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Results for “Cochlear Implantation”

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PubMed2002

Pediatric cochlear implants.

Cochlear implants are a safe and effective treatment for children with severe to profound sensorineural hearing loss. As implant technology continues to improve and outcomes are analyzed, younger and younger children are being deemed candidates for implantation. The decision to operate is made after a thorough evaluation by a multidisciplinary team. This review will highlight the preoperative and postoperative issues related to pediatric cochlear implantation.

Age Factors↗

PubMed1997

Basic neurophysiology of cochlear-implants.

Cochlear implants work because the fibers of the auditory nerve can be stimulated electrically. Currently used multi-channel electrodes distribute the stimuli to different cochlear places (place principle) and provide information on the fine-time structure of the acoustic stimulus thus allowing periodicity analysis by the central nervous system. The paper treats the limitations of current cochlear implant technologies and discusses conceivable improvements.

Auditory Pathways↗

PubMedDate not supplied

Introduction to cochlear implants.

Cochlear implants have been very successful in restoring partial hearing to profoundly deaf people. Many individuals with implants are now able to communicate and understand speech without lip-reading, and some are able to talk over the phone. Children with implants can develop spoken-language skills and attend normal schools (i.e., schools with normal-hearing children). The greatest benefits with cochlear implantation have occurred in patients who (1) acquired speech and language before their hearing loss, and (2) have shorter duration of deafness. Gradual, but steady, improvements in speech production and speech perception have also occurred in prelingually deafened adults or children.

Adult↗

PubMed1999

[Advances of research on speech signal processing strategy in cochlear implant].

Cochlear implant is a new technology to restore hearing ability to totally deaf people. First of all, this paper presents its principle and system design. Then, the advances of research on its speech signal processing strategy is reviewed in detail. Finally, on the basis of preliminary results, further promising development in cochlear implant is proposed.

Algorithms↗

PubMed1986

Contraindications to cochlear implantation.

Cochlear implantation is still a controversial surgical procedure because its results in providing hearing for the deaf patient are far from ideal. The possible benefits of implantation should be carefully weighed against the complications that might arise. Many individuals with profound deafness are candidates for this procedure; however, there are some patients who are not. Contraindications to cochlear implantation, absolute and relative, systemic and local, are discussed. The surgeon's decision to withhold surgery is based on these contraindications.

Age Factors↗

PubMedDate not supplied

Observations on an experimental expansile electrode for use in cochlear implantation.

Cochlear implants in children must be designed to allow for a child's growth and maturation. An experimental animal study was performed to document the influence of head growth on a prototype expansile electrode system. Seven kittens were implanted with a stimulated electrode which had been coiled to allow for a two-to-one expansion in length. Head growth was monitored both by direct skull measurements and by serial radiography. The animals were sacrificed when they had reached maturity and the implanted devices were studied. When implanted in subcutaneous tissue, the coils became encased in fibrous tissue, while within air-containing spaces, such as the bulla, they distended freely. This suggested that a route which maximized the amount of air-containing space traversed by an electrode should be the preferred route for a cochlear implant in children.

Animals↗

PubMed1996

[Cochlear implants].

Cochlear implantation is a method of utmost importance recently employed in ear surgery. It makes even speech understanding possible with electrical stimulation of the inner ear in case of bilateral total deafness of cochlear origin. The authors have performed cochlear implantation for 10 years at the Ear-Nose and Throat Clinic of Semmelweis University. Since 1985 different implantation techniques have been used in case of 58 patients, both adults and children. The authors give account of of technical details, rapidly changing selection criteria and the call attention to the problems of peri- and postoperative period and rehabilitation, on they basis of their own results. Importance of team-work of the ear-surgeon, audiologist, psychologist, physicist and speech-therapist is emphasized, because success of the operation is based on proper selection, skillful operating techniques and postoperative rehabilitation, as well.

Cochlear Implants↗

PubMed2006

Cochlear implants.

