Fifty years ago, there were no treatments for deafness and severe hearing loss until Dr. William House first invented the cochlear implant with six-channel electrodes and implanted them into the cochlea of ​​the first patient in 1964. Graeme Clark has completely changed that since he first developed the cochlear implant system in 1978, calling it a bionic ear. Cochlear implantation is rapidly successful, and the Cochlear Division of Nucleus has developed a variety of cochlear implants. There are now 219,000 cochlear implant recipients worldwide including adults and children. The cochlear implant is an electronic medical device that helps profoundly deaf and severely hard-of-hearing adults and children to hear sounds. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay The cochlear implant is a two-part device. The first part of the device is an external part called BTE (behind the ear) which is located on the ear and the BTEs have a microphone, a sound processor and a transmission system, and the second part of the device with a receiver and an electrode system that is surgically implanted under the skin in the head and behind the ear. The implant is equipped with electronic circuits that will pick up environmental sounds through the BTE processor and send them through the damaged ear's electrical current simulating the auditory nerve before it reaches the brain. However, cochlear implant surgery is a routine procedure for otolaryngologists and neurologists. They will perform the surgery together by implanting the device in your head and behind your ear. Decades ago, the surgery took many hours, a large incision in the scalp and half of the patient's head was shaved. Nowadays, the surgery can be performed in a short time with a small incision behind the ear and little or no chance of having a shaved head. The implant will not be noticed because it will be implanted under the skin and hair will grow on it. Before surgery, surgeons will prepare the patient for surgery with anesthesia and by inserting a required intravenous antibiotic one hour before the skin incision is made. Once the patient has been heavily sedated with anesthesia, the incision should be free of hair which may be necessary to shave a small portion behind the edge of the auricle and above the canthomeatal plane line. The head should be rotated 30-40 degrees posterior-superior to accommodate the flat part of the skull and mark the incision line on the scalp behind the auricle. The surgeon will use the BTE templates together with the silicone elastomer implant template to ensure that both do not interfere between the coil and the speech processor at the ear. They will also ensure that the speech processor does not rest on the receiver/stimulator by marking them with a surgical pen. There should be a distance of at least 15 mm between the receiver/stimulator and the incision behind the auricle. After the incision has been marked, a drop of methylene blue will be applied to a bone by inserting an 18-gauge needle through the skin in the center of the implant bed before the incision can be formed. Additionally, the surgeon will make the incision until the flap is formed. The flap must always be kept moist with moist surgical gauze. The incision must be at least 15 mm to be large enough to accommodate the receiver/stimulator through the incision. The flap must be inferior and with an anterior base, but it is very important that the surgeon is able to fix the implantto the bone. The next incision will be made up to the avascular plane of the periosteum and temporal fascia and the flap must be stabilized. During the procedure, the position of the implant should be checked with the stainless steel surgical template kit before cutting under the periosteum and the lower part of the temporalis fascia muscle. First it is necessary to create a large palva flap on the anterior base by raising a large periosteal pocket for the antenna to pass through the temporalis muscle which allows the placement of the extracochlear ball electrode between the skull and the periosteum, however, the ball electrode extracochlear should be avoided by placing it in the temporalis muscle. After making the second incision, the mastoidectomy will begin and the surgeon will need to drill the hole where the blue spot is located on the bone to create a mastoidectomy cavity that allows the proximal redundant electrode to protrude both superiorly and posteriorly to help. The surgeon will use the drill with a circular router table to create a hole using the socket template which is almost oval but rounder in shape to allow the surgeon to rotate the receiver/stimulator. It will be necessary to achieve optimal positioning and then drill a channel connecting the well and the cavity so that the proximal intracochlear electrode array can pass through the facial recess. It is preferable that the receiver/stimulator is not extended beyond the edge or the mastoid cavity. After completing the mastoidectomy and well, a decision will be made on the longitudinal axis for the receiver/stimulator before creating attachment holes above and below the front of this receiver/stimulator so that the implant can be securely attached. They will use a 2mm diamond bur to drill the holes. After the short incus process, carefully open the facial recess and the horizontal canal should be clearly visible without the facial nerve being exposed. It is very important to know where the nerves are located during procedures. The chorda tympani nerve can be damaged very easily if doctors are not careful. It is located on the left on the anterior surface of the facial nerve in the posterior middle ear, including the stapedius tendon, promontory and round window niche which must be clearly visualized. The round window niche should be 2mm lower posteriorly than the oval window and staples. The membrane of the round window may be obscured by the overhang of the lateral margin of the niche. When the scala tympani is pierced anteroinferiorly to the window niche around it while performing the cochleostomy. The surgeon will pierce the promontory anteriorly and pass through the scala media or vestibules. If they drilled too far, they would miss the cochlea, which could cause a hypotympanic air cell that would lead to incorrect placement of the electrodes. It is necessary to drill it with a 1 or 1.4 mm diamond bur through the bone until a 1 mm endosteum point is exposed. They will need to be very careful not to be exposed to bone dust or blood entering the cochleostomy when opening the endosteum to ensure that the stapes plate tool is used for opening. The cochleostomy will need to have a diameter of at least 1 mm to accommodate the electrode system and to ensure that the electrodes do not get stuck in any bone crests. When opening the package to remove the device it is necessary to check for damage before implanting the device into the patient's head. The surgeon will need to hold the receiver/stimulator in the non-dominant hand and remove the protective tray from the system.