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Maurer, Jan, Nicolaos Marangos i E. Ziegler. "Reliability of cochlear implants". Otolaryngology–Head and Neck Surgery 132, nr 5 (maj 2005): 746–50. http://dx.doi.org/10.1016/j.otohns.2005.01.026.
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BACKGROUND: The long-term reliability of cochlear implants over time is an important issue for patients and cochlear implant teams. The calculation of cumulative survival rates including all hard failures of cochlear implants is suitable to report objectively about cochlear implant reliability. METHODS: This is a report of 192 cochlear implants from different manufacturers in adults (n = 58) and children (n = 134). RESULTS: The overall cumulative implant survival rate was 91.7% for a period of 11 years. The main reasons for hard failures were design errors of the products and direct or indirect trauma to the cochlea implant site (especially in children) with consecutive breaks of the implant body or electrodes. CONCLUSIONS: To improve our knowledge about reliability of cochlear implants more studies on cumulative long time survival of cochlear implants are needed, where functional failures and complications for whatever reason (design, mechanical, electronic, medical) are included. Cochlear implant reliability data should be considered during the choice of an implant for each individual patient. (Otolaryngol Head Neck Surg 2005;132:746-50.)
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Islam, Rumana, i Mohammed Tarique. "Investigating the Performance of Gammatone Filters and Their Applicability to Design Cochlear Implant Processing System". Designs 8, nr 1 (2.02.2024): 16. http://dx.doi.org/10.3390/designs8010016.
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Commercially available cochlear implants are designed to aid profoundly deaf people in understanding speech and environmental sounds. A typical cochlear implant uses a bank of bandpass filters to decompose an audio signal into a set of dynamic signals. These filters’ critical center frequencies imitate the human cochlea’s vibration patterns caused by audio signals. Gammatone filters (GTFs), with two unique characteristics: (a) an appropriate “pseudo resonant” frequency transfer function, mimicking the human cochlea, and (b) realizing efficient hardware implementation, could demonstrate them as unique candidates for cochlear implant design. Although GTFs have recently attracted considerable attention from researchers, a comprehensive exposition of GTFs is still absent in the literature. This paper starts by enumerating the impulse response of GTFs. Then, the magnitude spectrum, , and bandwidth, more specifically, the equivalent rectangular bandwidth (ERB) of GTFs, are derived. The simulation results suggested that optimally chosen filter parameters, e.g., critical center frequencies,; temporal decay parameter, ; and order of the filter, , can minimize the interference of the filter bank frequencies and very likely model the filter bandwidth (ERB), independent of . Finally, these optimized filters are applied to delineate a filter bank for a cochlear implant design based on the Clarion processor model.
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Toulemonde, Philippine, Michaël Risoud, Pierre Emmanuel Lemesre, Cyril Beck, Jean Wattelet, Meryem Tardivel, Juergen Siepmann i Christophe Vincent. "Evaluation of the Efficacy of Dexamethasone-Eluting Electrode Array on the Post-Implant Cochlear Fibrotic Reaction by Three-Dimensional Immunofluorescence Analysis in Mongolian Gerbil Cochlea". Journal of Clinical Medicine 10, nr 15 (28.07.2021): 3315. http://dx.doi.org/10.3390/jcm10153315.
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Cochlear implant is the method of choice for the rehabilitation of severe to profound sensorineural hearing loss. The study of the tissue response to cochlear implantation and the prevention of post-cochlear-implant damages are areas of interest in hearing protection research. The objective was to assess the efficacy of dexamethasone-eluting electrode array on endo canal fibrosis formation by three-dimensional immunofluorescence analysis in implanted Mongolian gerbil cochlea. Two trials were conducted after surgery using Mongolian gerbil implanted with dexamethasone-eluting or non-eluting intracochlear electrode arrays. The animals were then euthanised 10 weeks after implantation. The cochleae were prepared (electrode array in place) according to a 29-day protocol with immunofluorescent labelling and tissue clearing. The acquisition was carried out using light-sheet microscopy. Imaris software was then used for three-dimensional analysis of the cochleae and quantification of the fibrotic volume. The analysis of 12 cochleae showed a significantly different mean volume of fibrosis (2.16 × 108 μm3 ± 0.15 in the dexamethasone eluting group versus 3.17 × 108 μm3 ± 0.54 in the non-eluting group) (p = 0.004). The cochlear implant used as a corticosteroid delivery system appears to be an encouraging device for the protection of the inner ear against fibrosis induced by implantation. Three-dimensional analysis of the cochlea by light-sheet microscopy was suitable for studying post-implantation tissue damage.
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Ajieren, Hans, Radu Reit, Roxanne Lee, Tiffany Pham, Dongmei Shao, Kenneth Lee i Walter Voit. "Robotic Insertion Aid for Self-Coiling Cochlear Implants". MRS Advances 1, nr 1 (2016): 51–56. http://dx.doi.org/10.1557/adv.2016.71.
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ABSTRACTThis study investigates the use of shape memory polymers (SMPs) as a substrate for a self-coiling cochlear implant electrode array and investigates the self-coiling ability of a sham probe micromachined atop such a substrate. Through the use of a self-coiling cochlear implant, the capability to avoid contact with the tissue of the cochlear duct is investigated via the insertion of a dummy device into a model cochlea heated to an ambient 34 °C. Finally, a prototype straightening and insertion tool is developed for automated retraction and locking of the coiled shape into a bar geometry. Preliminary demonstration of the deployment of self-coiling cochlear implants is shown and paves the way for future studies focused on using histological analysis of the cochlear wall tissue to compare the degree of trauma resulting from linear cochlear implant arrays versus the self-coiling, non-contact probes demonstrated herein.
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Pamuk, G., A. E. Pamuk, A. Akgöz, E. Öztürk, M. D. Bajin i L. Sennaroğlu. "A study on modelling cochlear duct mid-scalar length based on high-resolution computed tomography, and its effect on peri-modiolar and mid-scalar implant selection". Journal of Laryngology & Otology 133, nr 09 (19.08.2019): 764–69. http://dx.doi.org/10.1017/s0022215119001671.
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AbstractObjectiveTo determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length.MethodsThe study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the ‘X’ line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured.ResultsCochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line.ConclusionUsing the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.
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Jackler, Robert K., Patricia A. Leake i William S. McKerrow. "Cochlear Implant Revision: Effects of Reimplantation on the Cochlea". Annals of Otology, Rhinology & Laryngology 98, nr 10 (październik 1989): 813–20. http://dx.doi.org/10.1177/000348948909801012.
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The removal of an indwelling cochlear implant electrode followed by reinsertion of a new device has been a maneuver of uncertain cosequences to the cochlea and its surviving neural population. The present study was conducted in an attempt to elucidate the factors at determine whether a reimplantation procedure will be successful. Cochlear implantation followed by explanation and subsequent implantation was performed in eight adult cats. Evaluation of cochlear histopathology suggested a significant increase in electrode insertion trauma when there was proliferation of granulation tissue in the round window area and scala tympani. In other cases, atraumatic insertion was achieved without apparent injury to the cochlea. The results of a survey of cochlear implant manufacturers and surgeons indicate that electrode replacement can usually be accomplished without adverse effects. Difficulties have been encountered, however, in moving implants with protuberant electrodes and when reimplantation was attempted on a delayed basis following explanation.
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Swain, Santosh Kumar. "Cochlear deformities and its implication in cochlear implantation: a review". International Journal of Research in Medical Sciences 10, nr 10 (27.09.2022): 2339. http://dx.doi.org/10.18203/2320-6012.ijrms20222547.
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Hearing loss is one of the world’s leading causes of chronic health conditions. Cochlea plays a vital role in the hearing mechanisms and it converts sound energy into electrical stimuli which are transmitted to the brain through the neural pathway. The human cochlea is difficult to explore because of its vulnerability and bordering bony capsule. Congenital malformation of the inner ear or cochlea is an important cause of congenital sensorineural hearing loss. The deformity of the cochlea may result from arrested development of cochlea at different stages of fetal life or from abnormal development due to genetic abnormalities. There are hair cells responsible for converting sound energy into electrical impulses. These hair cells are easily damaged, which results in permanent hearing loss. Cochlear implants are surgically implantable biomedical devices that bypass the sensory hair cells and directly stimulate the remaining fibers of the auditory nerve with an electric current. Cochlear implantation is capable of restoring a surprisingly large degree of auditory perception to patient that is suffering from severe to profoundly deaf. Children with cochlear anomalies are thought to have poorer outcomes with cochlear implantations, therefore would be poorer candidates due to their diminished ability to interpolate and use auditory information provided through a cochlear implant. Parents should be counselled to establish realistic post-implant expectations in case of children with cochlear deformity. So, patient selection has emerged as one of the most vital determinants of successful outcomes after pediatric cochlear implantation.
