Cochlear Implantation: An Overview

Abstract

A cochlear implant (CI) is a surgically implanted device for the treatment of severe to profound sensorineural hearing loss in children and adults. It works by transducing acoustic energy into an electrical signal, which is used to stimulate surviving spiral ganglion cells of the auditory nerve. The past 2 decades have witnessed an exponential rise in the number of CI surgeries performed. Continual developments in programming strategies, device design, and minimally traumatic surgical technique have demonstrated the safety and efficacy of CI surgery. As a result, candidacy guidelines have expanded to include both pre and postlingually deaf children as young as 1 year of age, and those with greater degrees of residual hearing. A growing proportion of patients are undergoing CI for off-label or nontraditional indications including single-sided deafness, retrocochlear hearing loss, asymmetrical sensorineural hearing loss (SNHL) in adults and children with at least 1 ear that is better than performance cut-off for age, and children less than 12 months of age. Herein, we review CI design, clinical evaluation, indications, operative technique, and outcomes. We also discuss the expanding indications for CI surgery as it relates to lateral skull base pathology, comparing CI to auditory brainstem implants, and address the concerns with obtaining magnetic resonance imaging (MRI) in CI recipients.

Welche Qualität macht den Unterschied in der Cochlea-Implantat-Versorgung?

“…Of course, this must also be possible outside the regular working hours. Even if there are currently no comparative studies, it appears logic and is described by different authors [1,91].…”

Pre- and post-operative imaging of cochlear implants: a pictorial review

“…The most commonly accepted imaging findings precluding cochlea implantation are [ 1 ]: Complete labyrinthine or isolated cochlear aplasia (Fig. 4 ) Cochlear sclerosis (Fig.…”

“…A cochlear implant (CI) is a surgically implanted device consisting of external and internal components [ 1 ]. An external microphone and speech processor are worn behind the ear and convert sound into an electric signal.…”

“…Over the past few decades, CI surgery has increased and revolutionized the treatment of severe to profound sensorineural hearing loss (SNHL) in both children and adults. In brief, current indications are (a) children (12–24 months) with profound SNHL (> 90 dB) and limited benefit from binaural amplification trial based on the meaningful auditory integration scale; (b) children (2–17 years) with severe to profound SNHL (> 70 dB) with limited benefit from binaural amplification defined by ≤ 20–20% word recognition scores; and (c) adults with moderate to profound SNHL in both ears (> 40 dB) with limited benefit from binaural amplification defined by ≤ 50% sentence recognition in the ear to be implanted (or ≤ 40% by centers for medicare and medicaid services criteria) and ≤ 60% in the contralateral ear or binaurally [ 1 , 2 ]. More recently, indications have been expanded to patients with single-sided deafness and ipsilateral vestibular schwannoma [ 2 ].…”

The Forgotten Second Window: A Pictorial Review of Round Window Pathologies

“…Cochlear implants may be inserted through a cochleostomy adjacent to the round window or directly through the round window membrane. 63,64 Most surgeons surveyed in 2007 preferred the former approach, though these decisions may be based on historical presumptions; early multichannel leads were thought to traumatize the cochlea if placed through the round window. 65,66 A more recent survey found that today most surgeons prefer round window membrane electrode insertions, given the natural and less traumatic access provided to the scala tympani-the preferred location of electrode placement.…”