SCIENCE UPDATE

New scientific studies summarized for you

Current developments in cochlear implantation

(Original title: Aktuelle Trends und Entwicklungen bei der Cochlea-Implantat-Versorgung. Müller J et al. Sprache · Stimme · Gehör 2024; 48: 22–31)

Take home message

Indications for cochlear implantations have continuously expanded to include patients with substantial residual hearing or single-sided deafness alongside the established bilateral and bimodal indications for CI.

There is a strong trend towards individualization in all phases of the implant process, from preoperative planning and electrode selection to anatomy-based fitting. The ultimate goals are always the same: maximum hearing performance with the CI and preservation of residual hearing.

Background:

Cochlear implants are regarded as the gold standard hearing care for people with severe to profound sensorineural hearing loss. The hearing results achieved with cochlear implants have outperformed conventional hearing aids, leading to CI indications continuously expanding and a growing number of patients benefitting from this.

Results:

Developments towards long-term hearing preservation and improved hearing performance which are increasingly being used in clinical practice, include:

• Preoperative diagnostics:
  • Enhanced preoperative imaging (CT, MRI) and specialized software for the precise measurement of the cochlea
  • Individual selection of CI electrodes based on preoperative diagnostics

• Intraoperative:
  • Gentle surgical techniques for all CI patients
  • Slow, robot-assisted electrode insertion
  • Robot-assisted surgery

• Postoperative:
  • Individual, anatomy-based CI fitting for more precise tonotopic frequency-place mapping
  • Remote care and rehabilitation

• Future developments currently being researched:
  • Intraoperative cochlear monitoring during electrode insertion to monitor residual hearing
  • Drug-delivering electrode arrays for long-term preservation of residual hearing

• Totally implantable cochlear implant (TICI): current feasibility studies are showing promising results

Read the abstract here: Thieme E-Journals – Sprache · Stimme · Gehör / Abstract