This review evaluates the potential of optogenetic methods for the stimulation of the auditory nerve and assesses the feasability of optogenetic cochlear implants (CIs). It provides an overview of all critical steps like opsin targeting strategies, how opsins work, how their function can be modeled and included in neuronal models and the properties of light sources available for optical stimulation. From these foundations, quantitative estimates for the number of independent stimulation channels and the temporal precision of optogenetic stimulation of the auditory nerve are derived and compared with state-of-the-art electrical CIs. We conclude that optogenetic CIs have the potential to increase the number of independent stimulation channels by up to one order of magnitude to about 100, but only if light sources are able to deliver confined illumination patterns independently and parallelly. Already now, opsin variants like ChETA and Chronos enable driving of the auditory nerve up to rates of 200 spikes/s, close to the physiological value of their maximum sustained firing rate. Apart from requiring 10 times more energy than electrical stimulation, optical CIs still face major hurdles concerning the safety of gene transfection and optrode array implantation, for example, before becoming an option to replace electrical CIs.
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