REVIEWS  HOT TOPICS IN OTOLARYNGOLOGY 

Otorinolaringologia 2010 June;60(2):101-14

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Cochlear implants: an update

Cosetti M. K., Lalwani A. K.

Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA

Since the introduction of cochlear implantation (CI) more than 25 years ago, tremendous advances have been made in areas of candidacy, internal and external hardware, software and speech processing strategies. Initially narrow candidacy criteria has broadened to include a myriad of patients affected by sensorineural hearing loss (SNHL), including those at the extremes of age such as infants under 12 month of age and elderly individuals older than 79 years, patients with auditory neuropathy/auditory dysynchrony (AN/AD) and individuals with residual low-frequency hearing. Outcomes data in speech perception and, where appropriate, speech and language development, suggest significant benefit from increased access to sound in these newly expanding candidate groups. Advances in electrode design, atraumatic cochleostomy techniques, unified external hardware combining CI and traditional hearing aid (HA) technology and novel speech processing strategies have paralleled advances in low-frequency hearing preservation and ongoing research in electroacoustic stimulation. Beyond speech understanding in quiet, data on post-implantation word understanding in noisy environments and music appreciation suggests improved auditory perception in these challenging listening environments may be an attainable future goal. The following review will highlight and discuss recent updates in areas of CI candidacy, speech perception and speech and language outcomes, electroacoustic stimulation, and manufacturer specific updates in hardware and software technology.