European multi-centre study of the Nucleus Hybrid L24 cochlear implant

Lenarz, Thomas; James, Chris; Cuda, Domenico; O’Connor, Alec Fitzgerald; Frachet, Bruno; Frijns, Johan H. M.; Klenzner, T.; Laszig, Roland; Manrique, Manuel; Marx, Mathieu; Merkus, Paul; Mylanus, Emmanuel A. M.; Offeciers, Erwin; Pesch, Joerg; Ramos‐Macías, Ángel; Robier, A.; Sterkers, Olivier; Uziel, Alain

doi:10.3109/14992027.2013.802032

Cited by 137 publications

(124 citation statements)

References 37 publications

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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%

“…Suction and drilling dust have to be avoided imperatively. Generally, good hearing preservation outcomes may be achieved reliably ( Figure 26) [14]. The outcome clearly depends on the length of the electrode as well as the size of the individual cochlea.…”

Section: Cochlea Implant Surgery and Hearing Preservationmentioning

confidence: 98%

“…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%

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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%

Section: Cochlea Implant Surgery and Hearing Preservationmentioning

confidence: 98%

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Cochlear Implant – State of the Art

2017

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“…This phenomenon, referred to as bimodal benefit or electricacoustic stimulation (EAS) benefit, has received considerable attention in recent years as a possible alternative to traditional cochlear implantation. Bimodal hearing is most often configured with a cochlear implant in one ear and a hearing aid on the opposite ear; however, recent improvements in surgical techniques also allow for the use of residual hearing in the implanted ear in some patients (e.g., Lenarz et al, 2013;Kopelovich et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Effects of contextual cues on speech recognition in simulated electric-acoustic stimulation

Kong

Donaldson

Somarowthu

2015

The Journal of the Acoustical Society of America

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Low-frequency acoustic cues have shown to improve speech perception in cochlear-implant listeners. However, the mechanisms underlying this benefit are still not well understood. This study investigated the extent to which low-frequency cues can facilitate listeners' use of linguistic knowledge in simulated electric-acoustic stimulation (EAS). Experiment 1 examined differences in the magnitude of EAS benefit at the phoneme, word, and sentence levels. Speech materials were processed via noise-channel vocoding and lowpass (LP) filtering. The amount of spectral degradation in the vocoder speech was varied by applying different numbers of vocoder channels. Normal-hearing listeners were tested on vocoder-alone, LP-alone, and vocoder þ LP conditions. Experiment 2 further examined factors that underlie the context effect on EAS benefit at the sentence level by limiting the low-frequency cues to temporal envelope and periodicity (AM þ FM). Results showed that EAS benefit was greater for higher-context than for lower-context speech materials even when the LP ear received only low-frequency AM þ FM cues. Possible explanations for the greater EAS benefit observed with higher-context materials may lie in the interplay between perceptual and expectation-driven processes for EAS speech recognition, and/or the band-importance functions for different types of speech materials.

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“…CIs and the surgical techniques to implant them are becoming less traumatic, and CIs are now implanted in patients with residual low-frequency hearing (Gantz et al, 2009;Lenarz et al, 2013). Eventually, if hearing can be completely or partially preserved, electrical stimulation might become a treatment option for patients with tinnitus and normal or mild hearing loss (Tyler, 1997).…”

Section: Discussionmentioning

confidence: 99%

A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant

et al. 2015

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Purpose Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant speech processor in an attempt to suppress tinnitus. Method First, patients were allowed to listen to several sounds and to select up to 4 sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use 1 background sound each day on the wearable device, and they sequenced the selected background sounds during a 28-day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus as well as the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire (Tyler, Stocking, Secor, & Slattery, 2014) at the beginning of the trial. Results Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. Conclusion The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected cochlear implant users.

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European multi-centre study of the Nucleus Hybrid L24 cochlear implant

Abstract: Useful residual hearing was conserved in 88% of subjects. Speech perception was significantly improved over preoperative hearing aids, as was sound quality and quality of life.

Cited by 137 publications

References 37 publications

Cochlear Implant – State of the Art

Cochlear Implant – State of the Art

Effects of contextual cues on speech recognition in simulated electric-acoustic stimulation

A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant

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