Combining acoustic and electrical hearing

Gantz, Bruce J.; Turner, Christopher W.

doi:10.1097/00005537-200310000-00012

Cited by 351 publications

(259 citation statements)

References 19 publications

(19 reference statements)

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“…It is crucial to preserve residual hearing in low frequencies to use the specific advantages of acoustic hearing and to combine them with electric hearing. Limit values for the useable residual hearing in low frequencies amount to about 60 dB at 500 Hz [12], [13], [14]. The electroacoustic hearing results achieved with short electrodes are significantly better in noise compared to the hearing outcome with long electrodes and electrical stimulation alone ( Figure 36).…”

Section: Electro-acoustic Stimulationmentioning

confidence: 97%

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Cochlear Implant – State of the Art

2017

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Cochlear implants are the treatment of choice for auditory rehabilitation of patients with sensory deafness. They restore the missing function of Thomas Lenarz 1 inner hair cells by transforming the acoustic signal into electrical stimuli in the majority of patients including the use of the telephone. Children can achieve a near to normal speech and language development provided their deafness is detected early after onset and implantation is performed quickly thereafter. The diagnostic procedure as well as the surgical technique have been standardized and can be adapted to the individual anatomical and physiological needs both in children and adults. Special cases such as cochlear obliteration might require special measures and re-implantation, which can be done in most cases in a straight forward way. Technology upgrades count for better performance. Future developments will focus on better electrode-nerve interfaces by improving electrode technology. An increased number of electrical contacts as well as the biological treatment with regeneration of the dendrites growing onto the electrode will increase the number of electrical channels. This will give room for improved speech coding strategies in order to create the bionic ear, i.e. to restore the process of natural hearing by means of technology. The robot-assisted surgery will allow for high precision surgery and reliable hearing preservation. Biological therapies will support the bionic ear. Methods are bio-hybrid electrodes, which are coded by stem cells transplanted into the inner ear to enhance auto-production of neurotrophins. Local drug delivery will focus on suppression of trauma reaction and local regeneration. Gene therapy by nanoparticles will hopefully lead to the preservation of residual hearing in patients being affected by genetic hearing loss. Overall the cochlear implant is a very powerful tool to rehabilitate patients with sensory deafness. More than 1 million of candidates in Germany today could benefit from this high technology auditory implant. Only 50,000 are implanted so far. In the future, the procedure can be done under local anesthesia, will be minimally invasive and straight forward. Hearing preservation will be routine.Keywords: cochlear implant, sensory deafness, diagnostics, surgical procedure, results, complications, future developments SummaryCochlear implants are electronical stimulus prostheses for the functional replacement of the inner ear. Because of the rapid technical development and the good results, they could be established as standard therapy for sensory deafness. Cochlear implantation requires an interdisciplinary team and a quality-controlled concepts that reaches from the indication to the life-long control and that is fixed in the AWMF guideline on cochlear implant [1]. Current cochlear implant systems are partially implantable and equipped with a multitude of additional functions similar to hearing aids for sound pre-processing and noise elimination. The intracochlear position of the electrode allows fo...

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Section: Electro-acoustic Stimulationmentioning

confidence: 97%

“…The preservation of the residual hearing ability in the context of high-frequency hearing loss allows the use of electroacoustic stimulation. In the future, new treatment concepts for presbyacusis might be developed [12], [13], [14].…”

Section: Preconditionsmentioning

confidence: 99%

Cochlear Implant – State of the Art

2017

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“…To date, the focus of EAS research has been on the degree of postoperative hearing preservation outcomes (Arnoldner et al, 2010;Gantz & Turner, 2003;Gstoettner et al, 2006;James et al, 2006;Kiefer et al, 2005;Lenarz et al, 2006;Gantz, & Tyler, 2010); perception of music (Brockmeier et al, 2010;Dorman, Gifford, Spahr, & McKarns, 2008;Gfeller, Olszewski, Turner, Gantz, & Oleson, 2006;Gfeller et al, 2007;Gifford, Dorman, & Brown, 2010); and functional performance (Driver & Stark, 2010;Gstoettner et al, 2008;Gstoettner et al, 2011;Helbig et al, 2011). In general, results with EAS have been compared with either the cochlear implant used in isolation, or with the preoperative condition with hearing aids.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Electric-Acoustic Stimulation