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Todt, I., R. Guerkov, H. B. Gehl i H. Sudhoff. "Comparison of Cochlear Implant Magnets and Their MRI Artifact Size". BioMed Research International 2020 (10.01.2020): 1–8. http://dx.doi.org/10.1155/2020/5086291.
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Introduction. Recent developments regarding cochlear implant magnets (e.g., a bipolar diametral magnet) and refined surgical techniques (e.g., implant positioning) have had a significant impact on the relation between cochlear implants and MRIs, making the reproducible visibility of cochlea and IAC possible. MRI scanning has changed from a contraindication to a diagnostic tool. Magnet artifact size plays a central role in the visual assessment of the cochlea and IAC. Objective. The aim of this study is to compare the CI magnet-related maximum artifact sizes of various cochlea implant systems. Materials and Methods. We performed an in vivo measurement of MRI artifacts at 1.5 and 3 Tesla with three cochlear implant magnet systems (AB 3D, Medel Synchrony, and Oticon ZTI). The implant, including the magnet, was positioned with a head bandage 7.0 cm and 120° from the nasion, external auditory canal. We used a TSE T2w MRI sequence on the axial and coronal plains and compared the artifacts in two volunteers for each tesla strength. Results. Intraindividual artifact size differences between the three magnets are smaller than interindividual maximum artifact size differences. 3 T MRI scans, in comparison to 1.5 T MRI scans, show a difference between soft artifact areas. Conclusion. We observed no major difference between maximum implant magnet artifact sizes of the three implant magnet types.
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AKKAPLAN, Selvet, Merve ÖZBAL BATUK, Hilal DİNÇER D’ALESSANDRO i Gonca SENNAROĞLU. "İnkomplet partisyon tip II bulunan unilateral ve bimodal koklear implant kullanıcılarının konuşma, uzaysal algı ve işitme kalitesinin değerlendirilmesi". Turkish Journal of Audiology And Hearing Research 4, nr 3 (grudzień 2021): 63–68. http://dx.doi.org/10.34034/tjahr.977893.
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Evaluation of the speech, spatial and qualities of hearing in unilateral and bimodal cochlear implant users with incomplete partition type II Objective: The aim of this study was to perform a scale-based assessment of the hearing abilities of cochlear implant users with IP type II malformation and normal cochlea, including discrimination, orientation, and positioning of speech and environmental sounds in their environment. Material and Methods: A total of 30 cochlear implant users, 15 participants with IP-II inner ear anomalies and 15 participants with normal cochlea, aged 18-55 years were included in this study. All participants included in the study are unilateral CI and bimodal users. Participants were assessed using the Speech, Spatial, and Hearing Qualities Scale (SSQ). Results: When cochlear implant users with IP-II malformations and cochlear implant users with normal cochlea individually scored auditory abilities, the results were similar. It was observed that bimodal listeners tended to have all subdomains and overall SSQ scores compared to use of unilateral CI. Conclusion: It is very important to benefit from the advantages of binaural hearing in hearing sounds. It is thought that the use of scales as well as routine audiological evaluation batteries in the follow-up processes of cochlear implant users will be beneficial for audiologists. Keywords: Cochlear implant, speech perception, spatial perception, hearing quality
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Zahara, Devira, Rima Diana Dewi, Askaroellah Aboet, Fikri Mirza Putranto, Netty Delvrita Lubis i Taufik Ashar. "Variations in Cochlear Size of Cochlear Implant Candidates". International Archives of Otorhinolaryngology 23, nr 02 (24.10.2018): 184–90. http://dx.doi.org/10.1055/s-0038-1661360.
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Introduction The cochlear anatomy varies in each individual, and that has an impact on decisions regarding the insertion of electrodes. The measurement of the cochlear size is the routine examination required to choose the proper cochlear implant (CI) electrodes. Objective To acquire normative data on the size of the cochlea (length, width, height, scala timpani [ST] height, cochlear duct length [CDL]) of CI candidates in Medan, Indonesia. Methods This descriptive study was conducted based on high-resolution computed tomography (HRCT) temporal bone data and on HRCT temporal data manipulated to reconstruct three-dimensional (3D) multiplanar images with OsiriX MD DICOM Viewer version 9.5.1 (Pixmeo SARL, Bernex, Geneva, Switzerland) viewer of 18 patients (36 ears) who were CI candidates in Medan, Indonesia, in order to determine cochlear length (A), cochlear width, cochlear height, ST height and CDL, calculated through a simple mathematical function. Results The average cochlear length (A) was 8.75 mm (standard deviation [SD] = 0.31 mm); the average cochlear width was 6.53 mm (SD = 0.35 mm); the average cochlear height was 3.26 mm (SD = 0.24 mm) and the average ST height at the basal cochlea was 1.00 mm (SD = 0.1 mm); and 0.71 mm (SD = 0.1 mm) at the half turn of cochlea. The average total CDL was 32.45 mm (SD = 1.31 mm; range: 30.01–34.83 mm). Conclusion The cochlear size varies in each individual; therefore, the temporal bone measurement of CI candidates using HRCT is essential: for the selection of suitable implant electrodes; to minimize cochlear damages at the insertion of the electrode arrays; and to maximize the hearing improvements.
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Langman, Alan W., i Suzanne M. Quigley. "Accuracy of High-Resolution Computed Tomography in Cochlear Implantation". Otolaryngology–Head and Neck Surgery 114, nr 1 (styczeń 1996): 38–43. http://dx.doi.org/10.1016/s0194-59989670281-4.
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Multichannel cochlear implants are a proven method for the auditory rehabilitation of individuals who have severe-to-profound sensorineural hearing loss. These devices typically require insertion into the scala tympani of the cochlea to provide auditory stimulations. A patent scala provides the best chance for an adequate insertion of the electrode array. Preoperative high-resolution computed tomography imaging has traditionally been used to determine the patency of the scala tympani. Its ability to accurately predict the patency of the cochlea has been questioned in several retrospective studies. A prospective study was undertaken in 28 consecutive individuals undergoing cochlear implant surgery to compare the findings on high-resolution computed tomography with the surgical findings in an attempt to determine high-resolution computed tomography's accuracy. Cochlear obstruction caused by ossification was accurately predicted in six of six individuals but overestimated in the round window region in three individuals. High-resolution computed tomography accurately predicted patent cochleas in 19 individuals. No false-negative results were encountered. In this study sensitivity of high-resolution computed tomography was 100%, and specificity was 86%. High-resolution computed tomography appears to be more helpful than previously reported for determining cochlear patency.
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Graham, John M., Peter D. Phelps i Leslie Michaels. "Congenital malformations of the ear and cochlear implantation in children: review and temporal bone report of common cavity". Journal of Laryngology & Otology 114, S25 (marzec 2000): 1–14. http://dx.doi.org/10.1258/0022215001904842.
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The objective of this review is to analyze aspects of congenital malformation of the ear in relation to cochlear implantation in children. Having briefly described the in utero development of the ear and the classification of types of external, middle and inner ear malformation, five practical aspects of these malformations are discussed. It seems likely that the combination of bilateral profound sensorineural deafness with bilateral microtia severe enough to make a surgical approach to the cochlea difficult will be extremely uncommon. No such cases have been reported, although Klippel-Feil deformity seems the syndrome most likely to produce this set of circumstances.Abnormalities in the intratympanic course of the facial nerve have been associated with cochlear malformation, emphasizing the benefit of intra-operative facial nerve monitoring, and a technique suggested for safely avoiding an abnormally placed nerve. Fistulae of cerebrospinal fluid (CSF) and perilymph can complicate surgery and are relatively common in common cavity and Mondini malformations. Strategies for facilitating surgery in the presence of ‘gushers’, for measuring the pressure of a gusher and for placement of the cochlear implant electrode array are reviewed, with reports of fluctuating levels of electric current when implants lie in dysplastic cochleas.The relationship of implant performance to VIIIth nerve tissue in malformed cochleas is discussed, with a description of the histological findings in a common cavity cochlea. Techniques for identifying the absence of the cochlear nerve are reviewed. Stimulation of the facial nerve by cochlear implants has been described in cases of congenital malformation of the labyrinth but is relatively uncommon. Case reports of the benefit received by implanted children with congenital cochlear malformation have appeared since 1988. Most cases reported have not yet been followed for long enough to establish a clear picture of the outcome following cochlear implantationin such children; no centre has yet built up a large series of cases, but there have been two multicentre postal surveys. It seems likely that in cochlear malformation the range of potential outcomes in terms of hearing threshold and the development of speech perception and production will be similar to the range found in implanted children without cochlear dysplasia. However there is, as yet, no clear picture of the mean level of performance within this range.
