Recent Developments in Bionic Hearing Restoration from the Round Window to the Inferior Colliculus (original) (raw)
Related papers
GMS current topics in otorhinolaryngology, head and neck surgery, 2005
Aim of this report is to explain the current concept of hearing restoration using hearing aids. At present the main issues of conventional hearing aids are the relative benefits of analogue versus digital devices and different strategies for the improvement of hearing in noise. Implantable hearing aids provide a better sound quality and less distortion. The lack of directional microphones is the major disadvantage of the partially implantable hearing aids commercially available. Two different clinical studies about fully implantable hearing aids have been started in 2004. One of the most-promising developments seems to be the electric-acoustic stimulation.
The Cochlear Implant: Historical Aspects and Future Prospects
The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology, 2012
The cochlear implant (CI) is the first effective treatment for deafness and severe losses in hearing. As such, the CI is now widely regarded as one of the great advances in modern medicine. This article reviews the key events and discoveries that led up to the current CI systems, and we review and present some among the many possibilities for further improvements in device design and performance. The past achievements include: (1) development of reliable devices that can be used over the lifetime of a patient; (2) development of arrays of implanted electrodes that can stimulate more than one site in the cochlea; and (3) progressive and large improvements in sound processing strategies for CIs. In addition, cooperation between research organizations and companies greatly accelerated the widespread availability and use of safe and effective devices. Possibilities for the future include: (1) use of otoprotective drugs; (2) further improvements in electrode designs and placements; (3) further improvements in sound processing strategies; (4) use of stem cells to replace lost sensory hair cells and neural structures in the cochlea; (5) gene therapy; (6) further reductions in the trauma caused by insertions of electrodes and other manipulations during implant surgeries; and (7) optical rather electrical stimulation of the auditory nerve. Each of these possibilities is the subject of active research. Although great progress has been made to date in the development of the CI, including the first substantial restoration of a human sense, much more progress seems likely and certainly would not be a surprise.
Biomedical engineering principles of modern cochlear implants and recent surgical innovations
Anatomical record (Hoboken, N.J. : 2007), 2012
This review covers the most recent clinical and surgical advances made in the development and application of cochlear implants (CIs). In recent years, dramatic progress has been made in both clinical and basic science aspect of cochlear implantation. Today's modern CI uses multi-channel electrodes with highly miniaturized powerful digital processing chips. This review article describes the function of various components of the modern multi-channel CIs. A selection of the most recent clinical and surgical innovations is presented. This includes the preliminary results with electro-acoustic stimulation or hybrid devices and ongoing basic science research that is focused on the preservation of residual hearing post-implantation. The result of an original device that uses a binaural stimulation mode with a single implanted receiver/stimulator is also presented. The benefit and surgical design of a temporalis pocket technique for the implant's receiver stimulator is discussed. Ad...
Cochlear Implant Research Updates, 2012
Cochlear Implant Research Updates 4 patients who are not traditionally considered CI candidates (Gantz & Turner, 2003; Cohen et al., 2002). These patients are characterized by severe and profound thresholds at frequencies ≥1000 Hz, with near-normal or mild hearing losses in the low frequencies. These patients commonly present with monosyllabic word recognition scores <50%. In these cases the aim is to preserve functional low frequency hearing while providing additional high frequency information via the CI. Successful implantation of this group of hearing impaired patients requires meticulous microsurgical techniques. This chapter will explore the indications for use of A+E stimulation, patient outcomes, microsurgical techniques, electrode design and possibilities for future interventions.
Cochlear Implants: An Excursus into the Technologies and Clinical Applications
An Excursus into Hearing Loss, 2018
Hearing loss causes severe alterations in social function and daily communications. Cochlear device implantation (CDI) is the only beneficiary method for auditory rehabilitation in patients with severe to profound sensorineural hearing loss (SNHL). Regarding a report in 2014, over 300,000 people had received cochlear implants throughout the world since December 2012 among which about 60,000 were adults and 40,000 were children in the United States. In this chapter, we discuss the history, origin, mechanism of action, and type of cochlear implants, as well as method of surgery and complications.
