Developing surgical techniques in cochlear implantation

Since Djourno and Eyries described their first experience of electrical stimulation of the auditory nerve in 1957, the journey to an easily insertable, reliable and effective cochlear implant has been one of the most exciting in the history of medicine. The hallmark of the venture has been global collaboration between basic scientists in many fields - bioengineering, microcircuitry, signal processing, cognitive science and linguistics - as well as surgeons and educationalists. Many ingenious devices have been developed and equally ingenious operations have been proposed in order to maximize their effectiveness and minimize their potential damage to the inner ear. Complicated extracochlear devices eventually gave way to intracochlear multi-channel implants, and surgical challenges such as paediatric implantation, ossification, CSOM and dysplasia were addressed and solutions found. The journey is not yet over, however, and progress continues to be made to develop a fully implantable cochlear implant, which should be a reality within five years.