Skip to main navigation menu Skip to main content Skip to site footer

Review article: Biomedical intelligence

Vol. 144 No. 0506 (2014)

Cochlear implantation in children and adults in Switzerland

  • Yves Brand
  • Pascal Senn
  • Norbert Dillier
  • Martin Kompis
  • John Allum
Cite this as:
Swiss Med Wkly. 2014;144:w13909


The cochlear implant (CI) is one of the most successful neural prostheses developed to date. It offers artificial hearing to individuals with profound sensorineural hearing loss and with insufficient benefit from conventional hearing aids. The first implants available some 30 years ago provided a limited sensation of sound. The benefit for users of these early systems was mostly a facilitation of lip-reading based communication rather than an understanding of speech. Considerable progress has been made since then. Modern, multichannel implant systems feature complex speech processing strategies, high stimulation rates and multiple sites of stimulation in the cochlea. Equipped with such a state-of-the-art system, the majority of recipients today can communicate orally without visual cues and can even use the telephone. The impact of CIs on deaf individuals and on the deaf community has thus been exceptional. To date, more than 300,000 patients worldwide have received CIs. In Switzerland, the first implantation was performed in 1977 and, as of 2012, over 2,000 systems have been implanted with a current rate of around 150 CIs per year. The primary purpose of this article is to provide a contemporary overview of cochlear implantation, emphasising the situation in Switzerland.


