15. Cochlear implantation

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  • 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