Understanding Cochlear

Implant & Sensorineural

Hearing Loss

How it works ?
Harim Priyono

The 1st Solo Otorhinolaryngology Course (SOC)

15th February 2020

S
Physiology of Hearing
Organ Corti
Normal Hearing
Why should cochlear
implant ?
 Will cochlear
implant give a good
benefit for certain ?
How the problem works ?
How the problem works ?
Normal

Proble
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 Bivariate analysis demonstrated that total spiral
ganglion cell count tended to be lower in older
than in younger deaf individuals and lower
with longer duration of hearing loss and
total deafness.

 However, multiple regression analysis

demonstrated that the cause of hearing loss
was the single most significant determinant of
total spiral ganglion cell count.
 Morphometric evaluation of spiral ganglion (SG) cell
somata within Rosenthal's canal demonstrated a
mean of 50% of normal cell density maintained in
the chronically stimulated ears, compared with 30%
on the control deafened side.

 A pronounced decrease in cell diameter in

neonatally deafened cats studied about 1 year
after deafening, and an additional decrease after
long‐term deafness (2.5–6.5 years).
 Why NRI/NRT/ART
sometimes could not be
detected ?
How the problem works ?
 Why cochlear
implantation is
recommended as
soon as possible ?
 Why deafness
duration gives a
significant impact
on post
implantation final
result ?
 Sensory perception results from interaction
between sensory input and ongoing cortical
activity (neuronal oscillations or oscillatory
transients = ‘oscillatory activity’).
 Oscillatory activity :
1. Stimulus detection and stimulus selection.
2. Auditory stimulus familiarity and choice.
3. Listening effort and auditory attention.
4. Auditory streaming.
5. Auditory decision tasks.

 Oscillatory activity is tightly related to

language physiology.
Mendengar dengan CI
 Is that true ?
Congenital Profound SNHL
= Neural Development
Emergency

S
 Post Implantation
Management
Higher
Order
Parents
Psycologist
Developmental
Primary
pediatrician
Cortex

Thalamic
AVT
Auditory
Mapping
Cochlear
 Remarks

 The function of cochlear implant is only to replace

the HAIR CELLS function.

 In some cases, sensorineural hearing loss

involving a more complex organ dysfunction (i.e:
hair cells only or in conjunction with nerve fibers
dysfunction and central processing).
 Remarks

 Hearing habilitation/rehabilitation is highly

recommended as soon as possible to prevent the brain
high order is occupied by other sensory input (i.e:
visual).

 The success of cochlear implantation is not only to

achieve ability of hearing, also to achieve language
development.

 The best cochlear implant result is expected when the

defect is only on the hair cells.
Thank you