Technique and indications for the French multichannel cochlear implant "Chorimac-12" for total deafness rehabilitation.

To obtain some speech discrimination without lip reading it is necessary to elicit different frequency sound sensations in the totally deaf cochlea. Thus, electrically proofs compartments must be created all along the cochlear keyboard. The placement of twelve intracochlear electrodes is greatly facilitated by using our electrode-bearer, which is introduced through the round window by a posterior tympanotomy approach. However, partial or complete ossification of the cochlea may sometimes necessitate the use of our first technique of placement of electrodes one by one with Silastic pieces through twelve cochlear fenestrations. The indications for implanting depend on certain immutable criteria (total deafness, auditory response to electrical stimulation of the round window, patient's motivation), but other criteria are also described and discussed (socialization level, cochlear ossification, and preoperative electrophysiologic data). Associated handicaps (autism, blindness, tetraplegia) are not contraindications and often represent supplementary reasons for implantation.