[Cochlear implant for children: indications and surgical aspects]

Since the late 80s cochlear implants (CI) have proved to be an efficient means to help bilaterally profound deaf patients. The CI is supposed to replace the function of the inner ear. A CI-system consists of an externally worn speech processor and the implants itself with intracochlear electrodes. A preoperative promontory test serves to differentiate between inner ear deafness and non-functioning hearing nerve, but is performed only in the case of adults. In small children results of electrocochleography form the basis for such an assessment. CI-surgery in small children is basically not more complicated than in adults. Whereas cochlear implants in adults are only indicated for late-deafened patients, both small children deafened after having acquired speech as well as deaf born children can learn to understand and develop speech. However, consistent technical and pedagogical rehabilitation is an indispensable prerequisite for success. This is being done in Hannover in a special children-like rehabilitation center where children and 1 parent are trained in-house for 12 times once a week. Results are the better, the shorter the duration of deafness, i.e. if children are implanted already during the 3rd year of age, and deafened children - mostly after meningitis - immediately, if possible. Some children even achieve to develop spontaneous speech with elements of dialects and a nearly-unimpaired level of understanding.