小児人工内耳の近未来像 Future of Pediatric Cochlear Implantation
The number of pediatric cochlear implants (CI) has markedly increased both in Japan and world wide. However, when pediatric CI is recommended for use, several points should be taken in consideration, such as the age of indication, improvements in the device and the establishment of a rehabilitation system. In regard to the age for indication, some reports recommend early implantation at less than 2 years of age, but other studies have reported the importance of duration after implantation rather than the age at implantation. Therefore, except for in cases of meningitis, an immediate lowering of the age for implantation does not appear to be necessary at least for the immediate future in Japan. In regard to improvements in the device that are now taking place for both the hard and soft parts, the miniaturizing of implantable parts and speech processor should produce an intra canal type of CI followed by a fully implantable CI in the near future. The development of NRT (Neural Response Telemetry) has the potential for automatic mapping, especially in pediatric patients who respond less to oral stimulation. A suitable rehabilitation system after CI was yet to be fully established in Japan and local centers for CI, possibly utilizing deaf schools for mapping and rehabilitation, are urgently needed. In the 21st century, however, it is possible that the number of deaf people in Japan may decrease towards zero by the wide spread promotion and use of CI.
耳鼻咽喉科臨床 94(3), 205-212, 2001-03-01