Indications for multi- or single-channel cochlear implant for rehabilitation of total deafness

Only totally deaf patients who do not experience improvement when using classical hearing aids are candidates for a cochlear implant. Preoperative assessment of potential benefits of a cochlear implant may improve selection of patients with pre- or postlingual total deafness, so that the most appropriate system can be implanted. The psychological status of potential candidates for implantation is particularly important because the results of postoperative re-education depends on motivation of the patient. The Round Window electrical stimulation test supplies us with important and measurable data (electrical threshold level, tone decay test). The duration of deafness, the degree of the deafness, and the cochlear tomodensitometry do not affect the decision to implant a cochlear device, (i.e., since the socialization level of the patient is a considerable factor). Preoperative assessment of the patient is very useful. As a result of our experience in 115 implanted cases suffering from pre- and postlingual deafness, we are now able to predict the good or bad results in our patients. Therefore, in patients who have many adverse factors for recovery, it seems to us more reasonable and cheaper to implant a single-channel system instead of a multichannel system, which must be reserved for patients who should do well. In very young children, the most appropriate system seems to be extra cochlear single-channel implant.