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Implantes cocleares. ¿Quién puede usarlos? ¿Cómo es la cirugía? ¿Cuánto se tarda en oír correctamente

En España unos 18.000 pacientes llevan implantes cocleares, una de las soluciones más eficaces para permitir oír a personas con sordera. Se trata de una cifra muy baja, pues a pesar de que su efectividad y de que es un tratamiento cubierta por la sanidad pública en la mayoría de los casos, solo un 5% de las personas que podrían beneficiarse de ellos recurre a este tratamiento, según GAES.

Estas bajas cifras se deben en parte al desconocimiento que existe sobre esta técnica, a pesar de estar presente en España desde hace 36 años. Para dar a conocer mejor esta solución auditiva, responderemos algunas de las preguntas más frecuentes.

¿Qué es un implante coclear y cómo funciona?

Un implante coclear es un dispositivo electrónico indicado para restaurar la función del oído interno dañado. Se implanta quirúrgicamente dentro del hueso del oído y consta de dos partes, una externa o procesador, que recoge los sonidos, y una interna, que convierte las señales que el procesador le envía en impulsos eléctricos, estimula el nervio auditivo para que este envíe los impulsos al cerebro, donde se interpretan como sonido.

¿Para quién está indicado?

No todo el mundo que padece sordera o hipoacusia puede beneficiarse de un implante coclear. Los pacientes indicados para ello son aquellos que tienen hipoacusia neurosensorial de moderada a severa en ambos oídos y que no obtienen los resultados esperados con los audífonos o prótesis auditivas. Está indicado tanto para personas con hipoacusia congénita -que la padecen de nacimiento- como para aquellas personas que han perdido la audición, ya sea manera progresiva o repentina. Además de cumplir estos requisitos, los potenciales tendrán que someterse a una serie de tests y pruebas de reconocimiento para confirmar que son candidatos idóneos para recibir este tipo de implantes. En general, los mejores candidatos suelen ser las personas post-locutivas -que ya tenían lenguaje antes de padecer sordera- con una sordera de poco tiempo de evolución, y los niños implantados precozmente, debido a su mayor plasticidad neurosensorial.

¿Cómo se implanta?

El implante coclear se implanta mediante una operación quirúrgica, que suele durar entre dos y tres horas. Mediante esta operación, que requiere anestesia general, se colocan los electrodos en la cóclea o caracol. Para ello, se realiza una pequeña incisión detrás del oído para abrir el hueso y ubicar y fijar allí el estimulador receptor. El alta se recibe en uno o dos días y los puntos se retiran después de una semana. Cuando cicatrice, se colocará la parte externa del dispositivo.

¿Qué riesgos tiene la operación?

Los riesgos existen, como en cualquier cirugía, pero es una operación bastante segura. Pueden aparecer problemas en la cicatrización o efectos secundarios, como dolores de cabeza mareos, vértigos, meningitis, algún daño en el nervio… pero son bastante infrecuentes.

¿Cuándo se empiezan a ver los resultados?

Después de la operación, pasa alrededor de un mes antes que se conecten las partes externas del aparato y empezar a oír. Además, los efectos sobre la audición tampoco son inmediatos, sino que el paciente tiene que someterse a un proceso de rehabilitación para aprender a sacar al implante el máximo potencial. La rehabilitación suele durar entre seis meses y un año y en ella intervienen audiólogos, logopedas y otorrinos.

¿Qué mantenimiento tienen implantes cocleares?

Los implantes cocleares funcionan con baterías, que se deben cambiarse regularmente y cuya durabilidad depende del uso que se le dé. Además, hay que tener mucho cuidado tanto con la parte externa como la interna y evitar todo tipo de golpes que puedan dañar el aparato. Si el dispositivo interno se dañase, el paciente debería someterse a una cirugía de nuevo, por lo que es importante no llevar a cabo actividades de riesgo. Además, el paciente se somete a revisiones regulares, al principio cada tres meses, para asegurarse de que el aparato funciona correctamente.

¿Se puede llevar una vida normal o tiene algunas limitaciones?

El pronóstico después de ponerse un implante coclear y de realizar la rehabilitación correctamente es muy bueno y la mayoría de las personas que lo usan asegura que han ganado mucho en calidad de vida. Es un proceso que en algunos casos puede dudar años, por lo que, para conseguir unos resultados óptimos, hay que estar muy motivado y tener paciencia.

Al principio, la recepción del sonido se oye algo metalizado y con falta de discriminación de los sonidos y el habla, pero, según se acoplan los electrodos al oído y realizando ajustes, la discriminación mejorará.

En algunos casos, el implante puede interferir con ciertos teléfonos móviles y, al tratarse de implantes metálicos, a la mayoría de las personas con implantes cocleares no se les pueden hacer resonancias magnéticas.

Por lo demás, se puede llevar una vida prácticamente normal, e incluso, salvo los primeros meses, realizar actividades deportivas como la natación. Los deportes de impacto sí estarían contraindicados para evitar que el aparato se dañe.


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