Shepherd, Robert K., N.E. Meltzer, J.B. Fallon, and D.K. Ryugo (2006) Consequences of deafness and electrical stimulation on the peripheral and central auditory system. In: Cochlear Implants, (eds. S.B. Waltzman and J.T. Roland), Thieme Medical Publishers Inc., New York, NY, pp. 25-39.

Cochlear implants provide important auditory cues necessary for auditory awareness and speech perception in severe to profoundly deaf subjects. Over the past three decades more than 80,000 adults and children worldwide have received these devices. Clinical experience has shown, however, a large variability in outcome among implant users. Factors predicting a successful clinical outcome reflect the importance of auditory experience--either before an acquired hearing loss or with use of a cochlear implant. Moreover, deaf children, with little or no prior auditory experience, can obtain significant benefit from a cochlear implant provided that their device is fitted at a young age. This clinical experience suggests that such a response can be at least partially attributed to plasticity within the auditory system.

This chapter reviews the response of the auditory system to both deafness and its reactivation through a cochlear implant, and includes experimental data from animal models as well as human material where applicable. Understanding the complexities of this response will help provide a substrate for understanding the clinical variability evident among cochlear implant users.

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