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Deep, Nicholas, Baishakhi Choudhury i J. Roland. "Auditory Brainstem Implantation: An Overview". Journal of Neurological Surgery Part B: Skull Base 80, nr 02 (14.02.2019): 203–8. http://dx.doi.org/10.1055/s-0039-1679891.
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AbstractAn auditory brainstem implant (ABI) is a surgically implanted central neural auditory prosthesis for the treatment of profound sensorineural hearing loss in children and adults who are not cochlear implant candidates due to a lack of anatomically intact cochlear nerves or implantable cochleae. The device consists of a multielectrode surface array which is placed within the lateral recess of the fourth ventricle along the brainstem and directly stimulates the cochlear nucleus, thereby bypassing the peripheral auditory system. In the United States, candidacy criteria for ABI include deaf patients with neurofibromatosis type 2 (NF2) who are 12 years or older undergoing first- or second-side vestibular schwannoma resection. In recent years, several non-NF2 indications for ABI have been explored, including bilateral cochlear nerve avulsion from trauma, complete ossification of the cochlea due to meningitis, or a severe cochlear malformation not amenable to cochlear implantation. In addition, growing experience with ABI in infants and children has been documented with encouraging outcomes. While cochlear implantation generally remains the first-line option for hearing rehabilitation in NF2 patients with stable tumors or post hearing preservation surgery where hearing is lost but a cochlear nerve remains accessible for stimulation, an ABI is the next alternative in cases where the cochlear nerve is absent and/or if the cochlea cannot be implanted. Herein, we review ABI device design, clinical evaluation, indications, operative technique, and outcomes as it relates to lateral skull base pathology.
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Swain, Santosh Kumar. "Vertigo following cochlear implantation: a review". International Journal of Research in Medical Sciences 10, nr 2 (29.01.2022): 572. http://dx.doi.org/10.18203/2320-6012.ijrms20220310.
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Cochlear implantation may cause a detrimental effect on vestibular function and residual hearing. A significant number of patients with a cochlear implant present with vertigo. There are several mechanisms for dizziness following cochlear implantations. The causes may be surgical trauma, disruption of normal cochlear physiology, or ensuing endolymphatic hydrops. Vibratory trauma affecting the cochlea during cochleostomy plays a vital role in causing paroxysmal vertigo in patients with a cochlear implant. In addition, the vibrations affecting the cochlea are enough to dislodge otoconia particles. During cochlear implantation, it is necessary to insert an electrode array into the cochlea and thus the chance of damage to cochlear and function may happen. Dizziness or vertigo may develop after cochlear implantation. It usually occurs due to vestibular hypofunction. Vertigo following cochlear implantation has not frequently been documented in the literature previously. However, the increasing number of cochlear implantations in the current scenario is showing different postoperative complications like vestibular symptoms among patients with an implant. The vestibular symptoms following cochlear implantation range from a gradual sense of mild unsteadiness or lightheadedness to brief attacks of whirling vertigo. Vertigo following cochlear implantations affects the quality of life although vestibular therapy is often helpful to manage this condition. The article aims to provide a comprehensive review of vertigo following cochlear implantation.
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Swain, Santosh Kumar. "Current criteria for selecting cochlear implant in deaf patients: a review". International Journal of Advances in Medicine 9, nr 1 (23.12.2021): 50. http://dx.doi.org/10.18203/2349-3933.ijam20214881.
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Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.
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Graham, J., C. Lynch, B. Weber, L. Stollwerck, J. Wei i G. Brookes. "The magnetless Clarion® cochlear implant in a patient with neurofibromatosis 2". Journal of Laryngology & Otology 113, nr 5 (maj 1999): 458–63. http://dx.doi.org/10.1017/s0022215100144214.
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AbstractWe present our experience using the Clarion® magnetless multichannel cochlear implant with a woman profoundly deafened following bilateral acoustic neuromata as a consequence of neurofibromatosis 2 (NF2). The right neuroma had been previously removed without an attempt at neural preservation. On the left, however, a posterior fossa approach had been taken with the aim of preserving hearing. Although the left cochlear nerve appeared to be undamaged at the end of the operation, no hearing thresholds could be elicited on post-operative audiometry, because of damage either to the cochlear nerve or to the blood supply to the cochlea. Round window electrical stimulation subsequently produced a perception of sound, confirming that the cochlear nerve was capable of functioning and that a cochlear implant would be effective. Because she would need regular magnetic resonance imaging (MRI) to monitor existing and future NF2 lesions, it was decided to use a magnetless Clarion® implant, which has been shown to be MRI compatible. We report our experience of using the device in this case and discuss some of the issues related to the provision of cochlear implants to patients with NF2.
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Neria, Christy M. "Where Are the Voices of Adolescents? An Examination of Adolescent Cochlear Implant Users' Socio-Emotional Development". Perspectives on School-Based Issues 10, nr 4 (grudzień 2009): 123–26. http://dx.doi.org/10.1044/sbi10.4.123.
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Abstract The advancement of cochlear implant technology has led researchers to focus on its functionality, rather than the socio-emotional effects cochlear implants may have on young recipients. This paper will examine recent research on social-emotional development of cochlear implant recipients while discussing the importance of exploring the social emotional responses of adolescents with cochlear implants.
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Sampaio, André L. L., Mercêdes F. S. Araújo i Carlos A. C. P. Oliveira. "New Criteria of Indication and Selection of Patients to Cochlear Implant". International Journal of Otolaryngology 2011 (2011): 1–13. http://dx.doi.org/10.1155/2011/573968.
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Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant.
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Noda, T., Y. Kakazu i S. Komune. "Cochlear implants for mumps deafness: two paediatric cases". Journal of Laryngology & Otology 129, S2 (23.02.2015): S38—S41. http://dx.doi.org/10.1017/s0022215114002369.
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AbstractBackground:Good outcomes have been reported regarding the use of cochlear implants for mumps deafness. The mumps virus induces meningitis and/or encephalitis, which can cause central nervous system damage resulting in retrolabyrinthine hearing loss, for which a cochlear implant would be less effective.Cases:We installed a cochlear implant in two patients with bilateral mumps deafness; one achieved a good result with the cochlear implant, but the other did not. We discuss two possible reasons for the different outcomes. Case 1 was a three-year-old girl with bilateral parotid swelling, vomiting and walking disorder. One year after cochlear implant insertion, speech perception did not develop despite of good pure tone thresholds. Case 2 was an eight-year-old girl with bilateral parotid swelling. A cochlear implant enabled her to improve hearing perception.Conclusion:Although cochlear implants have been reported to be helpful for mumps deafness, cases that involve central nervous system damage may not achieve good results.
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Khan, Aayesha M., Ophir Handzel, Donald K. Eddington, Doris Damian i Joseph B. Nadol. "Effect of Cochlear Implantation on Residual Spiral Ganglion Cell Count as Determined by Comparison with the Contralateral Nonimplanted Inner Ear in Humans". Annals of Otology, Rhinology & Laryngology 114, nr 5 (maj 2005): 381–85. http://dx.doi.org/10.1177/000348940511400508.
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It is generally assumed that at least a minimal number of spiral ganglion cells is essential for successful speech perception with a cochlear implant. Although the insertion of a multichannel cochlear implant frequently results in loss of residual hearing in the implanted ear, this outcome does not imply that significant damage to residual populations of spiral ganglion cells has occurred. The purpose of the current study was to compare spiral ganglion cell counts in implanted and nonimplanted cochleas in 11 patients for whom both temporal bones were available and in whom a multichannel cochlear implant had been placed unilaterally. The temporal bones were processed for light microscopy by standard techniques. The cochleas were reconstructed by 2-dimensional methods. Spiral ganglion cell counts of the implanted and nonimplanted sides were compared by a paired t-test (2-tailed). The mean spiral ganglion cell counts for implanted and nonimplanted ears were not statistically different in the most basal three segments of the cochlea. However, the mean spiral ganglion cell count in segment 4 (apical segment) and the mean total spiral ganglion cell count were lower in the implanted cochleas than in the nonimplanted cochleas (p < .01). The results of this study suggest a modest decrease in the total spiral ganglion cell count in the implanted ears as compared to the nonimplanted ears, principally in the apical segment. Possible interpretations of this finding are discussed.
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Balkany, Thomas, Bruce Gantz i Joseph B. Nadol. "Multichannel Cochlear Implants in Partially Ossified Cochleas". Annals of Otology, Rhinology & Laryngology 97, nr 5_suppl2 (wrzesień 1988): 3–7. http://dx.doi.org/10.1177/00034894880975s201.
