Artificial Hearing Implants for Age-related Deafness Age-related deafness is one of the extremely common geriatric diseases, with a prevalence of nearly 100% in the elderly. They often find it difficult to talk to people, turn on the TV very loud and “disgusting”, so they prefer not to go out, not to talk and live an isolated life. With the improvement of living standards, the concept of old age is being updated. Many people are 60 years old and in good health, so it is difficult to call them elderly; however, with the rise of life stress, many middle-aged people have already developed deafness, which we call “the rejuvenation of senile deafness”. The loss of a healthy middle-aged person’s ability to work because of deafness is sad for the country and for the family. Age-related deafness can often be helped by hearing aids, but for a significant number of patients, hearing aids do not work very well. These patients previously belonged to the category where there was nothing that could be done but to let them live a life without hearing. In recent years, the technological application of artificial hearing implants has revolutionized the treatment of severe deafness in the elderly. In western developed societies, artificial hearing implants for the elderly have been widely used, and the number of surgical cases has exceeded that of pediatric congenital deafness, greatly improving the quality of life of the elderly. In China, there are not many cases of artificial hearing implantation for the elderly because of economic and social factors, but more importantly because of the perception of patients, their families and even many doctors that “if you are old and can’t hear, you can’t hear”. This is actually a very big conceptual error. Imagine an elderly person who is deaf at the age of 60, but has more than 20 years of life expectancy, and it is a terrible and sad thing to live in a silent world for 20 whole years. The purpose of this article is to correct the above misperception and to shed light on all current artificial hearing implant technologies. Cochlear implantation is a technology that implants an artificially manufactured electronic hearing device into the cochlea (replacing the function of the cochlea) of patients with severe or profound sensorineural deafness and directly stimulates the auditory nerve fibers in the cochlea. This means that external sound is converted into electrical stimulation to produce electrical hearing, and the patient needs to learn and train to re-establish the appropriate connection between sound and electrical hearing, thus enabling the patient to re-understand speech and return to the audible world. The procedure can be performed in pediatric patients as young as 12 months of age (FDA approved), and in some special cases, the age of implantation can be several months earlier. Patients with prespeech deafness have better results before the age of 8 years, especially before the age of 4 years. If the patient can wear a hearing aid for 3-6 months before the surgery and undergo aural rehabilitation, it will greatly help to improve the speech ability after the surgery. For adults with post-speech deafness, there is no significant age limit, and I have seen cochlear implants in the United States in people as young as 90 years old. In developed Western countries, the number of cochlear implants for deafness in older adults has surpassed that of children, greatly improving the quality of life of older adults. Indications for cochlear implantation in adults 1. bilateral severe sensorineural deafness 2. severe tinnitus that affects life Recent studies have found that cochlear implants can have a significant inhibitory effect on tinnitus. 3.Unilateral severe sensorineural deafness and severe tinnitus with high quality of life requirements Pre-operative evaluation Pre-operative evaluation is needed according to the patient’s general condition and hearing condition. For patients with declining brain function, the function of the auditory center may also decline, which needs to be informed to the patient before surgery. The duration of preoperative deafness is also an important indicator. Although it is said that there is no clear evidence on how long deafness prevents cochlear implantation, clinically it is seen that the longer the duration of deafness, the worse the outcome after surgery. For geriatric deafness a preoperative multidisciplinary team evaluation is required. Surgical procedure Cochlear implantation is not a very difficult procedure for experienced otologists, and is generally not very invasive. Post-operative post-ear dressings can be discharged within a few days, and complications rarely occur, making it a safe but delicate procedure. The cost of the surgery is equivalent to the cost of an otitis media surgery, which is usually about 20,000 yuan for the entire hospital stay and is covered by medical insurance. There are domestic and imported cochlear implants, with imported ones costing around 200,000 and domestic ones around 80,000. In many areas, the Disabled Persons’ Federation can reimburse most of the costs, such as for Shanghai residents, the Federation can reimburse 60,000 yuan. For a domestic cochlear implant, the out-of-pocket cost is only 20,000 RMB. Post-operative Rehabilitation Generally, the cochlear implant is turned on one month after surgery. For adult cochlear implants, since they can speak and previously had hearing, they do not need speech rehabilitation, and it is still very convenient to put an external device behind the ear and take it off when you are not using it during sleep. There are basically no mechanical problems with cochlear implants, only the need to change the batteries.