Cochlear implant does not require craniotomy and the risk of operation is extremely low. Why is the operation simple and so expensive?

In the last two days, it was reported that someone had lost the cochlear implant and asked everyone to help him find it, and it was suggested that if he could not find it, he would need to have a craniotomy and implant it again. But in fact, cochlear implantation not only does not require a second transplant for craniotomy, but even the first operation, the risk is extremely low. If it is lost, you only need to re-purchase and configure the extracorporeal equipment. So what else do you need to know about cochlear implants? Please follow the four questions to learn about cochlear implants! How does cochlea affect hearing? Cochlea is a part of the inner ear. At the front of the inner ear, it is a structure that transmits and feels sound waves. Its essence is a spiral bone tube, which hovers around the cochlear axis for two and a half weeks and looks like a snail's shell. It is separated by bone spiral plate and basement membrane, and the upper part is vestibular step, which leads to vestibular window; The lower part is the tympanic step, which leads to the cochlear window, and lymph is filled between the two tubes. There are sound receptor cells on the basement membrane, which are connected with auditory nerve. The sound comes in from the external auditory canal, vibrates the tympanic membrane, and then travels to the vestibular window through the activity of the ossicles, causing the external lymph in the vestibular step to vibrate, and then causing the vestibular membrane and the internal lymph to vibrate. The hair cells on the basement membrane collide with the tectum, causing the hair cells to be excited, and the impulse goes up through the cochlear nerve, then through the inferior colliculus of the midbrain to the medial geniculate body, and finally to the temporal lobe of the cerebral cortex to form hearing. What's the difference between hearing aid and cochlear implant? Hearing aid is an instrument worn outside the body to help improve hearing. In fact, it is more like a small semiconductor loudspeaker. Its function can make the weak sound be amplified and transmitted to headphones, and the hearing aid can listen to the sound by using the residual hearing of the patient. It only plays a role in amplifying the sound. Therefore, the use of hearing AIDS has a premise that cannot be ignored, that is, the wearer must have a certain residual hearing, and the hearing loss cannot exceed 7 decibels. Once the loss exceeds 7 decibels, you need the help of cochlear implant. Cochlear implant is an acoustic-electrical conversion device that simulates the function of human cochlea. It is mainly composed of implants, audio processing unit, batteries, connecting wires, etc. The implants need to be implanted into patients through surgery, and other parts can also be collectively referred to as external devices. Its working principle is mainly as follows: the microphone collects the sound from the environment and converts the mechanical vibration signal of the sound into an electrical signal; Audio processing unit performs arithmetic processing on the audio electrical signal, and transmits the processed electrical signal to the implant through the skin through the magnetic induction coil; Finally, the processed electrical signal forms a stimulating electric field and is transmitted to the cochlea, thus stimulating the excitement of the auditory nerve endings, and transmitting the formed sound information to the brain, which is integrated and analyzed by the brain to produce hearing. Cochlear implantation does not require craniotomy and the surgical risk is extremely low. Cochlear implantation does not require craniotomy, and the surgical path generally adopts the recess approach. By making an incision behind the ear, cutting the skin and subcutaneous, and grinding a bone groove to accommodate the electrode lead to pass through after confirming the implantation site; After drilling the tympanic step, implant the cochlea, insert the electrode into the tympanic step through the small hole of the fossa window of the facial recess, and then carry out postoperative treatment. Cochlear implant is clinically considered as a minimally invasive operation, which is far from craniotomy. The incision was about 2cm and the operation time was about 1 hour. The safety is actually very high, and there is no need to worry about the risk of surgery. Children are not only risk-free in surgery, but also need it as early as possible. Rick Fang Hua, an otorhinolaryngology head and neck surgeon at Shanghai Children's Hospital, said that if it is a cochlear implant for children, the best age is 6 months to 1 year old. These children are prelingual deaf patients, and their speech system has not yet developed. Therefore, deafness may directly affect children's speech ability in the future, and cochlear implants are needed as soon as possible. Normal cochlear anatomical structure and intellectual development are the necessary conditions to ensure cochlear implantation. Families with post-lingual deafness should also choose to implant in time to ensure normal life. The operation is simple. Why is it so expensive? The cost of cochlear implant is about 7, to 8,, and the cost of imported cochlea is about 1, to 2, and 3,, and there are different prices according to different models and performances. The high price of cochlear implant is also inseparable from its cost, which is mainly divided into three reasons: cochlear implant production involves a large number of patents, and the production and manufacturing costs are high; Cochlear implants need to go through a lot of testing links and manufacturers are not directly supplied by hospitals, which will inevitably increase the sales cost; If you buy a cochlear implant from abroad, you need to pay a certain value-added tax. For example, the domestic market inquiry of Australia Collier N6+CI522 is about 268, yuan, while the latest price of Hong Kong N7+CI522 is only about 2, Hong Kong dollars, and the cochlear implant import will be charged 17% tariff. However, due to the high cost of surgery abroad, it is no different from the cost of implant surgery in China. Author | Yang Xinzhou Reviewer | Huang Sida The article of otolaryngologist in Xiangya Hospital of Central South University was published by Tencent Science's "Popular Science Headline Creation and Promotion Project in China". Please indicate that it is from "Popular Science China".