Stöver T, Lenarz T
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover.
Laryngorhinootologie. 2009 May;88 Suppl 1:S12-31. doi: 10.1055/s-0028-1119552. Epub 2009 Apr 7.
Cochlear implants (CI) represent the "gold standard" for the treatment of congenitally deaf children and postlingually deafened adults. Thus, cochlear implantation is a success story of new bionic prosthesis development. Owing to routine application of cochlear implants in adults but also in very young children (below the age of one), high demands are placed on the implants. This is especially true for biocompatibility aspects of surface materials of implant parts which are in contact with the human body. In addition, there are various mechanical requirements which certain components of the implants must fulfil, such as flexibility of the electrode array and mechanical resistance of the implant housing. Due to the close contact of the implant to the middle ear mucosa and because the electrode array is positioned in the perilymphatic space via cochleostomy, there is a potential risk of bacterial transferral along the electrode array into the cochlea. Various requirements that have to be fulfilled by cochlear implants, such as biocompatibility, electrode micromechanics, and although a very high level of technical standards has been carried out there is still demand for the improvement of implants as well as of the materials used for manufacturing, ultimately leading to increased implant performance. General considerations of material aspects related to cochlear implants as well as potential future perspectives of implant development will be discussed.
人工耳蜗(CI)是治疗先天性耳聋儿童和语后聋成年人的“金标准”。因此,人工耳蜗植入是新型仿生假体开发的成功案例。由于人工耳蜗不仅在成年人中,而且在非常年幼的儿童(一岁以下)中得到常规应用,对植入物提出了很高的要求。对于与人体接触的植入部件表面材料的生物相容性方面尤其如此。此外,植入物的某些组件必须满足各种机械要求,例如电极阵列的柔韧性和植入物外壳的机械阻力。由于植入物与中耳黏膜密切接触,并且电极阵列通过耳蜗造口术定位在鼓阶内,存在细菌沿电极阵列转移到耳蜗的潜在风险。人工耳蜗必须满足各种要求,如生物相容性、电极微力学,尽管已经达到了非常高的技术标准,但仍需要改进植入物及其制造所用材料,最终提高植入物性能。将讨论与人工耳蜗相关的材料方面的一般考虑以及植入物开发的潜在未来前景。