Cochlear implant - quo vadis = Polžkov vsadek - quo vadis
Lehnhardt, Ernst ; Lehnhardt, Monika
Technological progress is advancing faster and faster. Two decades ago physiologists stated that C.I. would never compensate for the deficiency in the inner ear and provide access to hearing for deaf ...people. Clinical results have proven their theories wrong and benefits outweigh the risks by far. Indications have broadened significantly: we recommend providing children witha C.I. as early as possible and we consider severely hearing impaired as very suitable candidates. What has raised our level of confidence? Smaller andvery flexible implant designs, a variety of speech coding strategies that suit the individual's needs, telemetry that confirms proper functioning of thedevice, Neural Response Telemetry that indicates what gets processed through the auditory pathway. Most convincing for me are the results I have seen when children are implanted under the age of 5, preferably even under 2. They acquire open set speech understanding and speech production that is comparable to normal hearing children. They can be mainstreamed and later become fully integrated members of the hearing society. The Cochlear Implant technology is currently exploited in other areas of sensory nerve deficiency, like pain relief, urinary incontinence, bowel control, functional electrical stimulation, sleep apnea, epilepsy, Parkinson's disease. These are amazing andhighly promising perspectives that will have a major positive impact on patients with serious problems. What will be the future of cochlear implants then? Anatomical considerations - especially in view of the lowering age at implantation - will become even more important. In depth histological studies will be needed before we will accept new electrode designs, getting very closeto the modiolus. Smaller, thinner and very flexible implants are desirable. Cosmetic considerations seem to lead to the totally implantable C.I. (Abstract truncated at 2000 characters).
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