Cochlear implants are cost-effective auditory prostheses that safely provide a high-quality sensation of hearing to adults who are severely or profoundly deaf. In the past 5 years, progress has been made in hardware and software design, candidate selection, surgical techniques, device programming, education and rehabilitation,and, most importantly, outcomes. Cochlear implantation in the elderly is well tolerated and provides marked improvement in auditory performance and psychosocial functioning.

Aged↗

PubMed1999

Auditory rehabilitation in neurofibromatosis type 2: a case for cochlear implantation.

Cochlear implantation has a limited but definite role in the rehabilitation of certain neurofibromatosis type 2 (NF2) patients. The presence of a dead ear either before, or after, tumour removal does not necessarily imply loss of function in the eighth nerve; in some instances the hearing loss will be cochlear. Promontory or round window electrical stimulation may help to identify those individuals with surviving eighth nerve function. In such patients multichannel cochlear implantation promises a better level of audition than the auditory brain stem implant. This paper highlights such a case and the management problems are discussed.

Adolescent↗

PubMed2003

Technology and the future of cochlear implants.

Cochlear implants are one of the dramatic success stories of the bioengineering enterprise. Although these prostheses are used extensively, they still can be improved substantially. We suggest that high-density electrode designs will permit field shaping and field steering to an extent not presently possible with the arrays that are used today. Those opportunities will make it possible to make use of the phase information that is richly available to normal listeners. Although this information makes possible more precise location of sound sources in the auditory environment, and will likely improve the recognition of intelligent sound in noise, it will require the consumption of additional power in future cochlear prostheses. Those opportunities and trade-offs provide the designers of cochlear implants with exciting goals for the future.

Biomedical Technology↗

PubMed2006

[Comparison of the clinic results of speech processing strategies and latest advances on cochlear implant].

Cochlear implant (CI) is a neural prosthetic device used to provide the sensation of sound to those who are profoundly deaf by delivering electrical stimulus to auditory nerve directly . It is becoming one of the main research frontiers in the area of otology and rehabilitation engineering . This symposium proposes an introduction about the new achievements of cochlear implant research , which consists of the following parts: the structure of CI, new speech processing strategies, comparison of the clinical results of speech processing strategies and the hotspots of the research.

Algorithms↗

PubMed2006

Use of neural response telemetry measures to objectively set the comfort levels in the Nucleus 24 cochlear implant.

Cochlear implant programming necessitates accurate setting of programming levels, including maximum stimulation levels, of all active electrodes. Frequently, clinical techniques are adequate for setting these levels; however, they are sometimes insufficient (e.g., very young children). In the Nucleus 24, several methods have been suggested for estimation of comfort levels (C levels) from neural response telemetry (NRT); however, many require co-application of clinical measurements. Data was obtained from 21 adult Nucleus 24 recipients to develop reliable predictions of C levels. Multiple regression analysis was performed on NRT threshold, slope of the NRT growth function, age, length of deafness, length of cochlear implant use and electrode impedance to examine predictive ability. Only the NRT threshold and slope of the growth function measures were significant predictors yielding R2 values from 0.391 to 0.769. Results demonstrated that these measures may provide an alternative means of estimating C levels when other clinical measures are unavailable.

Adult↗

PubMed2001

New method for inserting and fixing the active electrode during cochlear implantation.

Cochlear implantation has been performed for 15 years by the authors; altogether 117 implantations were carried out during this period. Different techniques had been used: at first after having performed atticoantrotomy the active electrode was inserted through posterior tympanotomy but fixing the electrode with this method was relatively not that easy. During the last 6 years implantations were carried out using the authors' new method. At the beginning of the operation cochleostomy was prepared by means of lateral tympanotomy. Introduction of the electrode was performed through a tunnel that had been drilled previously through the posterior wall of the external auditory canal. With a piece of muscle the active electrode was properly secured in the cochleostomy and also a narrow tunnel was prepared in the posterior wall for securing the cable with a Dacron tie. The authors' method of implantation proved to be perfect for introducing the electrode and also for fixing it with long-lasting results.

Cochlear Implantation↗

PubMedDate not supplied

[Preoperative computed tomography of temporal bones and its use in selecting patients with sensorineural deafness for cochlear implantation].

