[Experiences in Kiel with the cochlear implant]

Since 1988 22 deaf patients were provided with a 22-channel cochlear implant at the Kiel University Hospital. No surgical or postoperative complications were seen in any of the patients. Side effects like facial stimulation and pain sensation during electrode activation do not reduce the utility. Tinnitus may initially be severe but usually subsides to preop levels after a few days. A tinnitus masking effect is pronounced during stimulation but hardly lasts long after switch off. Besides an individually arranged hearing training the accurate speech processor fitting to the needs of the patient remains the cornerstone of successful rehabilitation. Objective intraoperative measurements such as the electrically evoked brain stem potentials and the middle ear reflexes yield estimates of the threshold values relevant for initial processor programming. Further information needed for the following extensive fine adjustment is obtained by subjective evaluation of loudness growth during electrical stimulation with variable parameters, by loudness scaling of narrow band noises with different middle frequencies and intensities presented under free field conditions and by speech audiometric procedures. The latter include a monosyllabic rhyme test and a logatom test developed at this institution. More speech testing is applied to document the degree of auditive rehabilitation. The results of speech tracking and the Freiburg tests as well as a new sentence test in silence and noise are discussed. In the multisyllable Freiburg test all but two of the adults understand the complete presented material, in the open set monosyllable test an average of 55% correct is achieved. Speech discrimination-oriented ranking showed 95% of all postlingually deaf patients in the highest performance category.