Cochlear implants: A remarkable past and a brilliant future
Hearing Research, 2008
The aims of this paper are to (i) provide a brief history of cochlear implants; (ii) present a status report on the current state of implant engineering and the levels of speech understanding enabled by that engineering; (iii) describe limitations of current signal processing strategies; and (iv) suggest new directions for research. With current technology the ''average" implant patient, when listening to predictable conversations in quiet, is able to communicate with relative ease. However, in an environment typical of a workplace the average patient has a great deal of difficulty. Patients who are ''above average" in terms of speech understanding, can achieve 100% correct scores on the most difficult tests of speech understanding in quiet but also have significant difficulty when signals are presented in noise. The major factors in these outcomes appear to be (i) a loss of low-frequency, fine structure information possibly due to the envelope extraction algorithms common to cochlear implant signal processing; (ii) a limitation in the number of effective channels of stimulation due to overlap in electric fields from electrodes; and (iii) central processing deficits, especially for patients with poor speech understanding. Two recent developments, bilateral implants and combined electric and acoustic stimulation, have promise to remediate some of the difficulties experienced by patients in noise and to reinstate low-frequency fine structure information. If other possibilities are realized, e.g., electrodes that emit drugs to inhibit cell death following trauma and to induce the growth of neurites toward electrodes, then the future is very bright indeed. Ó 2008 Elsevier B.V. All rights reserved. ''.. .I am just as deaf as I am blind. The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus-the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man." These poignant descriptions convey the feelings of isolation that often accompany deafness. Beethoven stressed loneliness as the major hardship, as opposed to a separation from his music. Helen Keller stressed that ''blindness cuts one off from things, but deafness cuts one off from people." Just thirty years ago there were no effective treatments for deafness or severe hearing impairments. The advent of cochlear implants (CIs) changed that, and today implants are widely regarded as one of the great achievements of modern medicine.
The cochlear implant has not only provided partial hearing to more than 120,000 persons worldwide but also served as a model for successful academic and industrial collaboration. The present chapter reviews the development of modern cochlear implants and the dynamic interactions between academia and industry. The chapter takes a system approach to the cochlear implant system design and specifications. The design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator, and electrode arrays. Safety and reliability issues are considered in the context of the system design and the regulatory requirements. Future directions are discussed with regard to the expanded role of the cochlear implant in treatment of hearing impairment and in development of other neural prostheses.
Hospital chronicles, 2011
Extensive research has improved cochlear implant technology in a number of aspects. New coding strategies are important for better speech understanding and music appreciation. Obstructed cochleas can be implanted due to specially designed electrodes. Hybrid devices permit hearing preservation at the low frequencies which can be amplified with the use a hearing aid. Criteria for cochlear implant candidacy have been expanded from profound to severe sensorineural hearing loss. It is important for the Otolaryngologists to be informed about these advances in cochlear implant technology , in order to provide patients with the best options for hearing loss rehabilitation.
Conversations in Cochlear Implantation: The Inner Ear Therapy of Today
Biomolecules
As biomolecular approaches for hearing restoration in profound sensorineural hearing loss evolve, they will be applied in conjunction with or instead of cochlear implants. An understanding of the current state-of-the-art of this technology, including its advantages, disadvantages, and its potential for delivering and interacting with biomolecular hearing restoration approaches, is helpful for designing modern hearing-restoration strategies. Cochlear implants (CI) have evolved over the last four decades to restore hearing more effectively, in more people, with diverse indications. This evolution has been driven by advances in technology, surgery, and healthcare delivery. Here, we offer a practical treatise on the state of cochlear implantation directed towards developing the next generation of inner ear therapeutics. We aim to capture and distill conversations ongoing in CI research, development, and clinical management. In this review, we discuss successes and physiological constrai...