15. Cochlear implantation

• Cochlear implants are prosthetic devices surgically implanted into the temporal bone
• They stimulate the auditory nerve directly via intracochlear electrodes
• A microphone and speech processor behind the hear picks up and processes the sound
• The sound is then sent wirelessly through the skin to the cochlear implant
• Prerequisite: Functional auditory nerve and central auditory pathway
  • Promontory test – direct stimulation of promontory reveals whether the auditory nerve and central auditory pathway work
• Indications
  • Moderate – severe SNHL
  • Lack of benefit from hearing aids
• Follow-up
  • Technical check of implant function and speech processor
  • Adjusting the speech processor
  • Auditory training – the patient must learn to interpret the electrical impulses as speech
  • Sign language and lip reading should also be taught