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CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 01): S36-S78
DOI: 10.1055/a-1731-9321
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Cochlea-Implantation: Konzept, Therapieergebnisse und Lebensqualität

Article in several languages: deutsch | English
T. Lenarz
1   Hals-Nasen-Ohrenklinik der Medizinischen Hochschule Hannover
,
A. Büchner
1   Hals-Nasen-Ohrenklinik der Medizinischen Hochschule Hannover
,
A. Illg
1   Hals-Nasen-Ohrenklinik der Medizinischen Hochschule Hannover
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Zusammenfassung

Cochlea-Implantate stellen heute eine unverzichtbare Methode zur auditiven Rehabilitation hochgradig hörgeschädigter Patienten dar. Durch die rasante Entwicklung der Implantat-technologie haben sich die Hörergebnisse erheblich verbessert, ca 80% der Patienten können telefonieren und Kinder erreichen eine nahezu normale Hör- und Sprachentwicklung. Das hat zu einer Indikationsausweitung hin zu Patienten mit Hochtontaubheit und einseitiger Taubheit geführt. Zur Zeit sind aber nur etwa 60 000 der ca 1 Million CI-Kandidaten implantiert. Zukünftig werden multimodale universelle Hörimplantate für die kombinierte elektro-mechanische Stimulation zur Verfügung stehen, die fortlaufend eine Anpassung der Stimulationsstrategie an den jeweiligen Funktionszustand von Haarzellen und Hörnerven auch bei progredienter Schwerhörigkeit ermöglichen. Brain-Computer-Interfaces erlauben die automatisierte Anpassung an die Hörsituation und eine Optimierung der Signalverarbeitung zur Erzielung eines bestmöglichen Hörvermögens. Binaurale Hörsysteme erlauben eine Verbesserung von Richtungshören und Hören im Störgeräusch. Advanced Implants besitzen additiv gefertigte individualisierte Elektroden, die sich nach atraumatischer robotisch assistierter Insertion aktiv der Anatomie der Cochlea anpassen. Sie sind in Abhängigkeit von der Pathophysiologie mit integrierten biologischen Komponenten ausgestattet, unterstützen die Erhaltung des Restgehörs und ermöglichen die Regeneration neuraler Elemente zur Verbesserung der Elektroden-Nerven-Schnittstelle. Dadurch lassen sich die heutigen grundsätzlichen Grenzen der CI-Technologie überwinden und in Richtung des physiologischen Gehörs verschieben. Das Bionische Ohr ist somit in Reichweite. Durch konsequente Weiterentwicklung mit Vereinfachung der Versorgung, hörerhaltender Implantation unter Lokal-Anästhesie und Anwendung robotischer Systeme werden zukünftig mehr Patienten von dem neuen physiologischen Hören profitieren.

Schlüsselwörter

Cochlea-Implantation heute - Technologie - Indikationen und Diagnostik - Chirurgie - Anpassung und Training - Nachsorge - Ergebnisse - Hörergebnisse - Sprachentwicklung - Erziehung - Bildung und Beruf - Weitere Ergebnisse - Komplikationen und Implantatausfälle - Lebensqualität - Zukünftige Entwicklungen


Publication History

Article published online:
23 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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