Cochlear implantation (CI) involves the insertion of electrode systems in the inner ear in order to restore hearing in patients with sensorineural deafness. Positive CI results are closely related with careful selection of candidates. Preoperative computed tomography (CT) and its results are decisive in this selection. Temporal bone CT was made in 40 patients aged 1 to 57 years who had sensorineural deafness. The following changes were detected: malformations of the inner ear, the inner auditory canal, meningititis-induced cochlear obliteration, post-traumatic temporal bone changes, local auditory ossicle malformation, inflammatory middle ear changes, the high position of the jugular vein bulb, and its diverticula. Temporal bone CT plays an important role in selecting candidates for CI and circumvents potential difficulties and complications at CI.

Adolescent↗

PubMed1995

Cochlear implants.

Cochlear implants are an appropriate alternative for selected deaf children and adults who do not benefit from conventional amplification. Improvements have been documented in speech perception and speech production skills. Multichannel systems, which provide spectral information in addition to temporal and intensity cues, have demonstrated performance advantages in children as they have in adults.

Age Factors↗

PubMed1992

Paediatric cochlear implantation.

Cochlear implantation may now be considered as a method of managing children with profound sensory hearing loss who do not benefit from conventional amplification. It involves a team approach with integration of many skilled individuals, as well as the child and his or her parents and family. As William House has said, in 1991, 'The future is not in the adult programme, but in the continued expansion of the children's programme'.

Child↗

PubMed1998

Cochlear implantation: an overview of existing implants.

Cochlear implants (CI) bypass the external and middle ear and parts of the inner ear, by delivering electrical stimuli to the remaining neural fibres of the acoustic nerve in a meaningful way. Many features of current CI are similar. They are all multi-channel devices with intracochlear placement of the active electrodes and with transcutaneous information and energy transfer. Factors affecting the auditory performance of CI recipients are patient-linked factors and device factors. An overview is given of key design parameters, processing characteristics and specifications of following CI platforms: Clarion S-Series, Combi 40 and Combi 40+, Digisonic DX 10, Laura-Flex and nucleus CI22 and CI24M. These data, combined with outcome parameters can enhance the information of CI-teams, patients or parents of children in their decision making process when faced with a hearing impairment to such an extent that hearing aids are of little or no benefit.

Cochlear Implantation↗

PubMed2001

Profiles of AEVs for intra- and post-operative integrity test measurements in young children with the Nucleus mini 22 cochlear implant.

Cochlear implantation of young children (<5 years of age) places additional demands on the implant team when compared to older children and adults. For these young children, it is essential to have integrity testing (IT) available to objectively assess the function of the internal device. Unfortunately, very few publications are available which document normal working ranges for IT. Thus the aim of the present study was to establish intra- and post-operative normal ranges for the averaged electrode voltage (AEV) which can be used in the clinical environment to assist in child management. As part of the routine protocol in Nottingham, IT was performed intra-operatively and 2 or 5 years post-operatively in common ground (CG) and pseudo-monopolar 1 (MP1) modes of stimulation on 30 children. All the children were implanted with the Nucleus mini 22 device. Normal ranges were calculated (mean +/- 1 standard deviation (SD)) for both intra- and post-operative measurements. In addition, the post-operative percentage changes in AEV amplitude were calculated for the 2-year and 5-year data groups. Data were excluded from calculations if an electrode was known or suspected to be faulty by visual examination of the AEV profile by an experienced observer. The results demonstrated that the profile of the AEV across the electrode array was preserved between intra- and post-operative recordings, although the amplitude of all AEVs decreased post-operatively. The percentage decrease (mean +/- SD) in (i) CG after 2 years was 69 (+/-16%), (ii) in CG after 5 years was 77 (+/-15%) and (iii) in MPI after 2 years was 35 (+/-1%). IT is a valuable objective tool to assess device function, in particular for young children. Normal AEV ranges are presented which can be used in the clinical environment to aid interpretation of IT performed intra- and post-operatively for CG and MP1 modes. Test data validate the implementation of normal ranges. Electrodes whose values of AEV amplitude fall outside the range should be investigated further.

Child, Preschool↗