. "CI can make deaf people to hear"

I'd rather be 100% human than 25% robot/75% human. LOL
 
There is no just thing as a miracle. The CI companies including the surgeons who are greedy for big bucks just want to make big bucks from health insurance and rich people. CI does not always become successful for the deaf. That is what make me upset. :(
 
LThese twisted bastards wont stop until not one deafie remains.people like this guy are lauded as heroes by hearies.
Disgusting.
Expereminting on babies..thats exactly what people of his ilk do. To hearies its a religous ideal to implant us. And just like a religion they are moved and propelled onward by their utopian, i should say distopian vision of a world with no deaf and no sign.
the march of folly continues with the hearie obsession to cure and rid the world of people like us.
In the end, if it was up to them. Not one of us would be safe..
Bastards.
 
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as seriously people babies cause will wreck.it is affect high riskly behavior enviroments. it is failure implant or replacement seconand. development babies. can do things impossibles you can do fix adjustment to doctor do that babies go ahead cochlear implant become withouth deaf profoud or loss hearing . advise recommand hearing aid safe. that is advise hearing aid.. it is younger baby too late jump postpone it avoid destruction things.
 
I'm OK with the CI if evidence clearly 100% indicates that HAs do not work at ALL. The thing that I have issues with is that it's VERY hard to tell how well a baby/toddler responds with aids
I see a CI as basicly a more powerful HA.....and you must admit that they're great for progressive losses, cases of severe recruitment, auditory nereopathy and so on. I AM uncomfortable with the marketing of CIs.... Also I think it should be a good idea for the team to suggest ASL as a second language/another Very Useful Skill.
 
Isn't one of the reasons-parents consider a Cochlear Implant for their deaf babies-to "assist in learning to speak"?
 
It has been discussed in DVTV all the time. A few people said that it's the parents' decision since the baby is their own. IMO, we can't control those parents. If they decide that CI is good for their babies, let them be. Maybe their children will thank them or not. I oppose it but it's not my problem since it's not my child.
Isn't it sad these children are viewed as something people own?!
 
I never used to understand why parents wouldn't get babies/kids a CI if it was an option. I used to judge deaf parents who wouldn't "help" their children by getting them one. Now that i have kids and now that understand about the Deaf community it makes angry thinking CI's being pushed and promoted like you're kids needs to be "normal", hurry up and "fix" them... there's nothing wrong with them, let them decide when they're older if they want to go through something like that.

How about we promote self love and enrichment through diversity? Quit trying to "fix" people.
 
I never used to understand why parents wouldn't get babies/kids a CI if it was an option. I used to judge deaf parents who wouldn't "help" their children by getting them one. Now that i have kids and now that understand about the Deaf community it makes angry thinking CI's being pushed and promoted like you're kids needs to be "normal", hurry up and "fix" them... there's nothing wrong with them, let them decide when they're older if they want to go through something like that.

How about we promote self love and enrichment through diversity? Quit trying to "fix" people.

Lots of deaf people today implant their kids to give them access to both worlds.

The big objection is to raising kids with no ASL, and no knowledge of the deaf world.

Many times people who aren't deaf come here and they want to romanticize deafness.

I hate this when it starts another of the big CI battles like the old days. The main participants in those are star struck hearies and those who don't even have a deaf child.
 
I'm not deaf, I am losing my hearing. I hear that from people "i wish i had a deaf friend" type stuff. I think that's so strange, like they focus on the fact that someone is deaf an think it's cool, like all deaf people are the same or something.

I just learned that some people who are deaf don't learn to sign or have HA's. Why is that? How do they communicate? The people I've known who are deaf i met through a school for the deaf so they all signed. I didn't know some people don't.
Lots of deaf people today implant their kids to give them access to both worlds.

The big objection is to raising kids with no ASL, and no knowledge of the deaf world.

Many times people who aren't deaf come here and they want to romanticize deafness.

I hate this when it starts another of the big CI battles like the old days. The main participants in those are star struck hearies and those who don't even have a deaf child.
 
Its still common. Practicaly a policy in the ci professional world to have a negative view and an antagonist view of sign. For Deaf kids who get implanted. So that they do not " revert back to being Deaf". And thats a huge plm, until that changes many of us will be calling them and their ilk out.

A balanced book on the topic is the artifical ear, written by hearie parents who implanted their Deaf child, it explores both sides, right from the very fiest implants, the idea that drove them, and the first implants done to babies against medical advice, it explores us Deaf resistance to assimilation, not just in america but also France and the uk. And is a book international in charactor, as ci doesnt stop at the border,neither should the critique of it. It also explores the ci industry that resembles big pharma in every way..and how the push to inplant Deaf babies and fda approval of it, was first and foremost a bussiness decision to expand markets and profit for ci companies rather then any sencere desire to help Deaf kids or families
I recomend it.
Its a balanced book.
Many will ignore facts and scoff at them and thats cool.
But to others history and the present and the future. Our future. Our language and cultures future are very important.

Another book i highly recomend is the mask of benevolence from harlan lane. No small change writer. He sits on the acadamie francai, and has allot of usefull ideas for us, it asks hard questiins and offers serious thought to the topic, of hearie relations with us, audism, and assimiliation.

As for me. The writings on the wall for us,and one day they will have a world rid of people like us.they will have their preety perfect normal by order everyone of the same measurment.of normal, with little in way of difference world. The world will be worse for it. But it cannot be stopped.it wont be stopped. Our wishes are irrelavant. Our experences as Deaf dismissed.

We cant stop it. It wont be stopped.
And ive accepted it as such.and im not alone amongst us who accept that fate for us.
Stick a fork in us.
Its over
 
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Has anyone....ever met or known an ENT that knows ASL??? I've not met one...and I've been to many in different states.....Strange to me!
 
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