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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Eisen M. D. 1, Lustig L. R. 2
1 Department of Otorhinolaryngology University of Pennsylvania Medical Center Philadelphia, Pennsylvania, USA
2 Department of Otolaryngology Johns Hopkins University Medical Center Baltimore, Maryland, USA
Current topics and issues regarding the cochlear implant are addressed in this review. The history of the implant’s early development is first summarized. The basics of implant technology, including recent technological advances in the electrode array and speech processors are next discussed. The criteria for implant candidacy and workup of potential implant recipients is then reviewed, including radiologic evaluation. Patients with certain otological and neurotological co-morbidities, including Ménière’s disease and otosclerosis, challenge the implant surgeon, but do not preclude implantation. The surgery for cochlear implantation remains primarily a transmastoid facial recess approach for insertion through a cochleostomy into scala tympani. In patients with cochlear malformations or postmeningitis cochlear ossification, adjustments in the implant surgery may be warranted. Complications of implantation remain rare. Assessing implant performance has classically relied on behavioral testing methods, but objective measurements have been developed to evaluate implant function, especially in the youngest implant patients. These primarily involve electrophysiological measurements of the electrically-evoked cochlear nerve response, but also include functional imaging of central nervous system. Recent work has begun to correlate these objective measurements with behavioral testing. Outcome studies of cochlear implant patient performance with tests of speech perception, language acquisition, and speech production indicate that postlingual adults with a short period of deafness and the youngest prelingually deaf patients have the best results with their implants. Furthermore, several studies indicate that implantation is both cost-effective to society and improves the quality of life of deaf patients.