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Deposition of bone within the fluid spaces of the cochlea is encountered commonly in cochlear implant candidates and previously has been considered a relative contraindication to the use of multichannel intracochlear electrodes. This contraindication has been based on possible mechanical difficulty with electrode insertion as well as uncertainty about the potential benefit of the multichannel device in the patient. Fifteen profoundly deaf patients with partial ossification of the basal turn of the cochlea received implants with long intracochlear electrodes (11, Nucleus; 1, University of California at San Francisco/Storz; and 3, Symbion/Inneraid). In 11 cases, ossification had been predicted preoperatively by computed tomographic scan. Electrodes were completely inserted in 14 patients, and partial insertion was accomplished in one patient. All patients currently are using their devices and nine of 12 postlingually deaf patients have achieved some degree of open-set speech discrimination. This series demonstrates that in experienced hands, insertion of long multichannel electrodes into partially ossified cochleas is possible and that results are similar to those achieved in patients who have nonossified cochleas.
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Melo, Juliana Jandre, Paula Carolina Dias Gibrin i Luciana Lozza de Moraes Marchiori. "Vestibular dysfunction and postural balance in cochlear implant users: a narrative literature review". Revista CEFAC 20, nr 1 (luty 2018): 101–9. http://dx.doi.org/10.1590/1982-021620182019016.
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ABSTRACT Cochlear implants directly stimulate nerve fibers and ganglion cells of the auditory nerve, which transform sound energy into low levels of electrical current, stimulating the remaining fibers of the auditory nerve in patients with severe to profound hearing loss, in order to provide the significant range of auditory sensation and speech comprehension. Due to the close relationship between cochlea and vestibular receptors, some patients may present vestibular and postural balance changes concomitantly after surgery. This study aimed to perform a narrative review of the main studies that relate vestibular symptoms in patients implanted in the last six years. The research was performed through the databases: SciELO, LILACS and PubMed, using associated descriptors for "cochlear implant", "vestibular dysfunction", "vertigo" and "balance", totalizing 21 studies that fitted the inclusion criteria. The results were described in a chronological order of publication, showing the main conclusions. Of the total studies analyzed, 18 related vestibular function to cochlear implant and only 3 studies did not find such a relationship. The literature characterize the effects of the cochlear implant on the vestibular system, however, the results are contradictory.
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Tyler, Richard S., i Mary W. Lowder. "Audiological Management and Performance of Adult Cochlear-Implant Patients". Ear, Nose & Throat Journal 71, nr 3 (marzec 1992): 117–28. http://dx.doi.org/10.1177/014556139207100302.
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We review the signal-processing strategies of three of the most common cochlear implants in use today, the single-channel House, the multichannel Nucleus, and the Ineraid devices. The results of 65 postlinguistically-deafened patients tested at The University of Iowa are reviewed. The tests include everyday sound, accent, word and sentence recognition, as well as noise/voice differentiation. For all tests, patients with the Nucleus and Ineraid cochlear implants outperformed those with the House implant. In general, selection criteria should focus on comparing the performance of Patients who have already received an implant. Prelinguistically-deafened adults are typically not good cochlear-impact candidates. Cochlear-implant teams should be aware of the enormous time commitment for testing and rehabilitation of these patients, and be prepared to handle frequent implant breakdowns. Nevertheless, cochlear-implant patients have been helped significantly be these devices.
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Summers, K. F., N. R. Harn, L. N. Ledbetter, J. D. Leever i J. R. Bertsch. "Imaging of Auditory Brain Stem Implants". Neurographics 10, nr 4 (1.08.2020): 202–10. http://dx.doi.org/10.3174/ng.1900050.
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Auditory brain stem implants are infrequently encountered neuroprosthetic devices used for auditory rehabilitation in deaf patients with pathology between the cochlea and cochlear nuclei who would not benefit from cochlear implantation. This article reviews the device, the relevant anatomy, audiologic performance, operative approaches, and conditions in which auditory brain stem implants are indicated. The imaging appearance of auditory brain stem implants, including optimal lead positioning, and imaging safety considerations of the device are also discussed. Knowledge of the device can assist the radiologist in detecting postoperative complications and component malpositioning and in providing safe and effective imaging practices in patients with indwelling auditory brain stem implants.Learning Objective: To describe the auditory brain stem implant device, identify optimal lead positioning, and list indications for auditory brain stem implant placement.
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Levin, S. V., A. S. Lilenko, E. A. Levina, V. E. Kuzovkov, M. Shukuryan, A. E. Pashkova i V. A. Voronov. "Tonotopic fitting of the sound processor cochlear implant in normal cochlea anatomy". Meditsinskiy sovet = Medical Council, nr 7 (8.05.2023): 124–31. http://dx.doi.org/10.21518/ms2023-125.
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Introduction. Cochlear implantation is very effective due to the known tonotopic organization of the cochlea. These data are used in the distribution of signals along the channels of the cochlear implant electrode. The more accurate and natural the stimulation of the auditory nerve fibers, the better the perception of speech, sounds and speech intelligibility.The aim of the study was to compare the clinical and anatomical settings of the cochlear implant processor.Materials and methods. The study included 63 patients aged 2 to 60 years using cochlear implantation system, implants with a standard long electrode array (31.5 mm). All participants underwent computed tomography (CT) of the temporal bones with a step of 0.6 mm or less. CT data were processed using Otoplan and Sliser 3D software. The geometric dimensions of the cochlea, the length of the cochlear canal, the angular position and tonotopic frequency of each electrode were calculated, and a 3D reconstruction of the cochlea and electrode was built.Results. The correction of the frequency filters of the electrodes and the anatomical adjustment of the processor were performed according to the data obtained in the Otoplan program. A comparison was made between the clinical and anatomical setting. After the redistribution of frequency filters, patients noted a more natural sound, improved speech intelligibility. Thus, with anatomical adjustment, an exact correspondence is achieved between the central frequency of each electrode channel and the tonotopic frequency of the cochlear zone, individually determined by computed tomography.Conclusions. A new tool has appeared that allows you to significantly improve the quality and provide an individual approach to setting up processors after cochlear implantation.
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Mawman, D. J., J. D. Edwards, E. C. Giles, D. Y. Aplin, M. O'Driscoll, T. J. Woolford i R. T. Ramsden. "An audit of the cochlear implant service in Manchester". Journal of Laryngology & Otology 110, nr 11 (listopad 1996): 1046–54. http://dx.doi.org/10.1017/s0022215100135728.
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AbstractThe adult cochlear implant programme in Manchester was established in 1988 and the evaluation of the cochlear implant service involved the first 58 implants users (mean age = 51.65 years, range 19–75 years). Questionnaires were sent to implant users and their partners to evaluate the service with regard to provision of information, clinical care during in-patient assessments, waiting times, operation for cochlear implant and postoperative rehabilitation. The results show that the majority of patients (78 per cent) felt that the implant gave them as much or more benefit than expected. Areas identified for improvements include provision of more written information about cochlear implants; reduction in waiting times for first appointments; more information about the surgical risks and more instruction about home auditory training exercises for family and friends.As a consequence of the audit results the clinical practice and service provision for cochlear implantation in Manchester has been modified.
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Sudianto Utama, Muhammad Arif, i Artono Artono. "TIGA KASUS IMPLAN KOKLEA PADA DISPLASIA MONDINI". Jurnal Ilmiah Kedokteran Wijaya Kusuma 8, nr 2 (12.10.2019): 59–74. http://dx.doi.org/10.30742/jikw.v8i2.573.
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Mondini dysplasia is a kind of cochlear malformation caused by a failure growth of cochlea in the seventh week of pregnancy, results in cochlear turn which only reaches 1,5 turn until less than 2,5 turn. There is sensorineural hearing loss in Mondini dysplasia caused by anatomical malformation. The diagnosis of Mondini dysplasia is made by accurate anamnesis, audiology assessments and imaging results. This case study explains the importance of the holistic process of diagnosis and treatment of Mondini's dysplasia. Purpose: To explain that Mondini dysplasia should be diagnosed immediately and given the cochlear implant. Cases: There had been reported three cases of cochlear malformation of Mondini dysplasi type. They were first diagnosed with sensorineural hearing loss and speech delay in the age of 2-4 years. After had been done sequence of audiology assessments and imaging CT-scan and MRI simultaneously there were obtained that those three patients had Mondini dysplasia. Case Management: The use of hearing aid in those three patients had no effectiveness that brought them to the decision of cochlear implantation. Cochlear implant became such a great challenge even through for experienced physicians considering the scarcity of the case and the risk for complications like pelymph gusher and incorrect insertion of electrode. Cochlear implant surgeries had been done to those three patients with carefu consideration and the selection for appropriate type of electrode. On the first case there had been applied right ear cochlear implant, on the second case was bilateral, and on the third case was in the left ear. Complications of the surgeries were bleeding and perilymph gusher but they had been solved properly. Electrode insertion in all three cases had been placed correctly. Conclusion: Found three cases of Mondini dysplasia with symptoms of bilateral hearing loss, speech development, bilateral Mondini dysplasia, techniques and complications of cochlear implants. These three cases differ in the shape, width and size of the cochlear anatomy if they are studied more specifically. Two cases of unilateral cochlear implant placement and one bilateral case.
