Children's Services

Hearing Loss & Options

Hearing is one of those things most of us take for granted and it is only when it is taken away, especially if it is sudden, that we realize just how important it is for our safety, our communication with others, our sense of belonging, the pleasure of sound and so much more. We at MESIARC provide the best treatment depending on the type and cause of hearing loss. There are several types of hearing aids that can be prescribed, and surgical treatments such as cochlear implants may be indicated. Each patient is unique and comprehensive workup by our experienced team of neuro-otologists is the first step to determining the best treatment.

There are several obvious indicators of hearing loss. For example, a patient may report having to ask people to repeat themselves or turning the television volume louder than the rest of the family. A patient may also think that many people mumble or have difficulty communicating in a noisy environment. A one-on-one encounter, such as a patient-clinician conversation in a quiet room, may not be a good indicator of hearing loss because there are many redundant cues in the speech message. However, if the patient shows obvious difficulty during the conversation in a quiet room, hearing loss is almost certain. Hearing loss is a silent problem affecting millions of patients who receive treatment for other health conditions. Screening for hearing loss could be implemented easily into a primary care environment to identify and treat patients at an early stage. MESIARC offers numerous treatment options and technology to improve communication and quality of life for a substantial number of people.

Device & Implants

Mesiarc provides audiology and speech-language pathology services to children from birth to adulthood, including testing to determine the degree and type of hearing loss a child may have, fitting of devices to address any hearing loss (including hearing aids, bone conduction devices, and cochlear implants), and assessment of the development of listening and communication skills, especially speech and oral language. We work closely with our children’s school and therapy personnel so that we may be, effectively,one team working toward the best possible communication outcomes for children with auditory disorders.

Cochlear Implantation

For the young couple Asha and Navin (names changed to protect privacy), little Sasha’s singing isn’t just another proud parent’s joy- it is the culmination of a journey that seemed like a desperate gamble. When she was born profoundly deaf, the young parents were shattered. How could this happen to them? What had they done wrong? The family was never exposed to this handicap that was invisible but had a profound influence on the life of a child, affecting her ability to have a good education, career, and even marriage.
After visiting countless specialists and spending a lot of time and money, with nothing but despair gained, they heard about a clinic in Calicut. After visiting Dr. Manoj’s ENT Super Specialty Institute and Research Center, they learned about an amazing technology that was bringing hope and hearing to children like their daughter. Audiologists Sasidharan P Nair and Shabeena Backer, both trained at the Bionic ear Institute at Melbourne Australia, and at the Medel Laboratories at Wurzburg, Austria along with Dr. Manoj, who was the State’s first ENT surgeon to perform a Cochlear implant, lent a patient ear to their problems.

This was a unique experience in itself. The team, who is among the three most experienced cochlear implant teams in India, described to them how Sasha was born with defective hair cells of the inner ear or the cochlea-which was why she could not hear speech sounds through the hearing aid, even if it was the best in the market today. And as she was not developing normal speech and language even with intensive speech therapy, she had to have a surgery where a tiny electronic device would bypass the damaged hair cells and provide a good hearing.

The young couple was genuinely concerned- would the surgery be safe? Would the implant perform well in years to come? How long would she take to recover? Dr. Manoj’s team, instead of explaining all this medical information to them, which might have been bewildering, directed them to the speech therapy rooms where many young implanted children were being initiated into the wonderful world of hearing. The parents of those children told them what they wanted so desperately to hear. They were told that the surgery was safe, and in Dr. Manoj’s experienced hands, would take only a little over an hour. The children leave the hospital the very next day, are happily playing soon after. They also learned that the implants used at Dr. Manoj’s ENT Institute were among the safest in the world today, with over 99% reliability in the last 20 years.

They also learnt that Dr. Manoj, from the training that he had received at the Bionic ear Institute at Melbourne, Australia, and from courses held all around the world, had innovated new techniques like the minimally invasive surgery and the new “D ” well that placed the implant in a deep pocket, preventing damage to the implant from falls and bumps that young children are so prone to. They also learned that the team had also the largest proportion of very young children implanted in India and had one of the best safety records in the world today.
After a lot of time was spent on evaluations and counseling, the scans were ordered and little Sasha was posted for surgery. After an uneventful postoperative period, just as they had hoped, the child was “switched on at three weeks when the incision was almost invisible. The first switch on was an experience that the parents would never forget. Their daughter first screamed when she heard words for the first time and both of them burst out in tears. Their final moment of truth had arrived. She could finally hear!

Soon Ms. Daniya and her team of experienced speech therapists took over and the child always found the weekly sessions enjoyable. Ms. Daniya explained to the parents that they were the ones who had to train their child to speak, just as millions of parents do to their “hearing” children. So in most advanced countries, daily therapy sessions were never done. For hearing impaired children with no cochlear implants, this was sometimes necessary, but cochlear implants opened up a whole new world of hearing for these children so that they begin learning to speak.

Today, Sasha, thanks to an amazing new technology, is talking and behaving just as any “normal” child would do, just as most young children implanted at Dr. Manoj’s ENT Institute. The parents are proud of their young child and look back often fondly at the decision that they made some time back that changed their lives forever.

If you have a child with a hearing handicap, do not despair. There is hope for most, if not all of them. Do contact Dr. Manoj’s ENT Institute and Research Center.

Speech-Language Therapy

Auditory verbal therapy, the latest in auditory rehabilitation is a specialty of the institute. This method ensures that the deaf child learns the language the proper way (i.e., via listening) and becomes a contributing member of the society. Auditory Verbal Therapy) is a specialized type of therapy designed to teach a child to use the hearing provided by a hearing aid or a cochlear implant for understanding speech and learning to talk. The child is taught to develop hearing as an active sense so that listening becomes automatic and the child seeks out sounds in life. Hearing and active listening become an integral part of communication, recreation, socialization, education, and work.

Clinical Services

Diagnostic Audiology

Diagnostic audiology with children of all ages determines the type and degree of hearing the loss in each ear.
Auditory Brainstem Response (ABR) testing is used to assess auditory function in infants and very young children and in any child unable to participate in behavioral hearing testing. ABR is performed by MESIARC audiologists with young babies in natural sleep and in older infants and children under light sedation administered by the medical staff.

The audiologist has a number of tools at her disposal to assure appropriate hearing aid fittings. Measurements can be made of individual ear canal resonance or estimated from well-researched averages, and gain and output characteristics can be selected to match targets most appropriate for children.

Hearing aid fitting in babies requires specific expertise. The amount of power appropriate for a particular hearing loss is different for small babies than in adults, and it will change as the baby grows. So the audiologist must see the baby frequently and make changes to hearing aid programming based on the baby’s ear canal size and as more specific information is gathered about the baby’s behavioral hearing thresholds.

Virtually all hearing aids are now digital signal processors that can be programmed to closely suit individual hearing losses. It is important to understand, though, that no hearing aids “correct” hearing to normal, and that children with hearing aids still do not hear well in all circumstances. Depending on the degree and configuration of the hearing loss, hearing aids may provide access to sounds all across the speech range, or they may provide access only the low frequencies with minimal benefit in the high frequencies. In some cases, there is not enough measurable hearing for hearing aids to provide any significant benefit (see cochlear implants).

There is a difference between “hearing” and “understanding”–hearing aids can make sounds in different frequency ranges audible but cannot guarantee the user will be able to understand speech clearly. So even the best hearing aid fittings cannot stand alone; expert therapy and a strong educational program will be essential to success.

YOU as parents are a very, very important component in your child’s success, and every moment you are with him or her is a teachable moment. Your child’s teachers and therapists will help you to learn the most effective ways to work with your child at home.