Current and future research directions in cochlear implants Seminar

The variability in outcome between those who achieve excellent scores and those receiving virtually no open-set speech understanding at all is not reliably predictable at an individual level. Improvements in speech understanding in recent times have come largely through the application of sound cleaning technology often ported from the hearing instrument field. Here improvements in speech reception threshold of 7 or 8 dB have been recorded. The better cochlear implant users equipped with such technology return similar SRTs to normal hearing persons tested in the same conditions. Such outcomes also raise questions of candidacy, and have economic as well as audiological dimensions.

A major challenge facing cochlear implantation today, how best to combine acoustic and electrical hearing, either in the same ear, electrical-acoustic stimulation (EAS), or for electrical and acoustic hearing ears, bimodal listening. The nature of electrode array that should be used, when to intervene and whether to implant unilaterally or bilaterally all need careful consideration in this area. The place of drugs in the treatment of deafness, initially in support of cochlear implants but later perhaps as a replacement treatment, is also a topic that is starting to gain momentum.

While in many ways cochlear implantation is providing tremendous benefit for many people today, how even the current level of provision can be maintained, let alone extended to treat even larger numbers who either do not meet today’s candidacy or live in countries with poor provision is an issue that may need a different model of service delivery.