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Phelps, P. D. "Cochlear implants for congenital deformities". Journal of Laryngology & Otology 106, nr 11 (listopad 1992): 967–70. http://dx.doi.org/10.1017/s0022215100121486.
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AbstractThere have been few accounts of multi-channel cochlear implants in patients with congenital structural deformities of the inner ear which are associated with severe and sometimes progressive deafness. These malformations can now be recognized easily on 2 plane thin section high resolution CT studies which are mandatory for the pre-implantation assessment. However, no attempt seems to have been made to describe which of these malformations would be suitable for an implant or for which would this procedure be contra-indicated. True Mondini deformity of both the cochlea and dilated vestibular aqueduct type would appear suitable for a multi channel implant, but this type of implant should not be used for a primitive otocyst, severe labyrinthine dysplasia or the characteristic X-linked deformity.
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Sismono, Fergio, Lucia Mancini, Marc Leblans, Jana Goyens, Glynnis De Greve, Sara Schneiders, Karen Beckers, Joris Dirckx, Bert De Foer i Andrzej Zarowski. "Synchrotron radiation X-ray microtomography for the visualization of intra-cochlear anatomy in human temporal bones implanted with a perimodiolar cochlear implant electrode array". Journal of Synchrotron Radiation 28, nr 1 (1.01.2021): 327–32. http://dx.doi.org/10.1107/s1600577520014952.
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Recently, synchrotron radiation computed microtomography (SRµCT) has emerged as a promising tool for non-destructive, in situ visualization of cochlear implant electrode arrays inserted into a human cochlea. Histological techniques have been the `gold standard' technique for accurate localization of cochlear implant electrodes but are suboptimal for precise three-dimensional measurements. Here, an SRµCT experimental setup is proposed that offers the benefit of a high spatial and contrast resolution (isotropic voxel size = 4.95 µm and propagation-based phase-contrast imaging), while visualizing the soft-tissue structures and electrode array of the cochlear implant simultaneously. In this work, perimodiolar electrode arrays have been tested, which incorporate thick and closely spaced platinum–iridium contacts and wiring. These data can assist cochlear implant and hearing research, can be used to verify electrode segmentation techniques for clinical computed tomography or could be utilized to evaluate cochlear implant electrode array designs.
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Swain, Santosh Kumar. "Cochlear implant and tinnitus: a review". International Journal of Otorhinolaryngology and Head and Neck Surgery 7, nr 12 (25.11.2021): 1960. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20214698.
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<p>Tinnitus is the perception of a sound without any external auditory input and patient experiences as a ringing or buzzing sound in the ear or head. Tinnitus is a common and troublesome clinical entity that has existed for centuries. However, the exact etiology for tinnitus is not known. Electrical suppression of the tinnitus by cochlear implant is a secondary benefit to many cochlear implant recipients. Cochlear implants are often helpful to improve speech perception for those suffered with severe to profound hearing loss where hearing aids are no longer beneficial. There is high prevalence of tinnitus among patients with profound hearing loss which often reduced after cochlear implant. Although only few cochlear implant recipients show complete elimination of tinnitus after implantation and many uses result in improvement or stabilization. Cochlear implant causes appearance of homolateral tinnitus in small percentage of the cases. However, none of the cases of tinnitus which appear after cochlear implantation are thought to be severe to the patient. All literatures of cochlear implant and tinnitus were identified via Scopus, Google scholar, Medline and PubMed and analysed individually. Articles of cochlear implant and tinnitus included according to specified eligibility criteria. The review article analysed case series, case reports and original research on cochlear implant and tinnitus published in the English language. The aim of this review article is to provide a comprehensive review of the cochlear implant and its role in tinnitus.</p>
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Kuzovkov, V. E., A. S. Lilenko, S. B. Sugarova, V. A. Tanaschishina, D. D. Kaliapin, D. S. Luppov i I. N. Skirpichnikov. "Etiological factors of facial nerve stimulation in cochlear implant users". Meditsinskiy sovet = Medical Council, nr 20 (20.11.2022): 170–76. http://dx.doi.org/10.21518/2079-701x-2022-16-20-170-176.
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Cochlear implantation is a high-tech method of rehabilitation of persons with complete deafness. However, cochlear implantation in patients may be accompanied by a number of difficulties due to the peculiarities of the structure of the cochlea, the relative position of anatomical structures relative to it and the nature of the acquired pathology of the inner ear. The reaction of the facial nerve during stimulation of one of the electrodes of the cochlear implant system is a common complication that can lead to a deterioration in the patient’s quality of life due to significant discomfort and restrictions on the use of the cochlear implant system. The debut of twitching of facial muscles in patients after cochlear implantation can occur both at the stage of connecting the speech processor and at the stages of further rehabilitation, which according to world literature can reach an interval of 10 years from the moment of surgery. Anatomical features of the cochlea, its interposition with the facial nerve, changes in the bone labyrinth, further progression of remodeling or ossification of the cochlea play a significant role in the development of symptoms of facial nerve stimulation in patients with sensorineural hearing loss of the IV degree, including at the stage of subsequent settings of the speech processor. The frequency of occurrence of this complication in various literature sources varies from 1 to 14.9 %. The purpose of this work is to review the world literature on the etiology of facial nerve stimulation in users of cochlear implants, highlighting the main theories of the origin of non-auditory sensations in this category of patients, since the data conducted in various studies are variable, and with a certain etiology reaches 38 %.
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Venail, Frederic, Thibault Mura, Mohamed Akkari, Caroline Mathiolon, Sophie Menjot de Champfleur, Jean Pierre Piron, Marielle Sicard, Françoise Sterkers-Artieres, Michel Mondain i Alain Uziel. "Modeling of Auditory Neuron Response Thresholds with Cochlear Implants". BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/394687.
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The quality of the prosthetic-neural interface is a critical point for cochlear implant efficiency. It depends not only on technical and anatomical factors such as electrode position into the cochlea (depth and scalar placement), electrode impedance, and distance between the electrode and the stimulated auditory neurons, but also on the number of functional auditory neurons. The efficiency of electrical stimulation can be assessed by the measurement of e-CAP in cochlear implant users. In the present study, we modeled the activation of auditory neurons in cochlear implant recipients (nucleus device). The electrical response, measured using auto-NRT (neural responses telemetry) algorithm, has been analyzed using multivariate regression with cubic splines in order to take into account the variations of insertion depth of electrodes amongst subjects as well as the other technical and anatomical factors listed above. NRT thresholds depend on the electrode squared impedance (β= −0.11 ± 0.02,P<0.01), the scalar placement of the electrodes (β= −8.50 ± 1.97,P<0.01), and the depth of insertion calculated as the characteristic frequency of auditory neurons (CNF). Distribution of NRT residues according to CNF could provide a proxy of auditory neurons functioning in implanted cochleas.
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De Almeida, Amanda Naiara Barbon, Celine Garcia Dalpoz, Igor Giacometi Parreira, Fernanda da Silva Catellan, Lucas Valério Abrahim i Julia Tirloni Ramires. "DEAFNESS AND COCHLEAR IMPLANT: A COMPREHENSIVE PERSPECTIVE". Revista Contemporânea 4, nr 2 (16.02.2024): e3326. http://dx.doi.org/10.56083/rcv4n2-035.
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Deafness is an auditory condition that can have significant impacts on the quality of life, involving psychosocial impairments and communication challenges. Early diagnosis, facilitated by neonatal auditory screening programs, is crucial for directing timely interventions. The cochlear implant technique emerges as an effective approach to restore hearing in cases of severe to profound deafness. The surgery involves the insertion of electrodes into the cochlea, allowing for direct electrical stimulation of the auditory nerve. Technological advancements in surgical techniques and devices have contributed to significant improvements in the efficacy and safety of the procedure. Cochlear implants provide notable benefits, including the restoration of auditory capacity, improvements in communication, and overall quality of life. Post-surgical follow-up by a multidisciplinary team, which may include speech therapists, psychologists, and otolaryngologists, is essential for optimizing long-term outcomes, addressing emotional aspects, auditory rehabilitation, and clinical monitoring. Deafness and the cochlear implant technique are complex and interconnected topics, with medical and surgical approaches aimed at enhancing auditory functionality and the quality of life for individuals affected by this condition.
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Davidson, Lisa S. "Comparing Speech Perception of Children With Cochlear Implants or Hearing Aids". Perspectives on Hearing and Hearing Disorders in Childhood 20, nr 2 (wrzesień 2010): 70–75. http://dx.doi.org/10.1044/hhdc20.2.70.
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Cochlear implant (CI) candidacy guidelines continue to evolve as a result of advances in both cochlear implant and hearing aid technology. Empirical studies comparing the speech perception abilities of children using cochlear implants or hearing aids will be reviewed in the context of current device technology and CI candidacy evaluations.
