Biomedical subjects
Publications and source records attributed to G Hortmann.
From july 1987 through july 1989, we have performed eight extra-cochlear implants for the rehabilitation of bilateral total deafness. In this paper we develop this experience, to give the positive aspects but also the negative ones and we give the reasons why we prefer currently the intra-cochlear implant. However this implant and its method are a good solution in case of an ossified cochlea.
The transcutaneous eight-channel extracochlear implant has undergone continuous revision to simplify the surgical technique, to minimize patient morbidity, and to improve performance. The extracochlear electrode array has been miniaturized so that it can be inserted through the facial recess without disturbing the external auditory canal, tympanic membrane, or malleus. The use of the remote antenna placed around the external auditory canal has greatly increased battery life and patient comfort. With its simplified incisions, the surgical procedure can be performed as out-patient surgery. Preoperative cochlear nerve testing and use of evoked response cochlear nerve testing allow preadjustment of the speech processor. Current features and performance of the implant are discussed.
The Cologne-Düren research group has developed a new extracochlear eight-channel electrode system. The first observations on six cases have shown encouraging psychoacoustic results.
We attempted to elaborate an operating method, whereby the electrodes could be placed without opening the scale tympani or vestibule. In this respect the medial wall of the tympanic cavity, i.e. the bony cochlear wall provides the most favourable means of access. It is easy to reach surgically and provides adequate access to the cochlea.
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Apart from detailed clinical ENT investigations on the indication for cochlear implant, we considered the following conditions and corresponding preliminary investigations to be indispensable: (1) confirmation of diagnosis of complete deafness, (2) the detection of sufficiently functional auditory nerve fibers, (3) clarification of the sociocultural conditions of the patient, (3.1) family conditions; possibility of auditory training at home, (3.2) psychological state, motivation for auditory training, and (3.3) degree of intelligence. Individual points are explained in accordance with our statistical data.
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In the Field of Cochlear Implant Research the new terms are presented in a number of different ways. Further the achieved results have been based on varying data, making a comparison extremely difficult when not impossible. The contributors to this publication attempt to standardize the terminology, electrical data, and the evaluation of the hearing result, in order to achieve an objective comparison.
Six patients are described following insertion of an 8-channel cochlear implant. The prosthesis was modified from the Vocoder technique, and was implanted by a simplified method of the procedure previously reported by us. In addition to the perception of background noise as well as the differentiation of periodicity and frequencies, a distinct improvement of the patients' speech discriminations could be observed with this technique.
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We report on our observations following our first cochlear-implant operation in a patient, and have found that the implantation of a single electrode can allow the patient to realize background noise.