Unanswered questions concerning the indication for cochlear implant

In a discussion of the function of cochlear implant (CI), the following criteria should be mentioned: (1) If possible, all deaf persons (including the prelingually deaf and children) should benefit from CI. (2) Since the number of patients with late deafness is doubtlessly decreasing with better prevention and medical care (elimination of ototoxic damage, decrease of iatrogenic deafness), the percentage distribution of the deaf will be displaced in favor of the prelingually deaf. At present, the ratio of cases of late deafness to those of prelingual deafness among our CI candidates is 1:3. (3) The objective of CI must be to provide the advantage of the procedure to children as early as possible. This means that under certain circumstances a technique that is as low in risks as possible and with a handy implement should already have been used in patients at the age of 3 to 4 years.