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Mitchell, T. E., i W. P. R. Gibson. "Positioning of the receiver-stimulator for the CI–24M cochlear implant in infants". Journal of Laryngology & Otology 113, nr 3 (marzec 1999): 212–16. http://dx.doi.org/10.1017/s0022215100143609.
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AbstractA new cochlear implant (CI–24M) has recently been released by Cochlear Ltd. The shape and size of the receiver-stimulator differs from that of the CI–22M. Infants as young as one year of age are now receiving cochlear implants. We have examined the likely effect of skull growth following the implantation of a CI-24M cochlear implant in an infant of this age.
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Barker, Emma, Keith Trimble, Harley Chan, James Ramsden, Sajendra Nithiananthan, Adrian James, Gideon Bachar, Mike Daly, Jonathan Irish i Jeff Siewerdsen. "Intraoperative use of cone-beam computed tomography in a cadaveric ossified cochlea model". Otolaryngology–Head and Neck Surgery 140, nr 5 (maj 2009): 697–702. http://dx.doi.org/10.1016/j.otohns.2008.12.046.
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Objectives: To describe a cadaveric temporal bone model of labyrinthitis ossificans and investigate the utility of intraoperative cone-beam computed tomography (CBCT) in the facilitating cochlear implantation. Design: Cadaveric temporal bone study. Methods: Five cadaveric heads had cement introduced into the 10 cochleas. CBCT and a conventional CT scan were compared to assess the extent of cochlear obliteration. The cement was drilled-out (under CBCT guidance, if required) and cochlear implant electrode arrays (from 3 different manufacturers) inserted. Results: CBCT images demonstrated temporal bone anatomy and the extent of cochlear obliteration as clearly as conventional CT in all cases. Intraoperative CBCT guided drilling and facilitated electrode placement in two of five heads (3 of 10 ears). Streak-artifact from the electrodes of two devices partially obscured image clarity. Conclusions: The obliterated cochlear model reproduced a disease-ossified cochlear both radiographically and surgically. CBCT is useful for intraoperative imaging to facilitate electrode array placement in the obliterated or congenitally abnormal cochlea.
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Lobdell, Anne M., Joseph E. Dansie i Sarah Hargus Ferguson. "Building a Cochlear Implant Practice: Five Lessons Learned". Perspectives on Aural Rehabilitation and Its Instrumentation 20, nr 1 (styczeń 2013): 14–21. http://dx.doi.org/10.1044/arii20.1.14.
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Cochlear implants are becoming available to an increasing proportion of the deaf and hard-of-hearing population. As interest in and success with cochlear implants has grown, more and more private practice clinics are incorporating them into their scopes of practice. Over the past 2 years, the first 2 authors of this article have been heavily involved in developing cochlear implant programs in separate otolaryngology private practices. A recent conversation about this process revealed several common experiences and lessons learned. During these same 2 years, the third author began teaching the cochlear implant course at the University of Utah. Although her audiology and speech science background gave her extensive knowledge of the science behind cochlear implants, she had no clinical experience with them. The first author took this course the first time the third author taught it, and the experiences and insights she shared with the third author during and since the course have been an important component of the third author’s personal education in the clinical aspects of cochlear implants. In this article, the first 2 authors share 5 things we wish we had known when first beginning their work with cochlear implants.
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Zhu, Yun Feng, Ying Xu, Jia Ke, Fu Rong Ma, Lei Hu i Chang Sheng Li. "Research on Computer-Assisted Minimally Invasive Cochlear Implant System". Applied Mechanics and Materials 577 (lipiec 2014): 1241–44. http://dx.doi.org/10.4028/www.scientific.net/amm.577.1241.
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A computer-assisted minimally invasive cochlear implant system is developed to help doctors perform minimally invasive cochlear implant to avoid disadvantages of traditional complex operation like large invasive and long time to recovery et al. Virtual space visualization, space mapping and operation path plan, mechanism for drill positioning and holding are realized with multi-use of computer navigation and virtual space visualization technology and screw theory. Totally 6 cadaveric skull specimen experiments are performed. In experiments, all cochleae are opened perfectly without facial nerves damaged. The results demonstrate that the computer-assisted minimally invasive cochlear implant system can meet the clinical operation demands.
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Wang, Zuo, Jianjun Li, Yongzhen Wu, Ruifeng Zhu, Binrui Wang i Kai Zhao. "Optimal path generation in scala tympani and path planning for robotic cochlear implant of perimodiolar electrode". Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 234, nr 6 (18.03.2020): 578–89. http://dx.doi.org/10.1177/0954411920908969.
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In this study, a new idea of the optimal path generation method was proposed and a path planning strategy for robotic cochlear implant of perimodiolar electrode was designed. The centerline of scala tympani channel was taken as the optimal implant path of the perimodiolar electrode, which aimed to reduce the damage of the electrode to the cochlea during implantation. First, the three-dimensional cochlear model was reconstructed based on the micro-computed tomography images of cochlea, and it was re-segmented to obtain the cross sections of the scala tympani at different angles. Then, the image processing method was used to determine the central point of the scala tympani cross sections. The cubic B-spline interpolation method was used to fit these discrete central points to generate the optimal path. Finally, the coordinate information of the optimal path was combined with the stylet extraction state of perimodiolar electrode to conduct the path planning for robotic cochlear implant, and the result was sent to the robot for kinematic inverse solution to obtain the robot motion trajectory. The robotic cochlear implant experiment was performed with the model of scala tympani. The results showed that the maximum implant force based on path planning was 0.084 N, and the maximum implant force without path planning was 0.134 N. The optimal path generation and the path planning method effectively help to reduce the damage of the electrode to the cochlea.
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Wener, Emily, Lindsay Booth, Hailey Bensky, Veeral Desai, Jaina Negandhi, Sharon L. Cushing, Blake C. Papsin i Karen A. Gordon. "Exposure to Spoken Communication During the COVID-19 Pandemic Among Children With Cochlear Implants". JAMA Network Open 6, nr 10 (27.10.2023): e2339042. http://dx.doi.org/10.1001/jamanetworkopen.2023.39042.
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ImportanceSchool closures and other COVID-19–related restrictions could decrease children’s exposure to speech during important stages of development.ObjectiveTo assess whether significant decreases in exposure to spoken communication found during the initial phase of the COVID-19 pandemic among children using cochlear implants are confirmed for a larger cohort of children and were sustained over the first years of the COVID-19 pandemic.Design, Setting, and ParticipantsThis cohort study used datalogs collected from children with cochlear implants during clinical visits to a tertiary pediatric hospital in Toronto, Ontario, Canada, from January 1, 2018, to November 11, 2021. Children with severe to profound hearing loss using cochlear implants were studied because their devices monitored and cataloged levels and types of sounds during hourly use per day (datalogs) and because their hearing and spoken language development was particularly vulnerable to reduced sound exposure. Statistical analyses were conducted between January 2022 and August 2023.Main Outcomes and MeasuresDaily hours of sound were captured by the cochlear implant datalogging system and categorized into 6 auditory scene categories, including speech and speech-in-noise. Time exposed to speech was calculated as the sum of daily hours in speech and daily hours in speech-in-noise. Residual hearing in the ear without an implant of children with unilateral cochlear implants was measured by pure tone audiometry. Mixed-model regression analyses revealed main effects with post hoc adjustment of 95% CIs using the Satterthwaite method.ResultsDatalogs (n = 2746) from 262 children (137 with simultaneous bilateral cochlear implants [74 boys (54.0%); mean (SD) age, 5.8 (3.5 years)], 38 with sequential bilateral cochlear implants [24 boys (63.2%); mean (SD) age, 9.1 (4.2) years], and 87 with unilateral cochlear implants [40 boys (46.0%); mean (SD) age, 7.9 (4.6) years]) who were preschool aged (n = 103) and school aged (n = 159) before the COVID-19 pandemic were included in analyses. There was a slight increase in use among preschool-aged bilateral cochlear implant users through the pandemic (early pandemic, 1.4 h/d [95% CI, 0.3-2.5 h/d]; late pandemic, 2.3 h/d [95% CI, 0.6-4.0 h/d]) and little change in use among school-aged bilateral cochlear implant users (early pandemic, −0.6 h/d [95% CI, −1.1 to −0.05 h/d]; late pandemic, −0.3 h/d [95% CI, −0.9 to 0.4 h/d]). However, use decreased during the late pandemic period among school-aged children with unilateral cochlear implants (−1.8 h/d [95% CI,−3.0 to −0.6 h/d]), particularly among children with good residual hearing in the ear without an implant. Prior to the pandemic, children were exposed to speech for approximately 50% of the time they used their cochlear implants (preschool-aged children: bilateral cochlear implants, 46.6% [95% CI, 46.5%-47.2%] and unilateral cochlear implants, 52.1% [95% CI, 50.7%-53.5%]; school-aged children: bilateral cochlear implants, 47.6% [95% CI, 46.8%-48.4%] and unilateral cochlear implants, 51.0% [95% CI, 49.4%-52.6%]). School-aged children in both groups experienced significantly decreased speech exposure in the early pandemic period (bilateral cochlear implants, −12.1% [−14.6% to −9.4%]; unilateral cochlear implants, −15.5% [−20.4% to −10.7%]) and late pandemic periods (bilateral cochlear implants, −5.3% [−8.0% to −2.6%]; unilateral cochlear implants, −11.2% [−15.3% to −7.1%]) compared with the prepandemic baseline.Conclusions and RelevanceThis cohort study using datalogs from children using cochlear implants suggests that a sustained reduction in children’s access to spoken communication was found during more than 2 years of COVID-19 pandemic-related lockdowns and school closures.
