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The present and future of cochlear implants
Pérez Zaballos M.T. , Ramos de Miguel Á. , Falcón J.C. , Borkoski S. , Ramos Á.
Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain, 2Complejo Hospitalario Universitario Insular Materno
Infantil, Hearing Loss Unit ENT Department, Las Palmas de Gran Canaria, Spain
Intro: Much has changed since the invention of Cochlear implants in the 70s. At present, an external speech
processor filters sound into different frequency bands and extracts the envelope within each of them or, more
recently, the fine structure of the signal. The corresponding electrical stimulus is sent in sequence to 8 to 22
electrodes implanted in the cochlea. However, there are still situations where CI users are still far from hearing
like normal-hearing individuals, such as in noisy environments or music appreciation. This has led to the
development of many new approaches in the field that range from new coding strategies, to alternative forms of
stimulation, such as optical or piezoelectric. Therefore, the aim of this study is to provide an overview of the state
of the art regarding the most novel approaches in cochlear implants, covering not only commercially available
technology, but also promising prototypes in early stages of development.
Methods: extensive literature research was conducted in the fields of: 1) sound coding strategies; 2) coupling
configuration patterns; 3) electrode contact design 4) totally implantable devices; 5) optical stimulation; 6)
piezoelectric based devices; 7) regenerative medicine. The potential of each discovery was assessed based on
its feasibility, potential applicability, current technological limitations and state of development.
Results: The literature research reveals that the areas with the strongest research focus are novel coding
strategies. Extensive research is also being conducted in the fields of totally implantable devices, with some
models currently being available on the market. Optical stimulation on the other hand seems to be a strong bet
for the future, with important companies now funding such projects. Finally, other creative approaches include
piezoelectric artificial cochleae and 3D bioprinting ears, although these are in a much earlier stage of
Conclusion: This is an exciting moment for cochlear implant research. Many aspects of such devices are
subject to improvements. Due to the speed at which technology evolves, previously inconceivable solutions are
now the subject of serious and promising research. Interdisciplinary collaborations have led to remarkable
achievements. It is thus important to gather everything that has recently happened and to see the whole picture,
which spans much farther than one might think.
Learning outcome: This review will provide a broad view of the current state of the art in the field of cochlear
implants and their likely evolution in the future.