Artikel
Cochlear implantation for the deaf, improvement of quality of life by skull base surgery and rehabilitation
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Autoren
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J. Helms
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J. Müller
- Dept. of Otorhinolaryngology, University of Würzburg, Würzburg, Germany
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W. Shehata-Dieler
- Dept. of Otorhinolaryngology, University of Würzburg, Würzburg, Germany
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S. Brill
- Dept. of Otorhinolaryngology, University of Würzburg, Würzburg, Germany
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S. Schön
- Dept. of Otorhinolaryngology, University of Würzburg, Würzburg, Germany
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B. May-Mederake
- Dept. of Otorhinolaryngology, University of Würzburg, Würzburg, Germany
| Veröffentlicht: | 27. Januar 2009 |
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Gliederung
Text
Completely deaf children, prelingually or postlingually, as well as completely deaf adults should be rehabilitated by cochlear implantation. Serious degrees of hearing impairment give also frequently an indication. Very complex speech processing strategies provide constant and repeated information transfer to remaining neural structures inside the cochlea. An optimal result is obtained when the whole length of the cochlea is filled with an electrode. The apex region of the cochlea contributes considerably to speech understanding. The tip of the active electrode should therefore reach the apex of the cochlea.
Unilateral cochlear implantation brings most completely deaf patients back to the world of noises, sounds and to a varying degree of speech understanding, but not to an unilateral normal hearing. How could we improve this situation? It is obvious that with modern speech coding procedures this is possible with bilateral cochlear implantation.
A conclusion of the Wullstein Symposium in Würzburg 2001 was that children with bilateral cochlear implantation, both electrodes into the apex of the cochlea and with an excitation rate of 1500 Hz per contact and second, benefit when they are rehabilitated in a qualified, specialised institution. The children concentrate longer, are more interested in listening to somebody reading, show better reactions to unexpected sounds, attempt to speak more frequently, produce reactions to noises and warning signals, are able to pursue a moving sound source and integrate easier into groups of normals. It is obvious that the necessary energy that they have to provide in order to learn hearing is much less and with the same energy they accept their new hearing abilities much more easily.
Out of 118 bilaterally implanted patients until December 2004 were 94 children and out of this group 51 under the age of 4 years, when they received their second implant. Since 1999 the group of small children has considerably enlarged: age less then 2 years 81 children and in this group less then 1 year 21 children.
From our specialists in the rehabilitation centre (CIC Süd) we learned that early implanted children seem to have a better perspective for the future.