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Pamuk, G., A. E. Pamuk, A. Akgöz, M. D. Bajin, B. Özgen i L. Sennaroğlu. "Radiological measurement of cochlear dimensions in cochlear hypoplasia and its effect on cochlear implant selection". Journal of Laryngology & Otology 135, nr 6 (12.04.2021): 501–7. http://dx.doi.org/10.1017/s0022215121000979.
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AbstractObjectiveTo determine the effect of cochlear dimensions on cochlear implant selection in cochlear hypoplasia patients.MethodsTemporal bone computed tomography images of 36 patients diagnosed with cochlear hypoplasia between 2010 and 2016 were retrospectively reviewed and compared with those of 40 controls without sensorineural hearing loss.ResultsBasal turn length and mid-modiolar height were significantly lower in the cochlear hypoplasia patients with subtypes I, II and III than in the control group (p < 0.001). Mid-scalar length was significantly shorter in subtype I–III patients as compared with the control group (p < 0.001). In addition, cochlear canal length (measured along the lateral wall) was significantly shorter in subtype I–IV patients than in the control group (subtypes I–III, p < 0.001; subtype IV, p = 0.002)ConclusionCochlear hypoplasia should be considered if basal turn length is less than 7.5 mm and mid-modiolar height is less than 3.42 mm. The cochlear implant should be selected according to cochlear hypoplasia subgroup. It is critically important to differentiate subtype II from incomplete partition type I and subtype III from a normal cochlea, to ensure the most appropriate implant electrode selection so as to optimise cochlear implantation outcomes.
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Keppeler, Daniel, Christoph A. Kampshoff, Anupriya Thirumalai, Carlos J. Duque-Afonso, Jannis J. Schaeper, Tabea Quilitz, Mareike Töpperwien i in. "Multiscale photonic imaging of the native and implanted cochlea". Proceedings of the National Academy of Sciences 118, nr 18 (26.04.2021): e2014472118. http://dx.doi.org/10.1073/pnas.2014472118.
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The cochlea of our auditory system is an intricate structure deeply embedded in the temporal bone. Compared with other sensory organs such as the eye, the cochlea has remained poorly accessible for investigation, for example, by imaging. This limitation also concerns the further development of technology for restoring hearing in the case of cochlear dysfunction, which requires quantitative information on spatial dimensions and the sensorineural status of the cochlea. Here, we employed X-ray phase-contrast tomography and light-sheet fluorescence microscopy and their combination for multiscale and multimodal imaging of cochlear morphology in species that serve as established animal models for auditory research. We provide a systematic reference for morphological parameters relevant for cochlear implant development for rodent and nonhuman primate models. We simulate the spread of light from the emitters of the optical implants within the reconstructed nonhuman primate cochlea, which indicates a spatially narrow optogenetic excitation of spiral ganglion neurons.
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King, Jack. "Objective Measures and Programming Cochlear Implants". Perspectives on Hearing and Hearing Disorders in Childhood 19, nr 2 (wrzesień 2009): 54–62. http://dx.doi.org/10.1044/hhdc19.2.54.
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Abstract Advances in cochlear implant technology have allowed for amazing outcomes for children with severe to profound hearing loss. As result, cochlear implants are now provided for some children prior to their first birthday and are also provided to children with multiple disabilities. Frequently, it is difficult to use conventional behavioral measures to set cochlear implant MAPs for these patients, so clinicians have often relied on objective measures as a guide to determining appropriate MAP levels. The following discussion reviews the advantages and limitations of using objective measures to administer audiological management for the pediatric cochlear implant patient.
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Kuzovkov, V. E., A. S. Lilenko, S. B. Sugarova, V. A. Tanaschishina, D. D. Kalyapin i D. S. Luppov. "Risk factors for facial nerve stimulation in cochlear implant users: our experience". Russian Otorhinolaryngology 21, nr 5 (2022): 116–21. http://dx.doi.org/10.18692/1810-4800-2022-5-116-121.
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Nowadays, cochlear implantation is the most common method of rehabilitation of people with complete deafness. Surgical treatment may be accompanied by a number of difficulties due to the anatomical and topographic features of the cochleae. One of the most unpleasant complications after cochlear implantation is the reaction of the facial nerve when one or more electrodes of the cochlear implant system are stimulated. Subjective sensations as well as visible twitching of facial muscles during sound irritation bring discomfort, worsen the patient’s quality of life, and may lead to restriction of the use of a cochlear implant, including due to the forced use of speech processor settings that degrade the quality of rehabilitation. Stimulation of the facial nerve, which cannot be corrected, can lead to the patient’s complete refusal to operate the device. Anatomical features of the cochlea, its interposition with the facial nerve, changes in the bone labyrinth play a significant role in the development of symptoms of facial nerve stimulation in patients with severe sensorineural hearing loss, including at the stage of rehabilitation. The purpose of the publication is to highlight the etiological factors of the occurrence of this complication based on our experience in Saint Petersburg ENT Research Institute from 2017 to 2021.
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Silva, Liliane Aparecida Fagundes, Maria Inês Vieira Couto, Carla Gentile Matas i Ana Claudia Martinho de Carvalho. "Long latency auditory evoked potentials in children with cochlear implants: systematic review". CoDAS 25, nr 6 (25.11.2013): 595–600. http://dx.doi.org/10.1590/s2317-17822013.05000009.
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The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.
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Perényi, Ádám, Roland Nagy, Bence Horváth, Bálint Posta, Balázs Dimák, Miklós Csanády, József Géza Kiss i László Rovó. "Új műtéti képalkotó lehetőség a belsőfül-implantátum elektródasorának dinamikus helyzetmeghatározására". Orvosi Hetilap 162, nr 22 (30.05.2021): 878–83. http://dx.doi.org/10.1556/650.2021.32085.
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Összefoglaló. Bevezetés: A cochlearis implantátum egy műtétileg behelyezett elektromos eszköz, amely az akusztikus hanghullámokat elektromos jelekké alakítja, közvetlenül a hallóideget stimulálja, így segíti a súlyos fokú hallássérüléssel vagy teljes hallásvesztéssel élők életét. Cochlearis implantációt követően a legjobb rehabilitációs eredmény elérésének technikai feltétele többek között az esetre szabott elektródaválasztás és az elektródasor teljes, kontrollált, szövődménymentes bejuttatása a scala tympaniba, miközben a cochlea belső struktúrája a lehető legkisebb mértékben sérül. A rutin intraoperatív elektrofiziológiai tesztek fontos információt adnak a készülék működőképességéről és a hallóideg stimulációjáról, azonban nem hagyatkozhatunk rájuk az elektródasor cochleán belüli helyzetének igazolásában. Mivel előfordulhat, hogy a rendelkezésre álló elektrofiziológiai vizsgálatok eredménye megfelelő, és mégis rendellenes helyzetbe kerül az elektróda, az arany standardot a képalkotó vizsgálatok jelentik. Módszer: Közleményünkben egy modern, hibrid műtő által nyújtott technológiai háttér új alkalmazási területét mutatjuk be. Szimultán kétoldali cochlearis implantációt végeztünk Cochlear Nucleus Slim Modiolar típusú perimodiolaris elektródasorral, a belső fül fejlődési rendellenességével rendelkező betegen. Az intraoperatív képalkotást Siemens Artis pheno C-karos robot digitális szubtrakciós angiográfiás rendszer biztosította valós idejű átvilágító és volumentomográfiás funkcióval. Eredmények: Az intraoperatív képalkotás által dinamikusan követhető az elektródasor bevezetésének folyamata, ellenőrizhető az elektródasor statikus helyzete, így kiváltható a rutinnak számító posztoperatív képalkotó vizsgálat. A rendellenes helyzetbe kerülő elektródasor pozíciója egy ülésben korrigálható, az újból bevezethető, így elkerülhető az újabb altatással járó, bizonytalan kimenetelű revíziós műtét. Következtetés: A hibrid műtő jól kontrollált, minimálisan invazív eljárások elvégzését biztosítja. Különösen a hallószerv fejlődési rendellenessége vagy egyéb, az elektródának a cochleába vezetését nehezítő rendellenesség esetén javasolt a műtői képalkotó diagnosztika. Orv Hetil. 2021; 162(22): 878–883. Summary. Introduction: The cochlear implant is a surgically inserted electrical device that converts acoustic sound waves into electrical signals to stimulate the cochlear nerve, thus helps the rehabilitation of people with severe to total hearing loss. One of the most important technical conditions for achieving the best rehabilitation result after cochlear implantation is the personalized choice of electrodes. Additionally, it is vital that there is a complete, controlled, uncomplicated delivery of the electrode array to the scala tympani while minimizing damage to the inner structures of the cochlea. Routine electrophysiological tests provide important information about device functionality and auditory nerve stimulation. However, they probably do not show an abnormal position of the electrode array within the cochlea. Thus, imaging studies remain the gold standard. Method: In our paper, we present a novel application field of the modern technological background provided by a hybrid operating room. Simultaneous bilateral cochlear implantation was performed with cochlear implants with perimodiolar electrode array (Nucleus Slim Modiolar) in a patient with cochlear malformation. Intraoperative imaging was provided by a Siemens Artis pheno C-arm robot digital subtraction angiography system with real-time fluoroscopy and volume tomography function. Results: Intraoperative imaging ensures dynamic follow-up of the introduction and static determination of the position of the electrode array and replaces routine postoperative imaging. If the electrode array was inserted in an abnormal position, the revision can be performed in the same sitting. Also, the revision surgery with a potential risk of uncertain outcome, alongside additional anaesthesia, can be prevented. Conclusion: The hybrid operating room ensures that well-controlled, minimally invasive procedures are performed. Intraoperative imaging can be imperative in malformed cochleae and conditions that may complicate electrode insertion. Orv Hetil. 2021; 162(22): 878–883.
