A new behind the ear wearable speech processor for the Vienna cochlear prosthesis.
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Biomedical subjects
Publications and source records attributed to O Klasek.
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The authors present a 30 year old patient whose hearing was profoundly impaired in the course of meningitis 12 years ago. They present details on the preparation of the patient for the surgery and indications for the implant, consecutive stages of the surgery and the first stage of the rehabilitation process are described. The results of the capability of electrical conductivity of the cochlear nerve as the direct effect of the cochlear implant and the first audiogram illustrating the hearing effect after the first 2 months of rehabilitation are presented as well.
A behind the ear-wearable speech processor for the Vienna cochlear prosthesis has been designed. In a comparative study 6 patients used the new device for 1 week and were then tested. The results from the auditory test battery and a speech tracking were about the same, only the perception of speech from an open list was better when the patients used the conventional processor. It is possible to reduce the size of a speech processor substantially by modifying the speech-processing strategy without major decrease of the performance. More patients have to be tested after using the device for a longer time.
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The common selection criteria for cochlear implant patients do not allow any prognostic indication on the final result. On the other hand, some postoperative data (threshold, TDL, dynamic range, duration of deafness) corresponds clearly with the results, some of them also correspond with the preoperative data. Preoperative TDL, dynamic range as well as duration of deafness can therefore be used as suitable prognostic indicators.
Basing on the results obtained with 63 patients stimulated via the extracochlear or intracochlear version of the Vienna Cochlea Implant the following topics are discussed: Extracochlear versus intracochlear stimulation. Cochlea Implants in small children. Preoperative signs regarding the final result. Ideas for evaluation of results. Extracochlear or intracochlear stimulation enables speech understanding in about one-half of the postlingual deaf patients but the extent of speech recognition is greater when intracochlearly stimulated. Long-term follow-up as well as our experience with patients who had to be reimplanted demonstrate that the implantation manoevre does not create clinically relevant signs of damage. After the experiences with cochlear implants in adults their use in small children was encouraged, the more so since electric stimulation of prelingual deaf adults does not mediate speech recognition. There seems to be a chance to achieve speech comprehension if electric stimulation starts very early. The age limit in our group is the end of the third year. Final results cannot be presented but it is very clear that acoustic orientation and verbalisation are created and enhanced by electric stimulation. With regard to the preoperative prognosis, three parameters (threshold, dynamic range and TDL) are valid, of which TDL seems to be of major importance. The evaluation of the results should follow the hierarchical organisation of the language and must consider the three main levels of speech organisation.