Indications and contraindications for cochlear implantation
Cochlear implantation is a high-tech method of restoring hearing that requires careful selection of candidates. The success of the operation depends not only on the surgery itself, but also on the long-term follow-up rehabilitation.
Below are the main medical indications and contraindications for this procedure.
Indications for cochlear implantation
The main condition for the operation is a state in which the hair cells of the cochlea are destroyed, but the auditory nerve itself and the hearing centers in the brain are preserved.
Main medical and audiological indications:
- Bilateral grade IV sensorineural hearing loss or total deafness (hearing thresholds of 71 dB or higher at speech frequencies).
- Low benefit or no benefit from correctly fitted hearing aids over 3–6 months.
- Postlingual deafness (hearing loss after the person has already acquired speech).
- Prelingual deafness in children. The optimal age for surgery is up to 2–3 years.
- Unilateral sensorineural hearing loss with pronounced tinnitus not compensated by other methods.
Non-medical (social and psychological) conditions:
- Preserved cognitive function and intelligence.
- High motivation of the patient or their parents for long-term hearing and speech rehabilitation.
- Absence of serious psychological problems.
Contraindications for cochlear implantation
Contraindications are divided into absolute (where the operation is technically impossible or pointless) and relative (requiring prior treatment or a special decision by a medical board).
Absolute contraindications:
- Aplasia (complete absence) of the cochlea or auditory nerve.
- Complete or significant obliteration (ossification) of the cochlea.
- Retrocochlear pathology (for example, an acoustic neuroma).
- Lesions of the central parts of the auditory analyzer.
- Severe systemic conditions for which general anesthesia is contraindicated.
- Severe neurological and psychiatric disorders.
- Lack of motivation and family support, inability to undergo long-term rehabilitation.
Relative contraindications:
- Acute inflammatory diseases of the middle ear (surgery is possible after the infection has been fully resolved).
- Certain developmental abnormalities of the inner ear (the decision is made individually based on CT and MRI).