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Cochlear implants have become an important tool for the treatment of individuals with hearing impairment. A preoperative approach consisting of a multidisciplinary team that fully assesses each cochlear implant candidate will allow the selection of those patients likely to benefit. Cochlear implant technology continues to evolve including electrode design, receiver/stimulator design, and speech-processing modalities. Novel surgical techniques have enhanced the safety of cochlear implantation and have provided access to a growing number of patients. Children with congenital inner ear malformations and those with cochlear ossification are able to benefit from implantation.
COCHLEAR IMPLANTS have led to great advancements in auditory rehabilitation. Although amplification from hearing aids has enabled increased communication for many, those with severe hearing impairment often escape benefit. Because auditory deprivation, especially from birth to 4 years of age, is detrimental to speech and language development, children with sensorineural hearing loss require special attention (Dechicchis & Bess, 1993). Auditory deprivation may lead to alterations in the growth and maturation of central auditory pathways (Fleckeisen, Harrison, & Mount, 1991). Hence, in children, a narrow window or "critical period" exists for implementing auditory rehabilitation. Cochlear implants provide an exciting means of enhancing the hearing and language abilities of children with severe hearing impairment. This article will review the preoperative evaluation of pediatric cochlear implant candidates, special considerations for children receiving cochlear implants, variations in the surgical techniques between implant devices, and surgical techniques for congenital malformations.
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