Cochlear implant: indications, contraindications and complications

Abstract

Cochlear implant (CI) is a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf. CI represents the current treatment for patients affected by profound sensorineural hearing loss (SNHL). At first times, only deaf adults were considered to be candidates for a CI; however, with the development of technology and gained experience by pshycians, indications for cochlear implantation have been expanded. Today, CIs are implanted also in children and broader indications are followed. There are, however, a number of patients who are potential candidates for CI but do not completely fulfill the current indications. Residual hearing and duration of deafness represent prognostic indicators for CI performance; however, prelingually deafened adults and children with residual hearing are still point at issue. Anatomical variations such as cochlear malformation, ossification and chronic otitis media still represent a contraindication to CI for some surgeons. Although the technology for cochlear implant surgery is advancing everyday, there may be several complications related to the device or operation and some of them can be healed only with medical therapy but some are serious enough to process to reimplantation. In this article the indications and contraindications for cochlear implant candidates and complications that may occur during or after the operation were reviewed under the light of the literature.

Radiologische Diagnostik bei Schwerhörigkeit im Kindesalter

“…Bei einem schweren Neugeborenenikterus kann das Bilirubin die Blut-Hirn-Schranke passieren, den ventralen Cochlea-Kern schädigen und zu einer Schallempfindungsschwerhörigkeit führen [9].…”

“…Die Infektion breitet sich meist über den Subarachnoidalraum, den Cochlea-Aquädukt oder den inneren Gehörgang in Richtung Innenohr aus. Zu den häufigsten Erregern zählen Haemophilus influenzae, Streptococcus pneumoniae und Neisseria meningitidis [9].…”

Biocompatible Electrical and Optical Interfaces for Implantable Sensors and Devices

“…In terms of medical assessment, there are numerous methods using electrodes and probes to detect and analyze physiological signals, including electrocorticography (ECoG) [ 7 , 8 ], micro-electrocorticography (μECoG) [ 9 , 10 ], electroencephalography (EEG) [ 11 , 12 ], electromyography (EMG) [ 13 , 14 ], and others [ 15 , 16 , 17 , 18 , 19 ], which provides an important means to gain a deeper understanding of brain and muscle activity. Similarly, to treat diverse functional diseases, a great many implantable systems have been approved, such as cardiac pacemakers for cardiac dysfunction and cochlear implants for hearing impairment, significantly improving the quality of life of patients and bringing new possibilities to the medical field [ 20 , 21 , 22 ].…”

Utilidad de mediciones objetivas para la programación en implantes cocleares

“…El implante coclear representa la primera tecnología capaz de sustituir la función del órgano sensorial de la audición. Tiene, por el momento, como indicación principal la hipoacusia neurosensorial severa a profunda bilateral 1 . A contar de este año, el implante coclear será parte de la ley Ricarte Soto, la cual provee un implante coclear unilateral para los pacientes con hipoacusia neurosensorial severa a profunda (70 dB-90 dB) poslocutiva 2 .…”