The Future of Cochlear Implant Design.

This chapter discusses the multifaceted future of cochlear implant design. Current research is focused on novel strategies relating to the electrode array, aiming to improve the neuronal health and spatial selectivity, and reduce the power consumption. Future design iterations will most likely improve the neuronal health by reducing insertion trauma, minimizing the inflammatory pathway that follows electrode insertion or through the use of neurotrophins or stem cells. Improvements in spatial selectivity and in speech recognition in difficult listening environments can be achieved through changes in the electrode/neural interface. Designing an array that brings the electrodes closer to neural tissue, or changing the method of stimulation with current steering or even optical or piezoelectric stimulation are discussed. Increasing the MRI compatibility is an important consideration, and devices allowing remote programming have a huge impact on worldwide provision. Technology exists to realize the elusive goal of a fully implantable cochlear implant, allowing continuous and invisible hearing. Ultimately, future technologies will be integrated to allow tailoring of implant design to the individual, thereby addressing the broad variability in user performance. At the same time, there is an urgent requirement for a high quality, low cost, mass-produced implant for the developing world.