Cochlea-Implantation

Die Cochlea-Implantation ist eine unersetzbare Therapie bei Patienten mit hochgradiger Schwerhörigkeit bis Taubheit. Zugleich hinterlässt der dafür nötige Eingriff einen Schaden am Innenohr. Dieser Artikel gibt einen Überblick über die unerwünschten Auswirkungen der Cochlea-Implantation auf das Innenohr sowie über Monitoring-Methoden zur Messung der Innenohrfunktion während der Cochlea-Implantation.

Abstract

Cochlear implantation is the treatment of choice for patients with profound hearing loss and deafness. At the same time, inserting a cochlear implant (CI) leaves damage to the inner ear. The preservation of inner ear structure and function has become a central issue in CI surgery. The reasons for this are i) electroacoustic stimulation (EAS), i.e., the option of joint stimulation by a hearing aid and a CI; ii) an improved audiologic outcome in electric-only stimulation; iii) the preservation of structures and residual hearing for potential future therapy options; and iv) the avoidance of side effects, such as vertigo. The exact mechanisms that determine the extent of damage to the inner ear and which factors contribute to preservation of residual hearing are not yet fully understood. In addition to the surgical technique, electrode selection may play a role. This article provides an overview of what is known about the direct and indirect adverse effects of cochlear implantation on the inner ear, of the methods available to monitor inner ear function during cochlear implantation, and of the focus of future research on preservation of inner ear structure and function.

Kernaussagen

• Verletzungen des Innenohres durch die Elektrode des Cochlea-Implantats (CI) können zum unmittelbaren Hörverlust nach der Operation führen.

• Der verzögerte Hörverlust wird durch chronische Umbaureaktionen innerhalb des Innenohres erklärt.

• Schäden am Vestibularorgan können zu Schwindel und Gleichgewichtsstörungen führen.

• Ziel der Cochlea-Implantation sollte ein möglichst schonender Mechanismus sein, um Schäden an Cochlea und Vestibularorgan zu vermeiden.

• Die Elektrocochleografie ist eine geeignete Methode, um die cochleäre Funktion während der Operation zu kontrollieren und so das Insertionstrauma zu minimieren.

• Eine schonendere Cochlea-Implantation könnte auch das Auftreten von assoziiertem Schwindel minimieren.

Schlüsselwörter

Restgehör - Hörschaden - Cochlea-Implantat

Keywords

residual hearing - hearing los - cochlear implantation

Publication History

Article published online:
04 May 2023

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