[Cochlear implants].

Cochlear implants aim at the rehabilitation of profound bilateral deafness. The cochlear implant is a prosthesis made out of surgically implanted cochlear electrodes connected to an external vocal processor. The external acoustic signals are converted into electrical signals coded by the vocal processor. They are then sent out, by a transcutaneous mode, to an internal receptor. This receptor transmits the information to the intracochlear electrodes. Initially, the cochlear implantation was recommended to patients totally deaf following a trauma, a degenerative disease of the inner ear, a meningitis or the use of ototoxic drugs. These patients could not gain from conventional hearing aids and were condemned to silence. More recently, the authors have been impressed by spectacular results with patients having lost their hearing during adulthood (postlingual). The challenge here is quite different, as its aim is to open up--and not to reopen--a child to a sensation that he has never perceived before. This allows the child to develop a coding, a recognition of the acoustic message. The first results are very encouraging. Scientifically, the implantation is also a research tool in various fields: surgical, neurophysiological, neuropsychological, speech therapy, social and cultural. The cochlear implant is an "avant-garde" project. It has changed our approach to profound deafness. It represents the only hope for the profoundly deaf person to reach a satisfactory rehabilitation and social integration.