Tulane University School of Medicine, New Orleans, LA 70112, USA.
Department of Otorhinolaryngology and Biocommunications, Division of Neurotology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
Biomolecules. 2022 Apr 29;12(5):649. doi: 10.3390/biom12050649.
As biomolecular approaches for hearing restoration in profound sensorineural hearing loss evolve, they will be applied in conjunction with or instead of cochlear implants. An understanding of the current state-of-the-art of this technology, including its advantages, disadvantages, and its potential for delivering and interacting with biomolecular hearing restoration approaches, is helpful for designing modern hearing-restoration strategies. Cochlear implants (CI) have evolved over the last four decades to restore hearing more effectively, in more people, with diverse indications. This evolution has been driven by advances in technology, surgery, and healthcare delivery. Here, we offer a practical treatise on the state of cochlear implantation directed towards developing the next generation of inner ear therapeutics. We aim to capture and distill conversations ongoing in CI research, development, and clinical management. In this review, we discuss successes and physiological constraints of hearing with an implant, common surgical approaches and electrode arrays, new indications and outcome measures for implantation, and barriers to CI utilization. Additionally, we compare cochlear implantation with biomolecular and pharmacological approaches, consider strategies to combine these approaches, and identify unmet medical needs with cochlear implants. The strengths and weaknesses of modern implantation highlighted here can mark opportunities for continued progress or improvement in the design and delivery of the next generation of inner ear therapeutics.
随着用于深度感音神经性听力损失的生物分子听力恢复方法的发展，它们将与耳蜗植入物结合使用或替代耳蜗植入物。了解这项技术的最新现状，包括其优缺点，以及它在提供和与生物分子听力恢复方法相互作用方面的潜力，有助于设计现代听力恢复策略。耳蜗植入物（CI）在过去的四十年中不断发展，以更有效地为更多具有不同适应症的人恢复听力。这种演变是由技术、手术和医疗保健提供方面的进步推动的。在这里，我们提供了一篇关于耳蜗植入物现状的实用论文，旨在开发下一代内耳治疗方法。我们旨在捕捉和提炼正在进行的关于 CI 研究、开发和临床管理的对话。在这篇综述中，我们讨论了植入物带来的听力成功和生理限制、常见的手术方法和电极阵列、植入的新适应症和结果衡量标准以及 CI 使用的障碍。此外，我们还将耳蜗植入与生物分子和药理学方法进行了比较，考虑了结合这些方法的策略，并确定了耳蜗植入物存在的未满足的医疗需求。这里强调的现代植入物的优缺点可以为下一代内耳治疗方法的设计和提供指明继续进步或改进的机会。
