Abstract: Introduction: Worldwide, in recent years, the number of people with hearing loss. In 
2019, according to WHO data, 1.57 billion people have hearing loss of varying degrees. Cochlear 
implants (CI) are devices designed to convert sound waves into electrical impulses, transmitting 
them directly to the auditory nerve and bypassing the damaged cells of the inner ear.
Material and Methods: In this publication, we share our behaviural algorithm for patients with 
severe hearing loss and practical deafness. They are both children and adults. In a global problem, 
there are no major differences in developed countries regarding these criteria.
Results: The rule for congenital deafness is the fastest possible detection, diagnosis and timely 
treatment. In Bulgaria, this is possible thanks to the National Newborn Hearing Screening Program, 
which has been running since 2015.
Discussion: Cochlear implantation is associated with strictly defined indications and algorithms 
that have changed significantly over the years and differ even more between countries or centeres. 
The existence of such criteria certainly facilitates work with patients and constitutes the basis for 
good medical practice.
Keywords: cochlear implantation, deafness, treatment

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