Update Cochlea-Implantation: Indikationsstellung und Operation

Abstract

In childhood, inadequately rehabilitated hearing loss leads to impaired language acquisition and social, mental and emotional development. In adults, social withdrawal due to limited communication skills is often a consequence of unsatisfactory hearing rehabilitation. Therefore, in patients with profound hearing loss, the indication for cochlear implantation should be considered. Technical advances in cochlear implant development, as well as in microsurgical techniques and the rehabilitation process, have led to an expansion of indications in recent years. Adequate hearing rehabilitation is associated not only with an improvement in hearing function and speech understanding, but also with an increase in quality of life at all ages. In patients with unilateral profound hearing loss, cochlear implantation leads to an improvement of speech understanding and localization ability as well as to a reduction of the head shadow effect and tinnitus. The indication process, surgical treatment and the subsequent rehabilitation process require interprofessional cooperation in specialized centers.

Validierung eines Modells zur Vorhersage des Sprachverstehens nach Cochleaimplantation

“…1 bestimmte Vorhersagewert wird derzeit am Universitätsklinikum Erlangen als Parameter für die Qualitätssicherung und für die individuelle präoperative Beratung der CI-Kandidaten verwendet. Insbesondere bei Fällen mit noch substanziellem Restgehör ist eine individuelle Prognose wünschenswert [ 19 , 24 , 28 ]. Ziel dieser Studie ist es, das in einer früheren, retrospektiven Studie entwickelte Modell [ 14 ] im Rahmen einer prospektiven Studie zu validieren.…”

Evaluative audiometry after cochlear implant provision

“…Thus, the realistic prediction of the foreseeable speech intelligibility plays an important role in preoperative counseling of these patients. With considerable residual hearing—i.e., in Germany up to 60% monaural monosyllabic word recognition score (WRS) at 65 dB SPL with the best-fitting hearing aid, WRS 65 (HA)—reliable predictions based on preoperative findings are becoming increasingly important for the indication, counseling, and quality control [ 20 , 28 ].…”

“…[ 18 ] also pointed out the large variability in the data. However, despite this variability, clinically relevant statements applicable to individual cases can be derived [ 18 , 20 ]. For example, three quarters of the CI patients that were studied achieved or exceeded the prediction within a window of −12 percentage points (pp; [ 18 ]).…”

Research Status and Future Development of Cochlear Reimplantation

“…Since the 1970s, continuous advancements have been improved the speech-coding strategies, electrodes, and materials used for developing CIs ( Büchner and Gärtner, 2017 ; Carlyon and Goehring, 2021 ). The indications for CIs have also expanded gradually, and the number of patients with CIs has been increasing ( Lailach et al, 2021 ).…”