人工内耳医療の過去・現在・未来

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Cochlear implant (CI) technology, surgical technique, and candidacy criteria continue to rapidly evolve. Although outcomes are steadily advancing, there is still room for improvement. CI patients with residual hearing in the implanted ear can combine both electrical and acoustic stimulation (EAS/Hybrid CI) to improve speech perception, particularly in the presence of background noise. Binaural advantages are found in both adult and pediatric bilateral CI recipients, in terms of improved sound localization and enhanced speech perception under noisy conditions. Instead of widespread implantation in children younger than 12 months, evidence that supports infant implantation, with regard to speech perception and production outcomes, is still limited and of low quality. Long-term, high quality studies concerning both bilateral CI and infants’ CI are needed. While the long-term reports show that many profoundly hearing-impaired children using CI can develop functional levels of speech perception and production, attain age-appropriate oral language, and achieve satisfactory academic performance, cochlear implantation in younger children should be performed by skilled surgeons, provided that the attending pediatric anesthesiologist is considerably experienced and appropriate pediatric perioperative care facilities are readily available. In advanced future CI technology, gene therapy and/or regenerative medicine should be introduced to and combined with CI to preserve both auditory and vestibular function even after CI surgery, which might help it reach to a higher stage as the most successful innovation in the rebirth of artificial sense.
耳鼻咽喉科臨床学会の論文
2010-11-01

人工内耳医療の過去・現在・未来

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