The remaining obstacles for a totally implantable cochlear implant

Abstract

Purpose of the reviewFor years, the development of a totally implantable cochlear implant (TICI) has faced several technical challenges hindering any prototypes from reaching full commercialization. This article aims to review the necessary specifications for a viable TICI. An overview of the remaining challenges when designing TICIs will be provided, focusing on energy supply and implantable microphones. Recent findingsThe literature review highlights how research efforts to generate sufficient power to supply a fully implantable CI could take advantage of microelectromechanical systems (MEMS)-based energy harvesters incorporating piezoelectric materials. Using one of the various energy sources in the vicinity of the temporal bone would allow the development of a self-sufficient implant, overcoming the limitations of electrochemical batteries. Middle ear implantable microphones could also use similar fabrication techniques and transduction mechanisms to meet the sensor requirements for a TICI.

A New Floating Piezoelectric Microphone for Fully Implantable Cochlear Implants in Middle Ear

“…In addition, the patient's own middle-ear reflexes are used to reinforce isolation from internal body noises. 24 By comparing the volunteer data with the team's previous experiment on fresh temporal bone specimens, we assumed that physiological noise had not affected the ability of the NFPM to pick up the target frequencies. 13 However, due to the lack of subjective feedback from patients, we cannot exclude the possibility that physiological noise might be hidden in background noise.…”

“…In the case of physiologically intact external and middle ears, the sensor can utilize the acoustic benefits that are conferred by the pinna and EAC. In addition, the patient's own middle‐ear reflexes are used to reinforce isolation from internal body noises 24 . By comparing the volunteer data with the team's previous experiment on fresh temporal bone specimens, we assumed that physiological noise had not affected the ability of the NFPM to pick up the target frequencies 13 .…”

A Journey to Hear: The Evolution of Cochlear Implants

“…This innovation offers a discreet and aesthetically pleasing option for those prioritizing both functionality and subtlety in hearing restoration. However, considerations include surgical risks, substantial costs, suitability limitations, variable adaptation periods, potential sound quality constraints, device malfunctions, battery replacements, and the irreversibility of the procedure [47]. Prospective users should consult professionals for a comprehensive understanding of benefits and drawbacks before deciding.…”

The (in)visibility of deafness: Identity, stigma, quality of life and the potential role of totally implantable cochlear implants

“…TICIs are anticipated to provide cosmetic benefits, reduce stigma, improve convenience, and accommodate headwear use. 23 , 24 …”

“…TICIs are anticipated to provide cosmetic benefits, reduce stigma, improve convenience, and accommodate headwear use. 23,24 However, research into the aesthetic and cosmetic concerns around CIs and its association with identity, stigma, and quality of life is extremely limited. An additional consideration is the widespread underutilisation of CIs 25,26 and the extent that physical and cosmetic characteristics are a barrier to improving hearing health.…”