Results of Cochlear Implantation in Patients with Severe to Profound Hearing Loss—Implications for Patient Selection

Kiefer, med. Jan; Ilberg, C. von; Reimer, Bärbel; Knecht, Rainald; Gall, Volker; Diller, Gottfried; Stürzebecher, Ekkehard; Pfennigdorff, Thomas; Spelsberg, Anja

doi:10.3109/00206099809072991

Cited by 58 publications

(51 citation statements)

References 16 publications

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“…The neural representation of electric stimuli in ears with residual hearing may therefore be expected to be more Bnatural^(less deterministic) than what is produced by deaf ears. The peripheral processes of auditory nerve fibers are a proposed source of membrane noise and jitter (van den Honert and Stypulkowski 1984), and these processes are vulnerable to chemical deafening (Leake-Jones et al 1982). However, it is not clear how relevant these factors are to our comparison of deaf and hearing fibers, as our previous work with acutely deafened ears suggests that peripheral processes are functional in those cases (Miller et al 1999.…”

Section: Differences In the Responses Of Hearing And Deaf Fibersmentioning

confidence: 95%

“…Animal models show that hair cells apical to implanted electrode arrays can survive over chronic periods (Ni et al 1992;Xu et al 1997) and human studies indicate that acoustic sensitivity can be preserved after implantation (Kiefer et al 1998). The standard animal model for cochlear implant research has long used a deaf cochlea to isolate the direct, electrical, depolarization of auditory nerve fibers (i.e., the Ba^response of Moxon 1971).…”

Section: Introductionmentioning

confidence: 99%

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Electrical Excitation of the Acoustically Sensitive Auditory Nerve: Single-Fiber Responses to Electric Pulse Trains

Miller

Abbas

Robinson

et al. 2006

JARO

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Nearly all studies on auditory-nerve responses to electric stimuli have been conducted using chemically deafened animals so as to more realistically model the implanted human ear that has typically been profoundly deaf. However, clinical criteria for implantation have recently been relaxed. Ears with Bresidualâ coustic sensitivity are now being implanted, calling for the systematic evaluation of auditory-nerve responses to electric stimuli as well as combined electric and acoustic stimuli in acoustically sensitive ears. This article presents a systematic investigation of single-fiber responses to electric stimuli in acoustically sensitive ears. Responses to 250 pulse/s electric pulse trains were collected from 18 cats. Properties such as threshold, dynamic range, and jitter were found to differ from those of deaf ears. Other types of fiber activity observed in acoustically sensitive ears (i.e., spontaneous activity and electrophonic responses) were found to alter the temporal coding of electric stimuli. The electrophonic response, which was shown to greatly change the information encoded by spike intervals, also exhibited fast adaptation relative to that observed in the Bdirect^response to electric stimuli. More complex responses, such as Bbuildup^(increased responsiveness to successive pulses) and Bbursting^(alternating periods of responsiveness and unresponsiveness) were observed. Our findings suggest that bursting is a response unique to sustained electric stimulation in ears with functional hair cells.

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Section: Differences In the Responses Of Hearing And Deaf Fibersmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Electrical Excitation of the Acoustically Sensitive Auditory Nerve: Single-Fiber Responses to Electric Pulse Trains

Miller

Abbas

Robinson

et al. 2006

JARO

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show abstract

“…These people usually have some hearing sensitivity at relatively low frequencies, but little or no hearing at higher frequencies. In some research centers, they may now be implanted with a device that has a shorter electrode array than the array used in conventional implants, or they may receive a conventional device in which the electrode is not fully inserted during surgery (Kiefer et al, 1998;von Ilberg et al, 1999;Skarzynski et al, 2003).…”

Section: Enhancing Music Perception By Improving Sound Processor Designmentioning

confidence: 99%

Music Perception with Cochlear Implants: A Review

McDermott

2004

Trends in Amplification

438

390

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The acceptance of cochlear implantation as an effective and safe treatment for deafness has increased steadily over the past quarter century. The earliest devices were the first implanted prostheses found to be successful in compensating partially for lost sensory function by direct electrical stimulation of nerves. Initially, the main intention was to provide limited auditory sensations to people with profound or total sensorineural hearing impairment in both ears. Although the first cochlear implants aimed to provide patients with little more than awareness of environmental sounds and some cues to assist visual speech-reading, the technology has advanced rapidly. Currently, most people with modern cochlear implant systems can understand speech using the device alone, at least in favorable listening conditions. In recent years, an increasing research effort has been directed towards implant users’ perception of nonspeech sounds, especially music. This paper reviews that research, discusses the published experimental results in terms of both psychophysical observations and device function, and concludes with some practical suggestions about how perception of music might be enhanced for implant recipients in the future. The most significant findings of past research are: (1) On average, implant users perceive rhythm about as well as listeners with normal hearing; (2) Even with technically sophisticated multiple-channel sound processors, recognition of melodies, especially without rhythmic or verbal cues, is poor, with performance at little better than chance levels for many implant users; (3) Perception of timbre, which is usually evaluated by experimental procedures that require subjects to identify musical instrument sounds, is generally unsatisfactory; (4) Implant users tend to rate the quality of musical sounds as less pleasant than listeners with normal hearing; (5) Auditory training programs that have been devised specifically to provide implant users with structured musical listening experience may improve the subjective acceptability of music that is heard through a prosthesis; (6) Pitch perception might be improved by designing innovative sound processors that use both temporal and spatial patterns of electric stimulation more effectively and precisely to overcome the inherent limitations of signal coding in existing implant systems; (7) For the growing population of implant recipients who have usable acoustic hearing, at least for low-frequency sounds, perception of music is likely to be much better with combined acoustic and electric stimulation than is typical for deaf people who rely solely on the hearing provided by their prostheses.

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“…In 1998 Kiefer J et al realized a similar study in 17 implanted subjects. Using the tests for monosyllabic words the recognition scores increased significantly from 9% pre-operatively to even 42% post-operatively [19]. Prospective studies, such as that of Gstöttner et al, using tests for syllables, words and sentences recognition of closed-set after cochlear implantation and hearing rehabilitation training demonstrated that 98.7% of subjects could understand the text [20].…”

Section: Discussionmentioning

confidence: 97%

Assessment of Speech Development in Children with Cochlear Implants in Republic of Macedonia Using Monosyllabic-Troche-Polysyllabic Test (Closed-Set)

Lazarovska¹,

Davcheva-Chakar

2013

Maced J Med Sci

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Background: Electric stimulation of the auditory nerve via cochlear implants has made a great impact on treatment of sensory deafness. Advanced signal processing and stimulation paradigms have led to continuously improved results in speech understanding. Consequently, indication criteria have been extended to patients with profound and severe-to profound hearing loss and limited speech understanding with conventional acoustic amplification.

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Results of Cochlear Implantation in Patients with Severe to Profound Hearing Loss—Implications for Patient Selection

Cited by 58 publications

References 16 publications

Electrical Excitation of the Acoustically Sensitive Auditory Nerve: Single-Fiber Responses to Electric Pulse Trains

Electrical Excitation of the Acoustically Sensitive Auditory Nerve: Single-Fiber Responses to Electric Pulse Trains

Music Perception with Cochlear Implants: A Review

Assessment of Speech Development in Children with Cochlear Implants in Republic of Macedonia Using Monosyllabic-Troche-Polysyllabic Test (Closed-Set)

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