Today's indications for cochlear implantation.

Today's indications for cochlear implantation. During the last twenty years, the indications for cochlear implants (CIs) extended significantly due to positive experience with CIs, improved CI technology, and safer surgery. This paper reviews the classical and emerging indications for CIs anno 2007. Providing a postlingually deaf adult with a unilateral CI has been the earliest indication and remains the standard indication. However, CIs are also indicated for prelingually deaf adults, and for children younger than one year old. Recently, CIs are also indicated for adults with residual hearing: when best aided sentence recognition scores in quiet are lower than 70%. CIs for patients with residual hearing sometimes imply the use of a bimodal CI; a device that stimulates the cochlea both electrically and acoustically. Another promising evolution is bilateral implantation. Nowadays, it has also become possible to place a CI in the malformed cochlea. When an auditory nerve is absent or when implantation failed despite a functional device, auditory brainstem implants can restore some form of hearing to the deaf.