In India, three out of 1000 people have moderate, severe or profound bilateral hearing loss. This handicap is often treated as a low profile disability (as it cannot be seen), which leads to very low awareness about this sombre issue in the society. Former international cricket icon and Cochlear’s Global Hearing Ambassador, Brett Lee and ENT specialist, Dr Shankar B Medikeri, speak to M Neelam Kachhap, about the social responsibility towards people with hearing disabilities and the solutions to tackle this issue
Dr Medikeri what is the incidence of hearing impairment in children in India today?
Shankar B Medikeri (SBM): In India for every 1000 children born, four to five will have profound degree of hearing loss. I’m talking about sensorineural hearing loss and these children may not be benefited by a hearing aid. They require implanted devices. Actually over five per cent of the world’s population – 360 million people – have disabling hearing loss out of which 328 million are adults and 32 million are children.
What are the causes of disabling hearing loss in children?
SBM: There are many causes of hearing loss among children, which mainly are congenental or birth defects or post birth. Congenital hearing loss is present at birth and is the most common problem seen in newborn babies. It can be either inherited or caused by abnormal development in the foetal stages of life. These can be because of birth injuries, anoxia during birth, severe infections, severe jaundice. Other causes could be trauma, presbycusis (age-related hearing loss), noise exposure from machinery or firearms, Meniere’s disease and meningitis. Then there are ototoxic drugs which may be necessary to treat some life-threatening medical conditions but can also trigger hearing loss. Other than these a tumour on the hearing nerve can cause the rarer neural hearing loss.
Tell us about the genetics of hearing loss.
SBM: Hereditary hearing loss can be inherited in an autosomal dominant, autosomal recessive, or X-linked recessive manner, as well as by mitochondrial inheritance. In India, consanguineous marriages are the main cause of hereditary hearing loss. Mutation in GJB2 and GJB6 are used for molecular genetic testing.
At what age do parents seek help for hearing implant? Who has been your youngest patients so far?
SBM: I have been practising in this field for the past 13 years and my youngest implanted patient was nine months old at the time of implant. Parents seek help in first year of life onwards. We need to have more new born screening as its not one of the mandatory screening at birth. Infant hearing screening programmes can improve the linguistic and educational outcomes for the child. Early detection and intervention are crucial to minimise the impact of hearing loss on a child’s development and educational achievements.
What are the benefits and risks of cochlear implants?
SBM: Cochlear implant is an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants bypass the damaged hair cells of the inner ear (cochlea) to provide sound signals to the brain.
Earlier, we used to do Cochleostomy with round window enlargement techniques for cochlear implant which resulted in some amount of trauma. Now, the latest technique uses thin soft electrodes and minimised initial intracochlear trauma and preserve residual hearing.
Why have you associated with Cochlear?
Brett Lee (BL): I’m very proud to be associated with Cochlear as their first Global Hearing Ambassador. I have seen some of the recipients ‘switched on’ for the first time, when they suddenly hear sound! I saw their sheer joy at being able to hear life. It really affected me. This is something I have always wanted to do giving back to society. And it feels incredible.
What has been your experience in the past year working with Cochlear?
BL: It has been incredible to see the work Cochlear does around the world. As Cochlear Ambassador, I lead ‘Sounds of Cricket’ campaign to raise awareness of the significant medical, social and economic impacts hearing loss can have on individuals and their families. It is very important to promote social inclusion of people with disabilities. I feel like I’m part of a big family and raising awareness is fun. I learn new things everyday. Cochlear not only restore hearing but it brings back confidence.
Do you have a personal connection with the cause of hearing loss awareness?
BL: I understand the agony and anxiety a parent has when the kid has hearing loss. My son had a fall and had diminished hearing for a year but lucky his hearing came back to normal range. It is coincidental that I got involved with Cochlear.
What does your work with Cochlear entail?
BL: My work entails primary advocacy to raise awareness about hearing loss and cochlear implants and promoting social inclusion of people with disabilities. Also, for economically weaker people affected with hearing loss, I hope the government will come with initiatives for affordable hearing aids, cochlear implants and services.
People with hearing implants face social prejudice. Do you think implants could one day be as common and affordable as reading glasses?
BL: Yes, I see that people with hearing implants face a lot of social prejudice and stigma in all walks of life. I believe education and awareness will change this in future. It will become as easy going as spectacle. Earlier people used to frown upon spectacles, now it is a fashion accessory. Cochlear has worked on a sleeker design and different colour implants for people to choose from. Cochlear is working on a new technology to create totally invisible implant.
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