Cochlear Implants: From Principles to Practice

Review by A Banerjee
Middlesborough, UK

I have been looking forward to this book since I first heard about it on George Wanna’s LinkedIn page. It is a multi-author treatise, with four editors including my friend George Wanna. I was curious about this hybrid combination, because Jaypee Bros publishers are Indian but the authors are US-based. As I took the cellophane wrapping off, I was impressed with the quality of the binding, paper and printing, which has not always been the case with previous books published by this company.

The book is divided into five sections. There is a consistency of layout and house style of writing, which is a testament to a fantastic job done by the editors.

The first section is short, and covers the aetiology of hearing loss and its implications for cochlear implant performance. I was happy with the succinct way the various aetiologies were covered, but the implications on performance could have been a bit more detailed.

The second section, on assessment of candidacy, has three chapters: adult candidacy, expanding criteria and pre-operative imaging. The assessment is unsurprisingly quite US-centric, and British readers need to refer to the National Institute for Health and Care Excellence criteria for candidacy guidelines ( It was interesting to note that cochlear implant criteria in the USA do not include children aged under 12 months, as there is a significant body of evidence indicating that early implantation leads to better outcomes. Our centre aims to implant children as close to eight months of age as possible. Anecdotal evidence suggests that these children need less rehabilitation, as compared to children implanted after 12 months of age.

The section on surgery for cochlear implantation was detailed, but was let down by the quality of the photographs. The section on the insertion lays emphasis on the importance of training in a temporal bone laboratory to gain experience on the technical nuances. I really enjoyed the chapter on congenital anomalies. The classification of the anomalies is well presented, as is the section on pre-operative radiological examination. The decision-making regarding the side implanted and the different approaches used is very useful, even for an experienced cochlear implant surgeon.

The section on the results and outcomes of cochlear implantation is very comprehensive, and is a lot more detailed than the surgical sections. This section is well worth a read on its own, by experienced surgeons, trainees and audiological staff. The level of detail is at odds with most of the other chapters, but it was appreciated.

What did I think about this book? I liked it. It has some- thing for both the experienced and trainee surgeon. As a first edition, I think it is a work in progress and some of the sections will need refining. I think it will benefit from online resources, especially in the sections on the ever-changing choices of electrodes. I also hope that subsequent editions deal with the intra-operative electrophysiological monitoring of hearing, which is the brave new hope for hearing preservation.

Teacher’s report: A+ for effort, B+ for achievement. Not bad at all for a first effort, and it can only get better with more experience, a bit like cochlear implant surgery.

Amazon Link: Cochlear Implants: From Principles to Practice
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