Principle and history of cochlear implant The ear is divided into three parts: the outer ear, the middle ear and the inner ear. The cochlea is our inner ear organ, the place where the external sound is converted from mechanical energy to nerve electrical impulses. If this place loses its function due to some kind of disease, the pathway of sound conduction to our hearing center will come to an abrupt end, and such a person will become deaf. If there is a device that can replace the function of the damaged cochlea and directly convert external sound signals into electrical signals and excite the auditory nerve to restore or rebuild the hearing function of the deaf, won’t the deaf be able to hear sound? The principle is very simple, the reason is very understandable, but to realize it, it is a long and difficult road. Scholars after a long period of painstaking efforts, so that the cochlear implant (also known as: bionic ear, electronic cochlear implant) technology came into being, and gradually improve, and become more and more perfect. Today, cochlear implants are internationally recognized as the most effective device for restoring hearing to patients with severe or profound sensorineural deafness. Hundreds of thousands of deaf people worldwide have benefited from this technology. Tracing the history of cochlear implants, the earliest proof of the effect of electrical stimulation of the auditory nerve was a group of Russian scientists, who claimed to have observed a deaf patient perceiving sound under electrical stimulation, but said very little. 1957, the French doctor Djourno and others successfully used electrical stimulation to make two completely deaf patients to produce hearing perception, this experiment has a landmark significance, opening up a series of restoration of hearing in deaf patients since then. In 1972, the first single-channel cochlear implant sound processor was born, in 1977, the first multi-channel cochlear implant sound processor was born in Austria, and in 1978, Australian Graeme Clarke invented the real sense of cochlear implant. Clark invented the true cochlear implant, a great invention across the ages that marked the great success of electrical stimulation alternatives throughout the human world. Visual conduction and auditory conduction are similar in principle, and the welfare of the deaf arrived far ahead of the curve in comparison to the blind. Even today, with all the advances in technology, we humans have not been able to come up with a second human sensory replacement device that is so perfect and shocking. It makes me wonder once again how fortunate I am to be born in these great times, both for the healer and the patient. However, there is no one key that opens all the doors in the world, so who is a good candidate for this technology …… Who is a good candidate for a cochlear implant? First of all, let’s understand what prelingual deafness is, which means that the patient can’t hear before he/she learns how to speak. Such prelingual deafness usually occurs before the age of 3. Without medical intervention, they will become what we call deaf and mute, relying on sign language and lip-reading to communicate. It is important to note that there is nothing actually wrong with the voice, the organ of articulation in deaf people, it is just mute due to deafness. There are a variety of causes, including congenital, genetic, medication, and postmeningitis …… For most of these patients, cochlear implants can make a big difference. For these patients with prelingual deafness, it is critical that cochlear implants be implanted as early as possible; the sooner they are implanted, the better the child’s future speech development will be. This is because the best time for us humans to learn speech is up to the age of three, and if we miss this golden opportunity, it will be exponentially more difficult for us to learn speech, even if we can hear voices in the future. This reasoning is well understood. I’ve been learning English for decades, and I would be killed by the English level of a few-year-old American child. For a prelingually deaf child who is already older than 5 years old at the time of cochlear implantation, it is necessary for the child to have a certain foundation of hearing language, a history of hearing aid fitting and a history of hearing or speech training since childhood in order to ensure a good postoperative speech outcome. In contrast to prelingual deafness, postlingual deafness, as the name suggests, means that the patient has already acquired speech before he/she is unable to hear, and in such cases, he/she is usually only deaf but not mute. The timing of cochlear implantation for postlingual deafness is relatively broader. Previously, it was thought that cochlear implantation could be done within ten years of deafness, but now it is believed that as long as it is postlingual deafness, it will be effective even if it is later, of course, if the deafness is not too long, the effect will be better. Age-related deafness is actually the most common case of postlingual deafness. Nearly 10 million of our hearing impaired people with disabilities are elderly. Today, with the aging of the population, the elderly deaf are even the largest group of hearing impaired people in China. If hearing aids are not good enough to help them hear, cochlear implants will be a very effective treatment. However, due to cultural and economic factors, the elderly themselves and their families, usually think that this is just a normal phenomenon of people getting old, although some inconvenience, why to surgery? In developed countries, 60% of the cochlear implanted patients are elderly deaf patients, while in our country 90% of them are children and less than 10% are adults and elderly. In Chinese culture and tradition, people are willing to give all they have for the health of their children, but when an elderly person becomes deaf, their children’s desire to pay is not as strong, and the elderly themselves are not willing to allow their children to pay for the more expensive medical costs. Chinese old people often say, “At this age, if you can’t hear, just forget it, why should you have an operation”. However, deafness in old age often puts them in a situation of indifference, anxiety, low self-esteem, loneliness and poor speech, often making them feel that life is not fun, and some of them even lose their confidence in life. Along with the emergence and persistence of deafness, the elderly will also accelerate the decline of intelligence, emotional personality changes, and aggravation of underlying diseases. Happily, in today’s society, there is a huge shift in the awareness of the elderly. As far as I know, there is a gradual increase in the number of elderly people undergoing cochlear implant surgeries in China, with the oldest of them being over 90 years old, and I admire such elderly people for such a courageous quest for their quality of life. However, I believe that as people’s living standards improve and people aspire to pursue a higher quality of life, more and more adults and elderly people will be implanted with cochlear implants. Of course, not all deaf people can receive cochlear implants. Some very severe cases of inner ear malformations, such as Michel’s malformation or cochlear defects, auditory nerve defects, severe mental illnesses, and uncontrolled suppurative inflammation of the middle ear mastoid, will not benefit from cochlear implantation and may even be at risk, and the screening and judgment of a specialist is especially important for these patients. The end of cochlear implant surgery is just the beginning Both patients and parents of deaf children must understand the importance of post-cochlear implant auditory-linguistic rehabilitation, especially for pre-speaking deaf children. Surgery merely rebuilds hearing, which does not mean that the patient will immediately be able to speak like a normal person. The implanted person hears sounds that are slightly different from what we normally hear, and this is easier to adapt to for postlingually deaf patients who have previous experience of speech hearing. For prelingually deaf people with no previous hearing experience, it is the task of speech rehabilitation to associate these sounds with speech. It maximizes the cochlear implant signals for the development of hearing and, subsequently, verbal language. According to the law of language development of children, according to the deaf child’s “hearing age” in stages from shallow to deep gradually training. In the stage of auditory training, the main purpose is to utilize the residual hearing of the deaf child to listen to all kinds of sounds, to awaken their “sleeping state”, and to give them frequent stimulation, repeated training and reinforcement, so that the deaf child gradually adapts to the daily sounds of the audible world; the stage of vocabulary accumulation is based on the auditory training, supplemented by visual and other senses to make them know more The final stage of language training is based on the accumulation of vocabulary, training deaf children to speak more, from words to sentences, from simple to complex, from few to many, and gradually to understand other people’s language, and make other people understand their own language. In fact, the contraindications to surgery should also include those patients or parents who are too lazy to think that they can wait for the miracle to happen after installing a device, but in fact, the auditory-verbal training of the deaf child is still sometimes a relatively long-term, arduous work, of course, there are specialized language training teachers to complete this work, but the patience and perseverance of the parents to do so are also important factors to ensure that implantation results are indispensable. The story of the cochlear implant is told here. This is the end of the cochlear implant story. Of course, for professionals, this knowledge is not enough, but for the general public, knowing this is enough to understand the ins and outs of this technology, and perhaps one day, your knowledge will help someone close to you. Life is so beautiful, may you and I enjoy it together!