Hearing impairment is an important factor affecting public health and quality of life. According to the World Health Organization estimates, about 250 million people around the world suffer from severe hearing loss or more, 2/3 of them in developing countries. China is the world’s largest developing country, with 20.57 million hearing impaired people with disabilities, of which more than 9 million are elderly people. It can be said that elderly deaf people are the largest group of hearing impairment in China. Second, what is senile deafness Senile deafness refers to deafness caused by aging of the auditory system. Its pathogenesis is complex and includes not only the physiological and pathological processes of aging of the auditory system, but also influenced by environmental and social factors in the course of life. Clinically, progressive sensorineural deafness that begins in old age and is symmetrical in both ears is often diagnosed after excluding other causes? before diagnosing it as senile deafness. The age of onset of senile deafness is not fixed; a few people show aging of the auditory system at the age of 40, while others still have fairly sharp hearing in their old age. The diagnosis is based on the progressive sensorineural deafness of both ears in the elderly. The diagnosis should be made in the context of the aging of the systemic organs and should exclude the following diseases: drug-induced deafness, noise damage, Meniere’s disease (formerly known as Meniere’s disease), otosclerosis, auditory neuroma, tympanosclerosis, autoimmune sensorineural deafness, hereditary progressive sensorineural deafness, etc. The onset of senile deafness is slow and is characterized by the absence of other clinical manifestations, no perceived hearing impairment at the beginning, hearing loss binaural symmetry, and a gradual increase in deafness with age Nt~l:l. The clinical classification of senile deafness into 6 types: sensorineural, neurological, vascular, cochlear conduction, mixed and undetermined deafness. III: A new treatment for senile deafness: cochlear implant Aging is a universal law of nature, and so far, there is no definite and effective way to reverse this process. Maintaining a healthy lifestyle and avoiding the effects of various hearing-damaging factors can slow down the aging of the hearing system. In terms of treatment, for elderly deaf patients whose quality of life is affected by hearing impairment, most of them can restore their hearing through hearing aids. Some patients with severe and profound deafness can also restore their hearing through cochlear implants if wearing hearing aids does not work well. The cochlear implant is a high-tech biomedical engineering device that has been successfully developed internationally in recent years. It is the most effective treatment for severe and profound sensorineural deafness (including total deafness), and is suitable for patients with an average hearing loss of more than 90 decibels in both ears (inaudible to loud speech). More than 60,000 people worldwide have benefited from cochlear implant surgery, a significant proportion of whom are middle-aged and elderly patients. Most patients with post-speech deafness (see below) can use the telephone normally after surgery The remainder are able to talk freely with people with the aid of reading mouth patterns. For patients with severe and profound deafness, cochlear implants are significantly more effective than hearing aids, so they have become a routine clinical treatment for severe and profound deafness. The cochlear implant is composed of two devices, in vivo and in vitro: 1. In vivo device: including receiving circuit and electrodes. The core of the receiving circuit is a large-scale integrated circuit chip encapsulated in a ceramic or titanium alloy sealed housing slightly larger than a nickel to prevent erosion of the circuit by body fluids. The electrodes are made of platinum-iridium wire about 26 mm long and 0 6 mm in diameter and silicone rubber, which are connected to the circuit at one end and surgically implanted in the cochlea at the other end. The material used has good compatibility with human tissue and can theoretically be used for a lifetime. 2. The external part of the body is called the speech processor, and there are two types: the body-matching type can be hung on the belt like a cigarette case, and the ear-back type is similar to the ear-back type hearing aid, and uses batteries to provide energy. It has a microphone, a speech signal coding circuit board and a transmitter inside. V. Advantages of cochlear implants Compared with hearing aids, cochlear implants have obvious advantages. Hearing aids amplify the volume of sound and use the patient’s residual hearing to enable them to hear outside sounds. They are not very helpful for patients with total deafness who have no residual hearing. Research has shown that most people with total deafness have an intact auditory nerve and that it is the auditory receptors in the inner ear that are damaged. A cochlear implant uses electrodes implanted in the inner ear. The cochlear implant bypasses the damaged part of the inner ear. The cochlear implant uses electrodes implanted in the inner ear to bypass the damaged part of the inner ear and stimulate the auditory nerve with an electric current to restore hearing. This is something that hearing aids cannot do. The effectiveness of the cochlear implant is related to the encoding scheme of the speech processor carried outside the body. The multi-channel electrodes currently in use are capable of transmitting multiple frequency information. They also selectively stimulate different groups of auditory nerve fibers, which can transmit more speech information. The sound heard with a cochlear implant is the same as the sound heard by a normal person. The appropriate group of people for cochlear implants can be divided into pre-speech deafness and post-speech deafness according to whether they can speak or not. Pre-speech deafness refers to deafness that occurs before speech, and therefore the opportunity to learn to speak is lost. In addition to restoring hearing, patients with prelingual deafness need to learn to speak. In addition to restoration of hearing, language learning is required. The age of implantation is generally required to be between 18 months and 17 years. The older the age of surgery, the better the results. The older the age, the better the results. Deafness in the elderly is post-linguistic deafness. After surgery, only a short period of auditory training is required. There is no restriction on the age of implantation. There is no restriction on the age of implantation, as long as the patient is in good health and can receive general anesthesia. There is no restriction on the age of the patient. The oldest person who underwent the surgery in our hospital was 60 years old. The maximum age of foreign patients is 89 years old. In addition to the age factor, the following conditions are suitable for surgery: 1. Patients should be profoundly or totally deaf in both ears, i.e., unable to understand speech with the help of hearing aids; 2. The patient should have a correct understanding of the results of the surgery; 4. be able to adhere to the auditory training. When hearing cannot be restored with hearing aids, both children and elderly deaf people should receive cochlear implants as soon as possible. The cochlear implant should be received as soon as possible. Generally speaking, the shorter the time of hearing loss, the better the results after surgery. If the hearing loss is prolonged, the auditory nerve degeneration will increase. This will increase the difficulty of training and affect the outcome of the surgery. 40 Middle Aged Health Care 2OO4 4 Cochlear Implantation Method Before cochlear implantation. In addition to hearing test, hearing aid fitting and speech test, ear CT and whole body examination should also be done. The surgery can only be performed after passing all the tests. The surgery is performed under general anesthesia. A small incision is made at the back of the ear and a shallow circular groove is ground into the surface of the bone behind the ear. This is used to place the receiving device. The electrode is partially implanted through the mastoid cavity through the round window of the cochlea. The incision is closed. The head is bandaged. The implant is completely embedded under the skin. After the hair grows out, the incision scar is covered. The incision scar will be covered. It will not affect the appearance. You can get out of bed on the second day after surgery． The stitches will be removed on the 7th day. You can leave the hospital after 1 to 2 days of observation.