Cochlear implants in China.

China has approximately 6 million totally deaf people according to an official survey conducted in 1990, although the actual number is probably higher. A primary cause of deafness is the use of ototoxic drugs. There does not appear to be any emergent deaf culture in China at present. As the only available medical device that can restore partial hearing to a totally deaf person, the cochlear implant has been in development in China since 1979. This paper provides an overview of cochlear implants in China and is based on a review of published materials, visits to research institutes and hospitals, and personal communication with Chinese colleagues. As of 1993, about 1,000 deaf people, including 50 children below age 12 years, have received four types of single-electrode cochlear implants that were developed and fabricated by institutions in China. These single-electrode devices have provided an aid to lip reading, but are no longer in use due to their inability to produce open-set speech recognition. Present implant research in China focuses on development of multi-electrode devices. Basic research in electrical stimulation is relatively lacking and standardized audiological evaluation for cochlear implant effectiveness needs to be developed. The present economic growth and legal system reform in China, combined with advances in implant technology, may make it possible to produce an affordable yet effective cochlear implant system. This paper discusses cochlear implants only in China, but the social and economic factors are similar in many developing countries in Asia, South America, Eastern Europe, and Africa, where a low-cost, high-performance cochlear implant system is also needed.