Praetorius M, Staecker H, Plinkert P K
Sektion Otologie und Neurootologie, Hals-Nasen-Ohren-Klinik, Universitätsklinikum Heidelberg, Heidelberg, Germany.
HNO. 2009 Jul;57(7):663-70. doi: 10.1007/s00106-009-1948-6.
The cochlear implant (CI) has become a standard option for treating prelingually deaf children. But postlingual late deafness in adults is becoming increasingly common. In addition, hybrid implantation with a CI and a hearing aid in the same ear has come into focus, which demands a soft insertion technique that spares the apical parts of the cochlea. Also, the chorda tympani should be saved, especially in bilateral implantations, which are gaining importance because improved speech discrimination in noisy conditions is seen as proven today. Control of the electrode position intraoperatively with intraoperative computed tomography can further increase the safety and reliability of the position. The position and length of the skin incision is a more aesthetic issue. Future developments will include fully implantable CIs and navigation-assisted, minimally invasive drilling of a hole from the surface of the skull into the cochlea. Bioactive, neurotrophic-drug-releasing electrode designs for improved and sustainable connectivity to the neurons may become applicable.
人工耳蜗（CI）已成为治疗语前聋儿童的标准选择。但成人语后迟发性耳聋正变得越来越普遍。此外，同侧人工耳蜗与助听器的混合植入已成为关注焦点，这需要一种能保留耳蜗顶部的轻柔插入技术。而且，应保留鼓索，尤其是在双侧植入时，由于如今已证实双侧植入在嘈杂环境中能改善言语辨别能力，所以其重要性日益凸显。术中通过术中计算机断层扫描控制电极位置可进一步提高位置的安全性和可靠性。皮肤切口的位置和长度更多是美学问题。未来的发展将包括完全可植入的人工耳蜗以及导航辅助的、从颅骨表面向耳蜗进行微创钻孔。用于改善并可持续连接神经元的生物活性、释放神经营养药物的电极设计可能会得到应用。
