Cochlear implant research and development in the 21st century: A critical update
Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The introduction of directional microphones and of new noise-reduction and pre-processing algorithms have produced robust and sometimes substantial improvements. Improvements from novel speech-processing algorithms, the use of current-focussing methods, and individualised (patient-by-patient) de-activation of subsets of electrodes have been identified but have been more modest. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of revolutionary technologies, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.