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Cochlear Implantation

It is estimated that nearly 50 million people worldwide suffer from severe hearing loss. The majority of that burden is due to sensorineural hearing loss (SNHL). Current therapies for SNHL include hearing aids for milder hearing loss and cochlear implants as hearing loss advances. While hearing aids function to amplify sound through the traditional auditory pathway, cochlear implants directly stimulate spiral ganglion neurons which can enhance hearing even in patients with advanced hearing loss. Cochlear implants are often considered to be the most successful implanted sensory device in the world having restored hearing to thousands of individuals.

Cochlear Implantation Procedure Prep

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Ep 197 Trailblazers in ENT: Stories from House Clinic with Dr. John House
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Pre-Op Evaluation

Pre-operative evaluation involves a detailed hearing assessment to identify the relative benefit of well-fit hearing aids compared to cochlear implants. Insurance coverage is usually provided for patients who have bilateral SNHL that is moderate-severe at low frequencies and profound at high frequencies even when using hearing aids. It is common for the ear with the worse hearing to be selected for implantation first, thereby allowing the patient to retain the hearing aid in the contralateral ear.

Cochlear Implantation Podcasts

Listen to leading physicians discuss cochlear implantation on the BackTable ENT Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Surgical Approach

The classic surgical approach is a facial recess/posterior tympanotomy approach which is used in both pediatric and adult patients. Such an approach allows for a relatively direct route to the round window membrane through which the cochlear implant electrode is inserted. Alternative approaches are often reserved for patients with unique anatomic considerations that necessitate deviation from the facial recess approach.

Cochlear Implantation Articles

Read our exclusive BackTable ENT Articles for quick insights on cochlear implantation, provided by physicians for physicians.

Post-Op Considerations

The cochlear implant itself is typically not activated until 2-4 weeks following the procedure. The decision to undergo implantation in a second ear is often dictated by patient response to the first implant. Cochlear implant surgery is relatively low-risk and is often performed as an outpatient surgical procedure. Complications can include infection, hematoma, surgical site pain, and facial nerve paralysis. Additionally, nearly half of patients who undergo CI lose their pre-operative residual hearing ability, known as acoustic hearing, and become reliant on electrical stimulation. However, new technologies are being developed to mitigate this loss.

Cochlear Implantation Demos

Watch video walkthroughs of cochlear implantation on the BackTable ENT expanded content network.

Cochlear Implantation Tools

Check out cochlear implantation apps, calculators, and decision aids to assist you in your day to day practice.

References

[1] Naples JG, Ruckenstein MJ. Cochlear Implant. Otolaryngol Clin North Am. 2020 Feb;53(1):87-102. doi: 10.1016/j.otc.2019.09.004. Epub 2019 Oct 31. PMID: 31677740.
[2] Carlson ML. Cochlear Implantation in Adults. N Engl J Med. 2020 Apr 16;382(16):1531-1542. doi: 10.1056/NEJMra1904407. PMID: 32294347.

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Trailblazers in ENT: Stories from House Clinic  with Dr. John House on the BackTable ENT Podcast)
Aural Rehabilitation After Pediatric Cochlear Implantation: Expert Insight from Audiology with Dr. Sarah Cordingley on the BackTable ENT Podcast)
Working Together: Language Development in Deaf & Hard of Hearing Children with Dr. Anita Jeyakumar on the BackTable ENT Podcast)
Manejo de Condiciones Neurotologicas con Dr. Juan Chiosone on the BackTable ENT Podcast)
Pediatric Cochlear Implant Program in Costa Rica with Dr. Adriana Vega on the BackTable ENT Podcast)
Identifying Parathyroid Glands: Challenges & Innovations  with Dr. Michael Singer on the BackTable ENT Podcast)

Articles

Aural Rehabilitation Goals for Children with Cochlear Implants

Aural Rehabilitation Goals for Children with Cochlear Implants

Navigating the Cochlear Implant Process: A Guide for Parents & Practitioners

Navigating the Cochlear Implant Process: A Guide for Parents & Practitioners

Pediatric Cochlear Implant Surgery

Pediatric Cochlear Implant Risks, Complications & Counseling

Contributors

Dr. Marlan Hansen on the BackTable ENT Podcast

Dr. Marlan Hansen

Dr. John House on the BackTable ENT Podcast

Dr. John House

Dr. Jacob Hunter on the BackTable ENT Podcast

Dr. Jacob Hunter

Dr. Anita Jeyakumar on the BackTable ENT Podcast

Dr. Anita Jeyakumar

Dr. Christopher Kaufmann on the BackTable ENT Podcast

Dr. Christopher Kaufmann

Dr. Prashant Malhotra on the BackTable ENT Podcast

Dr. Prashant Malhotra

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