  1. Davis AC, Davis K. Descriptive epidemiology of childhood deafness and hearing impairment. In: Seewald R, Tharpe A-M, Gravel J, eds. Comprehensive handbook of pediatric audiology. San Diego, CA: Plural Publishing 2010.
  2. Van Naarden K, Decouflé P, Caldwell K. Prevalence and characteristics of children with serious hearing impairment in metropolitan Atlanta, 1991–1993. Pediatrics. 1999;10:570–5.
  3. Sohn W, Jörgenshaus W. Schwerhörigkeit in Deutschland. Z Allg Med. 2001;77:143–7. German.
  4. Olusanya D. “The Right Stuff”: The Global Burdon of Disease. PLoS Med. 2007;4:89.
  5. Mazelova J, Popelar J, Syka J. Auditory function in presbyacusis: peripheral vs. central changes. Exp Erontol. 2003;38:87–94.
  6. Stach BA, Spretnjak ML, Jerger J. The prevalence of central presbyacusi in a clinical population. J Am Acad Audiol. 1990;1:109–15.
  7. Stevens G, Flaxman S, Brunskill E, Mascarenhas M, Mathers CD, Finucane M. On behalf of the Global Burden of Disease Hearing Loss Expert Group. Global and regional impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health. 2013;23:146–52.
  8. Djourno A, Eyries C. [Auditory prosthesis by means of a distant electrical stimulation of the sensory nerve with the use of an indwelt coiling]. Press Med. 1957;65:1417. French.
  9. Eisen MD. Djourno, Eyries, and the first implanted electrical neural stimulator to restore hearing. Otol Neurotol. 2003;24:500–6.
  10. House WH. Cochlear implants. Ann Otol Rhinol Laryngol. 1976;85:3–97.
  11. Dillier N. Schweizerisches Cochlear Implantat Register (CI-Datenbank). HNO-Klinik Universität Zürich. 2012 ( German.
  12. Venail F, Sicard M, Piron JP, Levi A, Artieres F, Uziel A, et al. Raliablity and Complications of 500 consecutive cochlear implants. Arch Otolaryngol Head Neck Surg. 2008;134:1276–81.
  13. Shannon RV. Threshold and loudness functions for pulsatile stimulation of cochlear implants. Hear Res. 1985;18:135–43.
  14. Shannon RV. Quantitative comparison of electrically and acoustically evoked auditory perception: implications for the location of perceptual mechanisms. Prog Brain Res. 1993;97:261–9.
  15. Fun QJ, Shannon RV. Frequency mapping in cochlear implants. Ear Hear. 2002;23:339–48.
  16. Rauschecker JP, Shannon RV. Sending sound to the brain. Science. 2002;295:1025–9.
  17. Wilson BS, Finley CC, Lawson DT, Wolford RD, Eddington DK, Rabinowitz WM. Better speech recognition with cochlear implants. Nature. 1991;352:236–8.
  18. Taft DA, Grayden DB, Burkitt AN. Across frequency delays based on the cochlear traveling wave: enhanced speech presentation for cochlear implants. IEEE Trans Biomed Eng. 2010;57:596–606.
  19. Eisenberg LS, House WF. Initial experience with the cochlear implant in children. Ann Otol Rhinol Laryngol Suppl. 1982;91:67–73.
  20. Waltzman, Roland JT. Cochlear implant candidates in cochlear implants, Thieme Medical Publisher, New York, NY, USA 2006.
  21. Arndt S, Aschendorff A, Laszig R, Beck R, Schild C, Kroeger S, et al. Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus. Otol Neurotol. 2010;32:39–47.
  22. Mohr PE, Feldmann JJ, Dunbar JL, McConkey-Robbins A, Niparko JK, Rittenhouse RK, et al. The societal cost of severe to profound hearing loss in the United States. Int J Technol Assess Health Care. 2000;16:1120–35.
  23. Colletti L, Mandalà M, Zoccante L, Shannon RV, Colletti V. Infants versus older children fitted with cochlear implants: performance over 10 years. Int J Pediatr Otorhinolaryngol. 2011;75:504–9.
  24. Kral A, O’Donoghue GM. Profound deafness in childhood. N Engl J Med. 2010;363:1438–50.
  25. Stark T, Engel A, Borkowski G. Bilateral cochlea implantation in varying duration of deafness. Laryngorhinootologie. 2004;83:20–2.
  26. Sikyr S. Audiologische Resultate und subjektive Beurteilung nach Cochleaimplantation im Erwachsenenalter. Inaugural-Dissertation zur Erlangung der Doktorwürde der Humanmedizin der Medizinischen Fakultät der Universität Bern 2004. German.
  27. Philippon D, Bergeron F,Ferron P, Bussières R. Cochlear implantation in postmeningitic deafness. Otol Neurotol. 2010;31:83–87.
  28. Merkus P, Free RH, Mylanus EA, Stokroos R, Metselaar M, van Spronsen E, et al. Dutch cochlear implant group (CI-ON) consensus protocol on postmeningitis hearing evaluation and treatment. Otol and Neurotol. 2010;31:1281–6.
  29. Ramsden JD, Gordon K, Aschendorff A, Borucki L, Bunne M, Burdo S, et al. European Bilateral Pediatric Cochlear Implant Forum consensus statement. Otol Neurotol. 2012;33:561–5.
  30. Müller J, Schön F, Helms J. Speech understanding in quiet and noise in bilateral users of the MED-EL COMBI 40/40+ cochlear implant System. Ear Hearing. 2002;23:198–206.
  31. Lenarz M, Sönmez H, Joseph G, Büchner A, Lenarz T. Long-term performance of cochlear implants in postlingually deaf adults. Otolaryngol Head Neck Surg. 2012;147:112–8.
  32. Lalwani AK, Cohen NL. Does meningitis after cochlear implantation remain a concern in 2011? Otol Neurotol. 2012;33:93–5.
  33. Arndt S, Laszig R, Aschendorff A, Beck R, Schild C, Hassenpass F, et al. Einseitige Taubheit und Cochlearimplantatversorgung. HNO 2011:59;437–46.
  34. Jacob R, Selzig Y, Nopp P, Scheich P. Audiological results with cochlear implants for single-sided deafness. HNO 2011:59;453–60.
  35. Briggs RJ, Eder HC, Seligman PM, et al. Initial clinical experience with a totally implantable cochlear implant research device. Otol Neurotol. 2008;29:114–9.
  36. Wilson BS, Dorman MF. Cochlear implants: current designs and future possibilities. J Rehabil Res Dev. 2008;45:695–730.
  37. Wilson BS, Lawson DT, Muller JM, Tyler RS, Kiefer J. Cochlear implants: some likely next steps. Annu Rev Biomed Eng. 2003;5:207–49.

Most read articles by the same author(s)