[Cochlear implants. Prosthetic management of deafness at the turn of the century]

In recent years the cochlear implant has become an established method for rehabilitation of bilateral sensory deafness in adults and children. Intracochlear multichannel stimulation with sophisticated speech coding strategies has proved to be reliable and safe enough for use in adults as well as young children; thus, a few cochlear implant systems with different specifications are currently available. The differences in their hardware and software are discussed. Furthermore, the current indications for cochlear implants in patients whose hearing is severely impaired and important aspects of the preoperative evaluation are presented with special emphasis on difficult cases such as deformities, multihandicapped subjects and very young children. Our results after 12 years of experience and more than 700 implantations suggest that the most important prognostic factor is the duration of deafness.