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Key, Alexandra P. F., Heather L. Porter i Tamala Bradham. "Auditory Processing following Sequential Bilateral Cochlear Implantation: A Pediatric Case Study Using Event-Related Potentials". Journal of the American Academy of Audiology 21, nr 04 (kwiecień 2010): 225–38. http://dx.doi.org/10.3766/jaaa.21.4.2.
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Background: Past studies using event-related potentials (ERPs) elicited to single syllable stimuli in unilateral and bilateral cochlear implant users have suggested reorganization of the auditory cortex within the first 6–8 mo postimplantation (Sharma et al, 2002a, 2002b, 2006; Bauer et al, 2006). Better behavioral performance with bilateral implants is expected when bilateral cochlear implantation is performed simultaneously or when a second implant is provided after a short interval of auditory deprivation at a younger age (Murphy and O'Donoghue, 2007; Wolfe et al, 2007; Steffens et al, 2008). Purpose: The purpose of this case study was to examine changes in various levels of auditory processing using single syllable and word-level stimuli in a child who received bilateral cochlear implants sequentially. Research Design: Brain responses were recorded at pre-activation and 2, 4, and 6 mo postactivation of a second cochlear implant using passive paradigms involving two types of auditory perception (speech and word level). Auditory stimuli were presented at 75 dB SPL(A) through a speaker above the participant's head with the cochlear implant(s) at typical user settings. Cortical responses were recorded from 128 electrodes. Study Sample: The participant was a 6-yr-old female with the diagnosis of bilateral profound sensorineural hearing loss. She received her first cochlear implant in her right ear (2 yr, 4 mo of age), underwent revision surgery (3 yr, 6 mo of age), and later received a bilateral cochlear implant (6 yr, 8 mo of age). Data Collection and Analysis: For the purposes of the case study, the waveforms were visually examined for morphology and amplitude or latency differences between conditions. The ERPs of the cochlear implant user were compared to those from a group of five children with normal hearing. Conclusions: The results suggest that sequential bilateral cochlear implantation contributes to improved auditory processing beyond the benefits of the single implant even in users with an extended period of deafness in the later-implanted ear.
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Ali, Muhammad, Sayed Nusrat Raza, Abdul Hakim, Kashif Obaid Khan Niazi, Shakeel Ahmed i Riaz Ahmed Khokhar. "Sharing the Experience of Two Hundred Patients in A Novel Cochlear Implant Programme At Combined Military Hospital, Rawalpindi". Pakistan Armed Forces Medical Journal 74, nr 2 (27.04.2024): 277–81. http://dx.doi.org/10.51253/pafmj.v74i2.8366.
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Objective: To share our experience of difficulties encountered while implanting different types of cochlear implants and ascertain the affordability of cochlear implant surgery among the Pakistani population to treat sensorineural hearing loss in a novel cochlear implant programme. Study Design: Retrospective longitudinal study. Place and Duration of Study: Department of ENT, Combined Military Hospital (CMH), Rawalpindi Pakistan, from Apr 2017 to May 2021. Methodology: The study included patients who underwent cochlear implant surgeries. Patient demographics and causes of deafness, were collected. Intraoperative difficulties were encountered, and round window accessibility was also recorded. Results: Out of 200 patients, 112(56%) were males, while 88(44%) were females. 193(96.5%) patients were pre-lingual under 12 years of age, while post-lingual patients were 7(3.5%) and were adults. Cochlear implants from Med-El 186(93%), Cochlear 2(1%) and Advance Bionic 1(0.5%) were implanted through a transmastoid, facial recess approach, while Neubio 11(5.5%) was implanted through a postauricular transcanal approach. Congenital deafness with consanguinity was the leading cause of deafness, while round window variation was the most frequently encountered surgical challenge. Conclusion: In developing countries, financial restraints cause delays in surgery, leading to limited access to cochlear implant programmes. Surgical challenges are frequently encountered during surgery, and better understanding is required for easy implantation.
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Natarajsivam, Ashwin Kumar, Suresh Thontadarya, Srividya Asuri i Praveena Babu. "Spatial hearing abilities among children with bimodal versus unilateral cochlear implant: parents report on spatial hearing questionnaire". International Journal Of Community Medicine And Public Health 11, nr 6 (30.05.2024): 2296–303. http://dx.doi.org/10.18203/2394-6040.ijcmph20241488.
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Background: Spatial hearing questionnaire (SHQ) is a questionnaire developed and validated for evaluating the spatial hearing abilities for the tasks of localization of sound to complex task of speech perception in noise. SHQ is adapted in Dutch language, and in Persian language. The study aimed to compare the spatial hearing abilities of children using bimodal cochlear implant and unilateral cochlear implant using spatial hearing questionnaire a subjective assessment tool, SHQ. Methods: The participants of the study included parents of 30 cochlear implant using children of age range 5-10 years, among 30 participants, 16 belonged to parents of children using unilateral cochlear implant and 14 were parents of children using bimodal cochlear implants. SHQ consisted of 24 questions distributed under 8 domains and the responses from the parents were collected over telephonic interview and statistically analyzed across domains. Results: The results revealed that there was no significant difference observed between both the groups across all the 8 domains, except perception of children’s voice, showed statistical difference between 2 groups. The baseline of spatial skills in children population using unilateral and bimodal cochlear implants was analysed. Conclusions: Across the 8 domains of spatial hearing questionnaire there were no significant statistical difference found between unilateral and bimodal cochlear implanted groups.
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Connor, Carol McDonald, i Teresa A. Zwolan. "Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants". Journal of Speech, Language, and Hearing Research 47, nr 3 (czerwiec 2004): 509–26. http://dx.doi.org/10.1044/1092-4388(2004/040).
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Children with profound deafness are at risk for serious reading difficulties. Multiple factors affect their development of reading skills, including use of cochlear implants. Further, multiple factors influence the overall success that children experience with their cochlear implants. These factors include the age at which they receive an implant, method of communication, vocabulary skills, preoperative residual hearing, and socioeconomic status. Ninety-one children with prelingual and profound hearing impairments who received cochlear implants at varying ages participated in the study. Structural equation modeling confirmed that multiple factors affected young cochlear implant users' reading comprehension skills and that there were significant associations between the predictors of reading comprehension. Pre-implant vocabulary had an indirect positive effect on reading through postimplant vocabulary, which had a direct positive effect on reading. Overall, children with stronger language skills demonstrated stronger reading outcomes. Age at implantation both directly and indirectly, through postimplant vocabulary, affected reading outcomes, and the total effect was large. Children who were younger when they received their implants tended to have higher reading comprehension scores. Socioeconomic status negatively affected reading. Children who used total communication prior to implantation tended to have stronger pre-implant vocabulary scores, but the total effect of pre-implant communication method on children's reading skills was negligible. Research and educational implications are discussed.