Cochlear implantation: Do not miss the "golden window" to restore hearing

A 30-year-old female patient once fell into a "silent" world after suffering profound bilateral sudden sensorineural hearing loss that did not respond to medical treatment or high-powered hearing aids. Working at a fertilizer agency, the loss of hearing turned her life upside down, affecting everything from daily communication to answering phone calls and interacting with customers and partners. Following in-depth examination at the Department of Otolaryngology at University Medical Center Ho Chi Minh City, the patient was diagnosed with irreversible profound bilateral sensorineural hearing loss and indicated for a left cochlear implant. The surgery was successful, and the patient recovered well, being discharged after 3 days. After one month, the patient underwent device activation and initial hearing stimulation; following three months of rehabilitation with the support of audiologists and speech-language therapists, her left-ear hearing improved to near-normal levels, allowing her to return to her work and daily life.

From this case, MSc. Dr. Lê Văn Vĩnh Quyền from the Department of Otolaryngology at UMC HCMC noted that cochlear implantation is a modern treatment method for individuals with severe to profound hearing loss, especially when conventional hearing aids are no longer effective. Unlike hearing aids, which amplify sound, a cochlear implant is surgically placed inside the cochlea to convert sound into electrical signals, directly stimulating the auditory nerve and transmitting signals to the brain. This method can be indicated for patients with congenital or acquired hearing loss, depending on the degree of auditory impairment and speech comprehension capacity.

In addition to children with congenital hearing loss, cochlear implantation is also a vital treatment option for adults with severe-to-profound acquired hearing loss, particularly in cases of irreversible sudden sensorineural hearing loss unresponsive to medical management or high-powered hearing aids. For patients who previously had hearing and language capabilities, appropriate intervention can help restore sound reception, improve communication, and enable them to return to daily activities and work. For young children, the significance of cochlear implantation is especially crucial because children learn to speak by listening. The early years of life, particularly before the age of 3, represent a period of rapid brain development in cognition and language. If children with congenital hearing loss do not receive appropriate intervention, it leads to deaf-mutism, causing them to lose the opportunity for normal learning and social integration.

According to doctors, the most important aspect in treating children with hearing loss is not missing the "golden window." The ideal time for cochlear implantation in children with congenital hearing loss is before 2 years of age, preferably between 12 and 18 months. If detected and intervened late, especially after 5 years of age, a child's auditory cortex may have diminished capacity to receive and process sound. In such cases, even if the surgery is technically successful, the child will still face significant difficulties in understanding sounds and recovering language.

Therefore, all newborns should undergo newborn hearing screening. During child-rearing, if a child does not startle at loud noises, does not turn toward the source of sound, fails to respond when called, experiences delayed speech compared to their age, or uses only gestures to express needs, parents should bring the child to a specialized facility for hearing evaluation. Early detection enables doctors to accurately assess the degree of hearing loss, advise on appropriate intervention methods, and avoid missing the child's most critical language development stage.

Following cochlear implantation, patients do not recover hearing immediately. Typically, after about 2 to 4 weeks for the wound to heal, an audiologist will activate and program the device. Initially, sounds may feel unfamiliar, and the brain requires time to learn how to interpret these signals into meaningful sounds. Thus, treatment efficacy depends not only on the surgery itself but also on the hearing-speech rehabilitation process supported by doctors, audiologists, speech-language therapists, and family.

Experts recommend that cochlear implantation is not merely placing a device for a patient to hear sound. It is a comprehensive intervention journey ranging from screening, diagnosis, surgery, and device programming to hearing-speech rehabilitation. For children with severe-to-profound hearing loss, early detection and timely intervention can open up opportunities for better language development, learning, communication, and social integration. For adults with severe-to-profound sudden hearing loss, especially when unresponsive to medical treatment and hearing aids, in-depth evaluation and appropriate intervention also hold significant value, giving patients the chance to rediscover sound and return to everyday life.