Evaluation of Bilaterally Implanted Adult Subjects with the Nucleus 24 Cochlear Implant System

Ramsden, R. T.; Greenham, Paula; O’Driscoll, Martin; Mawman, Deborah; Proops, David W.; Craddock, Louise; Fielden, Claire; Graham, John M.; Meerton, Leah; Verschuur, Carl; Toner, J. G.; McAnallen, Cecilia; Osborne, Jonathan; Doran, Maire; Gray, R. F.; Pickerill, Margaret

doi:10.1097/01.mao.0000185075.58199.22

Cited by 106 publications

(111 citation statements)

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“…In particular, bilateral stimulation can provide a substantial benefit in recognizing difficult speech materials such as monosyllabic words and in recognizing speech presented in competition with spatially distinct noise, in comparison to scores obtained with either unilateral implant alone (e.g., Gantz et al, 2002;Müller et al, 2002;Laszig et al, 2004;Ramsden et al, 2005;Litovsky et al, 2006;Ricketts et al, 2006). In addition, use of both implants supports an improved ability to lateralize or localize sounds (depending on which was measured in a particular study), again compared with either unilateral implant (e.g., van Hoesel and Tyler, 2003;Nopp et al, 2004;Senn et al, 2005;Grantham et al, 2007;Tyler et al, 2007).…”

Section: Two Recent Advancesmentioning

confidence: 99%

Cochlear implants: A remarkable past and a brilliant future

2008

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The aims of this paper are to (i) provide a brief history of cochlear implants; (ii) present a status report on the current state of implant engineering and the levels of speech understanding enabled by that engineering; (iii) describe limitations of current signal processing strategies and (iv) suggest new directions for research. With current technology the "average" implant patient, when listening to predictable conversations in quiet, is able to communicate with relative ease. However, in an environment typical of a workplace the average patient has a great deal of difficulty. Patients who are "above average" in terms of speech understanding, can achieve 100% correct scores on the most difficult tests of speech understanding in quiet but also have significant difficulty when signals are presented in noise. The major factors in these outcomes appear to be (i) a loss of low-frequency, fine structure information possibly due to the envelope extraction algorithms common to cochlear implant signal processing; (ii) a limitation in the number of effective channels of stimulation due to overlap in electric fields from electrodes, and (iii) central processing deficits, especially for patients with poor speech understanding. Two recent developments, bilateral implants and combined electric and acoustic stimulation, have promise to remediate some of the difficulties experienced by patients in noise and to reinstate low-frequency fine structure information. If other possibilities are realized, e.g., electrodes that emit drugs to inhibit cell death following trauma and to induce the growth of neurites toward electrodes, then the future is very bright indeed.

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Section: Two Recent Advancesmentioning

confidence: 99%

Cochlear implants: A remarkable past and a brilliant future

2008

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“…Sequential implantation in 28 adults with 1 to 7 years between ears resulted in poor performance in the second implanted ear for subjects who had longer periods of time between implanted sides [74]. After 9 months of stimulation in the second ear, scores were poorer in noise in the second ear than the first ear.…”

Section: Speech Recognition: Sequential Implantationmentioning

confidence: 99%

“…For CI recipients using a dual microphone at each ear coupled to a single CI system, speech-recognition performance has been shown to be poorer than with bilateral implants [74,94,100]. Bilateral microphones with a single implant, therefore, do not achieve the binaural processing capabilities that may be afforded by bilateral implants.…”

Section: Fitting Of Bilateral Implantsmentioning

confidence: 99%

Restoring hearing symmetry with two cochlear implants or one cochlear implant and a contralateral hearing aid

Firszt

Reeder²,

Skinner³

2008

JRRD

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Abstract-With today's technology and the demonstrated success of cochlear implantation, along with expanded candidacy criteria, the opportunity to provide optimal hearing to both ears for individuals with severe-to-profound hearing loss is greater than ever. This article reviews the advantages of binaural hearing and the disadvantages of hearing with only one ear or hearing with two ears with significantly different sound thresholds. A case study is presented that demonstrates the benefit of bimodal hearing (i.e., a cochlear implant [CI] in one ear and a contralateral hearing aid [HA]) in a nontraditional CI candidate with asymmetrical hearing thresholds. Then, selected studies in adult recipients who use a CI and contralateral HA or who use two CIs are summarized. The data overall demonstrate that bilateral CI recipients, traditional bimodal recipients, and nontraditional bimodal recipients experience substantial binaural hearing advantages, including improved speech recognition in noise, localization, and functional everyday communication. These results indicate that bilateral stimulation of the auditory system through a CI and contralateral HA or two CIs is beneficial and should become standard clinical practice.

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“…These results are consistent with those seen in other studies such as Gibson and Sanli (2007) who showed 32/39 children with good EABR results and good functional outcomes. It is possible that the poorer functional outcomes measured in the subsequently implanted ear arose from the prolonged delay in implanting the second ear (Ramsden et al, 2005;Gordon et al, 2008) although conflicting evidence exists about the impact of duration of sequential implantation on functional outcomes (Zeitler et al, 2008). In any case, in contrast to Case 1, Case 2 provides an example of a subset of individuals identified as having ANSD with additional confounding factors, including cerebral palsy, developmental delay, Autism Spectrum Disorder.…”

Section: Role Of Evoked Potentials In Decision-makingmentioning

confidence: 98%