Pediatric cochlear implant surgery

Thirty years of cochlear implantation (CI) have produced abundant information about the evaluation of CI candidates, the surgical technique, and the management of complications. Continuous improvement in the management strategy and the surgical technique has optimized the rehabilitation of patients with severe and profound sensorineural hearing loss while limiting complications. This article will review the recent changes in indications for optimizing speech development in children with severe and profound sensorineural hearing loss, including the restoration of binaural hearing. The most appropriate tests for preoperative evaluation of candidates are discussed and technique adaptations are described. Optimal management would be CI before the first birthday. Bilateral implantation is considered in every surgical candidate. The surgical technique has been modified to consider residual hearing conservation and avoidance of known potential complications.