Possibilities of cochlear implantation in Russia

In 2017, it is exactly 20 years since the first cochlear implantation was carried out in Russia, and it was in St. Petersburg. This is a significant moment for domestic otolaryngology.

To date, the Institute is one of the world leaders in helping deaf and hard of hearing people. I'm not saying that St. Petersburg Research Institute of ENT does the most in the world of cochlear implantations, but the institute is engaged in both selection, operation and rehabilitation. The operation itself for cochlear implantation is only part of the difficult path that must be passed to the patient, doctors and parents. It is a single organism, and everyone must obey the same rules. Cochlear implantation is the lot of the whole team. This is one patient and about 27 specialists involved in the process all the way back to the world of sounds.

Let me remind you the statistics. In Russia there are approximately 140 million people. The need for cochlear implantation: one per 100,000 people per year is about 1,400 operations per year for the whole country. It is believed that for 1000 newborns 1 child is born deaf, and another 2-3 children lose their hearing in the first years of life.

We have two main categories - small children who were born deaf or lost hearing in the first years of life. The second big category of patients are people who have lost their hearing, having already mastered speech. There is also a category of elderly patients. We can help all categories.

When people first encounter this problem, they usually do not know what to do. They are looking for information on the Internet. Refer to otolaryngologists at the local level. Now people find the necessary information. But, nevertheless, always - the first question they ask: "Can this help us? Will this really help us? "At this stage, we have to conduct explanatory and educational work. Then we prepare the patient for the operation. People can learn about what awaits them after the operation only from us - from those specialists who will be engaged in rehabilitation. The operation itself is still half the battle.

After the operation, when the implant itself and the speech processor are connected, difficult times come for the patient. If this is a small child who has not heard before, then everything starts for him from the first day from birth. Patients who have lost their hearing, already having mastered speech, also face problems. Because at first sounds may be different from what they heard before. But in the process of postoperative rehabilitation these sounds add up to the general picture. In these patients, specialists in hearing-and-speech rehabilitation are helping. The most pleasant for us is when people come in a few months and say: "Doctor, I hear the same as before."

Cochlear implant gives a physical opportunity to hear sounds. But to find out exactly which sound it is, to understand what the word means, which is expressed by sounds - this patient must be taught. This is a long process. This situation largely resembles the situation when we do not just learn to hear, but learn a foreign language. Why are we always happy when there is an opportunity to perform an operation for a small child? Because everyone knows how easily any small child learns any language and how much more difficult it is for an adult to do it. So the brain is arranged. This is its peculiarity.

There are a lot of problems. We conduct operations for children and adults who live in different regions of Russia. The country is huge, and not all regions have specialists who can continue our work. Both children and adults need special classes, the ability to constantly adjust the speech processor, and all this requires new approaches.

SPb Research Institute of ENT is certainly Russia's leading institution that develops modern approaches that differ from the methods of teaching deaf people to speak, which were used earlier - in the 19th century, in the 20th century. Then people did not hear. They learned to speak, reading on the lips, looking at the written text, it was a support. We teach to hear and develop speech, as ordinary people do. This requires a lot of work with parents. Because usually a child learns a word, first of all, listening to the speech of close people, the speech of the mother who communicates with him most. But the mother of a deaf child, communicating with him, must take into account the characteristics of perception, which at the initial stage do not allow her child to spontaneously master the speech.

There is an all-Russian project - "I hear the world!", Which connects not hearing children, their parents and specialists of different nationalities from different regions of the country. The project is intended to support such families and such children.

SPb Research Institute of ENT develops family-oriented approaches, and the whole country works on benefits that are prepared at the institute. Our former compatriots, the countries of the near abroad, also work according to the methods developed in the SPb ENT Research Institute. Now in the institute we are discussing a very important task - the creation of materials in national languages. Of course, in Russia the main language is Russian. But there are a lot of families who speak other languages. And we need materials that will be used to teach children to speak and hear in a variety of languages. Materials have already been created in Avar, Armenian, Georgian, Kazakh, Tatar, Ukrainian, Yakut languages. This is also an important task.