The treatment of severe or profound hypoacusis has varied a lot since Cochlear Implants began to be performed. Many of the initial limitations (due to age, otological, concomitant, medical or psychiatric diseases) have been changing over the years, to the point that today any severe hypoacusis where the patient no longer obtains sufficient benefit from his hearing aids is really considered a candidate for Cochlear Implantation.
In childhood it has meant the most important development for those who were destined to communicate with sign language, to an intense personal and family effort to be equal to the children of their environment, to have access to their education and to develop intellectually in the same conditions as other children. Only in a few cases, severe malformations, agenesis, tumors, make this not possible or limit it.
The appearance of the Cochlear Implant represents the most striking advance of what biotechnology or bioengineering can achieve to help recover such a complex and essential sense as hearing.
First patient with Cochlear Implant
The first patient who was implanted in our center was on June 24, 1989. Some single-channel cochlear implants had already been performed in Barcelona, but this was the first multichannel cochlear implant performed in Spain. The patient suffered from Otosclerosis and had been operated by Dr. Antolí-Candela Cebrián in the 70’s for stapedectomy. Little by little her hearing loss had progressed, until she began to isolate herself from her family and friends and stopped playing the piano -which she liked so much- because she could not hear it.
A case like so many others we see so many times. The operation was performed by Dr. Antolí-Candela Cano. A Cochlear Ineraid implant was placed in his left ear, which was a revolution in terms of hearing performance, but it had an external pedestal and wires. It was quite a contraption and caused a lot of skin problems. But the patient could hear her friends and family again, and played the piano again. Subsequently, in 2001, a Med-El Cochlear Implant was placed in her right ear, and the following year the old Ineraid was explanted.
Cochlear Implants in the Antolí Candela ENT Institute
Since then, the history of the Antoli Candela ENT Institute has been linked to the evolution of Cochlear Implants, remaining as one of the private centers with greater implantation activity in Spain, limited by the economic cost to patients, and more since the Social Security began to place the candidate patients within their portfolio of services. This is a great social advance of which we should feel proud, since it allows most Spanish citizens to have access to an implant if they need it.
Logically, performing a Cochlear Implant privately is something that few can afford, but we can offer an alternative to those patients who want a contralateral implant (binaural) and suffer delays in the decision of implantation or assess bimodal stimulation. Private insurers cover hospitalization, surgery and anesthesia, but not the value of the implant, so even so, we understand that the cost is high. People belonging to some groups (MUFACE, ISFAS, MUJEJU) have the possibility to choose, if they wish, their medical coverage through some private insurers.
Our assistance to these groups makes it possible to maintain our flow of patients who are candidates for implants, not only cochlear implants, but also osseointegrated or bone conduction implants and middle ear implants. We have a Cochlear Implants protocol carried out in collaboration with Rv Alfa, an audiology and speech therapy center with wide and qualified experience, which allows us to expand our offer of pre and post-implantation evaluation, as well as specific post-activation speech therapy. This allows us to offer our patients the greatest possible benefit from their implant, since it is clear that the implant alone makes us hear, but the subsequent targeted stimulation increases its potential. All this in direct relation with the brands that supply the implants with which there is a fluid communication of the tests and controls they perform.
The Hearing Implant Unit is multidisciplinary and is formed by otorhinolaryngologists, audiologists and audiologists specialized in implants, psychologists and speech therapists, who carry out the previous evaluation of the candidate, to determine the suitability of the implantation, assessing the previous hearing situation of the patient, as well as subsequently monitoring its evolution.
We place great value on confirming that the hearing aids are adjusted, allowing the best hearing performance, even if the need for the implant is confirmed, and that the contralateral prosthesis is correctly adjusted to allow optimal bimodal stimulation.
The other fundamental pillar is rehabilitation, also in collaboration with Rv Alfa, with speech therapists specially trained in cochlear implants, either for adult patients, as part of personalized auditory training, or for children through auditory-verbal therapy.
For patients who do not belong to our autonomous community, and who are referred for implantation in many cases, we perform the evaluations in the shortest possible time, concentrating all the necessary audiological tests in one or two days, and thus advise and inform the whole process of evaluation, surgery, cures, activation, controls, speech therapy and even recommend professionals in their community that they may need.
Our relationship with the Hospitals of the HM Hospitals Group and with the University San Pablo CEU, has made necessary the expansion of our professional team, so that in addition to Otolaryngology, other head and neck pathologies are addressed, both in treatment and surgery.
Therefore, since January 2016 we have renewed our name to Instituto de ORL y Cirugía de Cabeza y Cuello de Madrid (IOM), where we maintain the values of tradition, innovation and personalized treatment that has always characterized us and where we are waiting for you.
Dr. A. Harguindey Antolí-Candela (IOM), Rosa Junguitu Rebollo (RV Alfa)