Feb 23, 2026
3 min read
The electronic artificial ear will be "smart": it will be able to be updated, have internal memory and can be controlled remotely.Interventions to insert them are also evolving, particularly in the field of robotics.Conference in Pisa, February 28, to celebrate 1000 plants.
Severe or profound hearing loss: Cochlear implant 2.0 provides highly customizable hearing care
The electronic artificial ear becomes "intelligent": it is capable of self-updating, has internal memory and can be controlled remotely.Interventions are also growing to include them, especially in the field of robotics.Summit in Pisa on February 28 to celebrate 1,000 plants
Cochlear implants have established themselves as the most effective treatment solution for severe hearing loss, resulting in results that have consolidated over time.Today, this situation is developing rapidly.Along with ever-expanding clinical indications, the field is experiencing a rapid phase of technological innovation that promises more invasive interventions, smarter devices, and increasingly personalized treatment pathways.
"In the clinical field, a key step is the recent publication of the Directive of the Istituto Superiore di Sanità, which officially approved the suitability of the cochlear implant for new categories of patients", says Professor Stefano Berrettini, Director of the U.O.Otorhinolaryngology University of Audiology and Phonology of the University Hospital of Pisa, which this year celebrates the achievement of the milestone of a thousand cochlear implants.The Pisan Center was the promoter, together with Professors Domenico Cuda from Piacenza and Gaetano Paludetti from Rome, national guidelines, coordinated by Professor Francesca Forli and Doctor Sara Ghiselli, Uoc of Otolaryngology Ausl Piacenza.The paper reiterates the importance of early intervention in children with profound, actionable congenital deafness in the first year of life, but also broadens the focus to adulthood.Age is no longer a limit and the implant is recognized as effective even in the elderly, as well as in cases of asymmetric or unilateral deafness, when excluded from this type of treatment.
ISS recommendations
At the same time, the equipment changes.The main goal of the engineering work is to reduce the process, to save the cochlear apparatus and, if possible, to hear everything." together with the fibers of the acoustic nerve", explained Forli.This can not only change the functional results, but also opens up the possibility of using future technologies that can use the implant in time." Among the most advanced examples are the so-called "drug-eluting electrodes", electrodes that can release protective substances or stimulate neuronal regeneration.
Surgical enlargement
Surgery is also progressing.Alongside traditional techniques, minimally invasive approaches and robotic solutions are emerging that support the surgeon in the most delicate step of the procedure: inserting the electrode into the cochlea.Robotic arms and motorized devices recently introduced into clinical practice, with the aim of reducing surgical trauma, require longer operating times and are still being evaluated on a large scale.There are also robotic systems that are able to perform most of the steps independently.
Another promise relates to the invisibility of the device.«After the first clinical trials launched in 2005, the evolution of batteries and microphones has once again sparked interest in fully implantable cochlear implants.Although not yet available in clinical practice, some European studies have already included a few dozen selected patients.The aim is a hybrid use: a few hours without external components, together with the use of a traditional processor for optimal charging and acoustic performance", explains Berrettini.
"Smart" system
Meanwhile, self-updating "smart" systems with internal memory have also arrived. "These represent a step towards a new technological level for cochlear implants, with reduced dependence on external processors and the increased possibility of controlling their functions remotely through telemedicine methods," said Foley. As a result, monitoring and adjustments can be made remotely, reducing hospital visits while maintaining regular personal check-ups.
gene therapy
Behind this, there remains great hope for gene therapy for hearing loss."Recently, very promising results have been published regarding gene therapy related to certain types of inherited hearing loss, specifically mutations in otoferlin (a protein essential for hearing, editor)," concludes Forli."Although these are preliminary data, have not been confirmed over time, and are attributable to a single specific subtype of hearing loss, these results represent a relevant conceptual step."It must be made clear that this is the old standard, adapted to a rapidly evolving situation, and that in the future biological therapies and prosthetic techniques may be combined and integrated, paving the way for increasingly individualized treatment strategies.
A Thousand Factories of Pisa: Conference on February 28th
From the first single-canal implantation performed in 1985 to the highly sophisticated modern surgery, the Otolaryngology Clinic of Aou Universitaria Pisana has developed in almost 40 years one of the most reliable programs in Italy for the treatment of severe and profound deafness.a regional wage system was adopted, which allowed the business to develop steadily. Also a decisive factor is the audiological screening of newborns, which has been carried out in Tuscany since 2007, which has facilitated early diagnosis and intervention.Today, the center is numbering in the thousands, numbers are constantly increasing, and the national role of case studies, research and complex case management.This will be discussed at the meeting "A thousand cochlear implants in Pisa: research, surgery and the rehabilitation path for patients", which will take place on Saturday 28/2 (9.30-12-30) at the Officine Garibaldi in Pisa.
