Résumé
Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures.The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical,audiological,radiological, and psychological diagnostic work-up.There are numerous changes are happening in cochlear implant candidacy.These have been associated with concomitant changes in surgical techniques,which enhanced the utility and safety of cochlear implantation.Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss.Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss.The advancement in designs of thecochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices.This review article aims to discuss the new concepts in the candidacy of the cochlear implant,cochlear implant in younger children and hearing preservation,a cochlear implant for unilateral deafness,bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.
Résumé
INTRODUÇÃO: O grande número de deficientes auditivos faz da perda auditiva um sério problema social, econômico e de saúde pública. Próteses auditivas e implantes cocleares representam os principais dispositivos utilizados como paliativos por pessoas com deficiência auditiva, sendo que os implantes cocleares são muitas vezes a única opção nos casos de deficiência auditiva severa e profunda. Nesse artigo discute-se de maneira geral os diferentes aspectos envolvendo implantes cocleares, tanto de âmbito tecnológico como seu papel socioeconômico. MÉTODOS: Baseado em dados do SUS, IBGE e outras fontes, um levantamento qualitativo e quantitativo é feito pela primeira vez especificamente para a população brasileira. O artigo discute ainda o estado da arte das tecnologias envolvidas no implante coclear, com base em literatura científica e informações de fabricantes, bem como as perspectivas para as próximas gerações de implantes cocleares. CONCLUSÃO: Há potencial e demanda para evoluções nos implantes atuais. A implantação precoce é benéfica para pacientes e sociedade, compensando os custos econômica e socialmente. No entanto, as políticas públicas de reabilitação necessitam se adequar para atender com eficácia à crescente população afetada pela deficiência auditiva.
INTRODUCTION: Due to the great number of affected people, hearing loss is considered a serious social, economic and public health problem. Hearing aids and cochlear implants are the primary devices used as palliatives for people with hearing loss, and cochlear implants are often the only option in cases of severe to profound hearing impairment. This paper covers both technological and socio-economic aspects of cochlear implant, which is considered as one of most recommended treatments to alleviate severe to profound hearing loss. METHODS: Brazilian unified health system data is used to display qualitative and quantitative analysis impact on Brazilian population and government. A state-of-art review based on scientific literature and manufacturer data is provided, as well as perspectives for the next cochlear implant generation. CONCLUSION: There is potential and demand for evolutions in current implants. Early implantation is beneficial for patients and society, compensating the costs economic and socially. However, public programs need to adapt in order to efficiently attend the increasing affected population.
Résumé
Otosclerosis is known to be rare in orientals, but there have been a few reports of the clinically suspicious otosclerosis cases in Korea. Otosclerosis is a bony disorder involving endochondral bone of the otic and labyrinthine capsule. Advanced and very advanced otosclerosis are conditions in which the otosclerotic involvement of the otic capsule has progressed to result in profound deafness with undetectable bone and air conduction thresholds. The patients, who have severe to profound hearing loss due to otosclerosis, potentially benefit from a stapes surgery and optimal hearing aid fitting. But there are a few reports that cochlear implantation may provide these patients with a superior outcome. We report a 58 year-old man with severe to profound hearing loss, which was a first reported case of cochlear implantation employed to treat otosclerosis in Korea. We present this with a review of the related literature.