Incerti

Ching

Cowan

2013

Trends in Amplification

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Cochlear implant systems that combine electric and acoustic stimulation in the same ear are now commercially available and the number of patients using these devices is steadily increasing. In particular, electric-acoustic stimulation is an option for patients with severe, high frequency sensorineural hearing impairment. There have been a range of approaches to combining electric stimulation and acoustic hearing in the same ear. To develop a better understanding of fitting practices for devices that combine electric and acoustic stimulation, we conducted a systematic review addressing three clinical questions: what is the range of acoustic hearing in the implanted ear that can be effectively preserved for an electric-acoustic fitting?; what benefits are provided by combining acoustic stimulation with electric stimulation?; and what clinical fitting practices have been developed for devices that combine electric and acoustic stimulation? A search of the literature was conducted and 27 articles that met the strict evaluation criteria adopted for the review were identified for detailed analysis. The range of auditory thresholds in the implanted ear that can be successfully used for an electric-acoustic application is quite broad. The effectiveness of combined electric and acoustic stimulation as compared with electric stimulation alone was consistently demonstrated, highlighting the potential value of preservation and utilization of low frequency hearing in the implanted ear. However, clinical procedures for best fitting of electric-acoustic devices were varied. This clearly identified a need for further investigation of fitting procedures aimed at maximizing outcomes for recipients of electric-acoustic devices.

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“…The increased implantation of individuals with aidable hearing and the preservation of hearing in the implanted ear allow the use of two listening modalities: bimodal hearing, in which a CI is used with a hearing aid (HA) worn in the contralateral, nonimplanted ear (e.g., Dooley et al, 1993), and hybrid or electro-acoustic stimulation (EAS), in which individuals with residual hearing in the implanted ear use the CI together with an HA in the same ear (Gantz & Turner, 2003;Gstoettner et al, 2004). Hybrid and EAS are names derived by the manufacturer, Cochlear and MED-EL, respectively.…”

mentioning

confidence: 99%

“…Hybrid and EAS are names derived by the manufacturer, Cochlear and MED-EL, respectively. Individuals using these multiple hearing modalities compared with use of a CI alone may demonstrate measurable improvements in speech perception both in quiet and in noise (Ching, Incerti, & Hill, 2004;Ching, van Wanrooy, & Dillon, 2007;Dettman et al, 2004;Firszt, Reeder, & Skinner, 2008;Flynn & Schmidtke, 2004;Gantz & Turner, 2003;Gstoettner et al, 2004;Most, Gaon-Sivan, Shpak, & Luntz, 2012;Mowry et al, 2012;Potts, Skinner, Litovsky, Strube, & Kuk, 2009;Straatman, Rietveld, Beijen, Mylanus, & Mens, 2010;Tuner et al, 2008a;Turner, Reiss, & Gantz, 2008b), sound localization (Ching et al, 2004(Ching et al, , 2007Firszt, et al, 2008;Flynn & Schmidtke, 2004;Potts et al, 2009), music perception (Bartov & Most, 2014;Flynn & Schmidtke, 2004;Mowry et al, 2012;Turner et al, 2008b), and voice recognition (Flynn & Schmidtke, 2004), as well as subjective benefits of access to binaural hearing and sound quality from combined acoustic and electric hearing (Ching et al, 2004;Firszt et al, 2008;Flynn & Schmidtke, 2004;Potts et al, 2009). However, the benefit of the addition of amplification to CI use is variable across individuals, particularly for speech perception, and an effective clinical protocol for programming of multiple hearing modalities has not yet been determined, as not every parameter has been investigated (Blamey & Saunders, 2008;Dorman, Spahr, Loizou, Dana, & Schmidt, 2005;Heo, Lee, & Lee, 2013;…”

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confidence: 99%

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

Fowler

Eggleston

Reavis³

et al. 2016

J Speech Lang Hear Res

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a Purpose: The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic-electric overlap. Method: Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble. Results: The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear (< 60 dB HL at 250 and 500 Hz) performed best for words in quiet as the LCF was raised. In contrast, bimodal subjects with worse hearing (> 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group. Conclusions: These findings suggest that reducing lowfrequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

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Combining acoustic and electrical hearing

Cited by 351 publications

References 19 publications

Cochlear Implant – State of the Art

Cochlear Implant – State of the Art

A Systematic Review of Electric-Acoustic Stimulation

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

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