I. Age of cochlear implantation.
1, prelingual deafness is best not to exceed 7 years old, because after the age of 7 years old, human hearing and speech centers basically stop developing, and then the effect of cochlear implantation is poorer, many can only hear sounds, but will not have the experience of language!
2. Cochlear implantation for young children is reported for children as young as 8 months old. If the child’s skull is too small, it may affect the surgery, and cochlear implantation is done under general anesthesia, which makes anesthesia cannulation difficult!
3. Cochlear implantation can also be performed in elderly deaf patients, provided that their general condition, especially cardiovascular and pulmonary function, can tolerate general anesthesia and surgery.
II. Indications for cochlear implantation.
1. Selection criteria for patients with prespeech deafness:
(1) Severe or profound sensorineural deafness in both ears.
(2) The best age should be 12 months to 5 years.
(3) No significant improvement in hearing and speech ability after 3-6 months of hearing rehabilitation with appropriate hearing aids.
(4) No contraindications to surgery.
(5) The family and/or the implant recipient has a correct understanding of the cochlear implant and appropriate expectations.
(6) There are conditions for hearing and language rehabilitation education.
The younger the patient is at the time of surgical implantation, the better the outcome, as this maximizes the potential for avoiding auditory sensory deprivation and expanding speech and language skills before the critical period of brain plasticity. Children or adolescents older than 6 years of age need to have some basis in hearing and speech, a history of hearing aid wear and a history of hearing or speech training since childhood. Ineffective or poor hearing aids are defined as having an open phrase recognition rate of ≤ 30% or a two-word word recognition rate of ≤ 70% in the best hearing aid listening environment.
2. Selection criteria for postlingually deaf patients:
(1) Patients of all ages with postlingual deafness.
(2) Severe or very severe sensorineural deafness in both ears.
(3) Ineffective or poor hearing aids, with an open phrase recognition rate of ≤ 30%.
(4) No contraindication to surgery.
(5) Good psychological and subjective motivation, correct understanding of cochlear implants and appropriate expectations.
(6) Family support.
The age of onset and duration of deafness in patients with post-speech deafness are closely related to the outcome of surgery. Generally speaking, patients with early onset of deafness and longer duration of deafness have poorer post-operative outcomes. In addition, the listening environment in the post-operative life and workplace can also affect the outcome of cochlear implantation.