Cochlear implants (CI) are neuroprosthetic devices which restore hearing in severe-to-profound deafness through direct electrical stimulation of the auditory nerve. Current CIs use an external audio processor that is worn behind the ear, which houses the microphone, power source, and signal processing hardware. For users, this external device can be a source of both inconvenience and limitations. A long-term goal in the field has been to develop a new generation of implants in which all components are contained within a single subdermal implant.

We present our surgical considerations and experience for the TICI, which are based on the experience with all generations of MED-EL Implants, from the Combi 40 in 1994 until the Synchrony 2 from today. Key elements that also apply to the surgical technique of a “normal” CI are highlighted.

Clinical results from the one year follow up feasibility study with the totally implantable cochlear implant (TICI) and data for 5 years follow up until October 2025 from the Munich Patients are shown. Clinical testing showed that the TICI provides high levels of hearing performance early after first fitting, equivalent to that of a conventional CI (73% Monosyllabic Words in Quiet, -2.2dB SNR in Noise [OLSA]). At the one year interval we found no difference between invisible mode and the classical CI mode in Quiet as well as in Noise. The results remain stable over more than 5 years

The development of the TICI is a step into a new technological era and advances the field of audiology and hearing implants.

cochlear implantation approach in pediatric otolaryngolgy subspecialty is discussed