Cochlear implant [Neurosurgery Wiki]

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====== Cochlear implant ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1BodOBQI_42ONLiTGYRaPuKNmLDyRGy4mtEjEpW6eF4OzaDc8n/?limit=15&utm_campaign=pubmed-2&fc=20241129043936}}

A cochlear [[implant]] is an electronic medical [[device]] developed for people with severe to profound perceptive [[hearing loss]] who have limited benefits from appropriately fitted hearing aids.
Hearing aids capture sound, amplify it and send it through the normal auditory channel. They are designed
for people with slight to moderately severe perceptive hearing loss.
In cases of severe to profound hearing loss, hearing aids are not powerful enough. If the ear damage is too
severe, amplifying sound using a traditional hearing aid will have no effect. The cochlear implant overcomes this by sending the signal directly to the [[auditory nerve]]. Unlike traditional hearing aids, cochlear implants bypass the damaged areas of the [[ear]]. They capture the sound, process it and electrically stimulate the auditory nerve.

===== Parts =====
The cochlear implant system consists of two parts:

• The internal part (A) is a receiver surgically implanted in the temporal bone underneath the skin, and
an electrode array placed in the cochlea.

• The external part (B) is a behind-the-ear sound processor and a lead connecting the processor to the
antenna. The antenna is magnetically attached to the skin over the internal part.
----


[[Auditory brainstem implant]]s have failed to produce consistent clinical results comparable to those with the [[cochlear implant]], both with surface and penetrating electrodes.
----
A 38-year-old male who presented with progressive [[hearing loss]], resulting in profound bilateral hearing loss. He had a past history of childhood [[medulloblastoma]], which was treated with [[posterior fossa]] [[craniotomy]] and [[radiotherapy]]. A [[ventriculoperitoneal shunt]] was put in place to manage the [[hydrocephalus]]. [[Cochlear implant]]ation (CI) was carried out on his right [[ear]] by a standard procedure. At CI activation, the electric [[impedance]] of the [[electrode]] was very high, and [[computed tomography]] revealed that there was no area of liquid density, suggesting depletion of the [[perilymph]] in the [[cochlea]] and [[vestibule]]. Eight months later, the impedance improved gradually, and the cochlea was filled with [[perilymph]]. Consequently, one of the causes of the [[pneumolabyrinth]] in the present case was that a scarred stenotic cochlear canaliculus secondary to surgery or [[radiation therapy]] might have prevented the [[CSF]] from filling the scala. In addition, it is also possible that the VP shunt might have altered the CSF pressure, leading to depletion of the [[perilymph]]
((Moteki H, Fujinaga Y, Goto T, Usami SI. Pneumolabyrinth, intracochlear and
vestibular fluid loss after cochlear implantation. Auris Nasus Larynx. 2018
Oct;45(5):1116-1120. doi: 10.1016/j.anl.2018.03.004. Epub 2018 Apr 19. PubMed
PMID: 29680680.
)).

===== Books =====

Cochlear Implants-Basic Textbook
((Arriaga M. Book Review: Cochlear Implants-Basic Textbook, Sandro Burdo, Arestampa Srl, Varese Italy, 2023. Otol Neurotol. 2024 Dec 1;45(10):1097. doi: 10.1097/MAO.0000000000004348. PMID: 39607993.))