The Cochlear Implant: Historical Aspects and Future Prospects

Abstract

The cochlear implant (CI) is the first effective treatment for deafness and severe losses in hearing. As such, the CI is now widely regarded as one of the great advances in modern medicine. This paper reviews the key events and discoveries that led up to the current CI systems, and we review and present some among the many possibilities for further improvements in device design and performance. The past achievements include: (1) development of reliable devices that can be used over the lifetime of a patient; (2) development of arrays of implanted electrodes that can stimulate more than one site in the cochlea; and (3) progressive and large improvements in sound processing strategies for CIs. In addition, cooperation between research organizations and companies greatly accelerated the widespread availability and use of safe and effective devices. Possibilities for the future include: (1) use of otoprotective drugs; (2) further improvements in electrode designs and placements; (3) further improvements in sound processing strategies; (4) use of stem cells to replace lost sensory hair cells and neural structures in the cochlea; (5) gene therapy; (6) further reductions in the trauma caused by insertions of electrodes and other manipulations during implant surgeries; and (7) optical rather electrical stimulation of the auditory nerve. Each of these possibilities is the subject of active research. Although great progress has been made to date in the development of the CI, including the first substantial restoration of a human sense, much more progress seems likely and certainly would not be a surprise.

As implicações do implante coclear para desenvolvimento das habilidades de linguagem: uma revisão da literatura

“…The advancement and technological enhancement in cochlear implant devices can be another important factor in the growth of researches 6,19,20 . From 2003 to 2013, companies have produced models of cochlear implants with important differences in the components (such as waterproof devices, for example), the programming and mapping software and the coding strategies (such as CIS, SPEAK and ACE); these changes, in turn, may imply distinct effects on perception of speech sounds and, therefore, the development of auditory skills and oral production 5,20 .An example …”

“…Some of these projections refer primarily to the phenomena of interest, such as bilateral cochlear implants 9,10,19 , scientific and technological innovation for cochlear implants (like breakthroughs in speech processors and the possibilities of totally implantable cochlear implants) 5,10,19 and strategies in auditory rehabilitation evidence-based 10,19 .…”

Implanted intracortical electrodes as chronic neural interfaces to the central nervous system

“…Three layers of silicon dioxide, silicon nitride, and silicon dioxide again, respectively, are deposited onto the boron substrate, acting as insulators from its conductivity and forming the lower dielectric layers. This process is done using low- 3 The protruding spike of the probe which contains the electrodes, see Figure 4 4 To accomplish this selective diffusion, the silicon wafer is thermally oxidized, preventing boron from diffusing. As parts of the oxidation are removed, the boron is free to diffuse, resulting in this formation.…”

“…There is clear segue from measurement techniques of individual neurons to rehabilitative technologies which can both record and stimulate neurons in the the central and peripheral nervous systems. House et al first began human trials of single-channel cochlear implants in the early 1960's [3,4] and are often cited as implementing one of the first neuroprosthetics. Since then, numerous other neuroprostheses have been created for restoring or aiding motor function [5], vision [6], and pro-actively treating epileptic seizures [7] or the effects of Parkinson's disease [8].…”

The Advances in Hearing Rehabilitation and Cochlear Implants in China

“…Cochlear implants are sophisticated medical devices used to provide auditory stimulation in patients with a bilateral severe to profound sensorineural hearing loss (SNHL). As the most effective treatment for patients with bilateral severe to profound SNHL (Eshraghi et al, 2012a), the clinical indications for CI have expanded to include patients with some residual hearing and those with single-sided deafness. As such, CI provide a great opportunity to appreciably reduce the impact of hearing loss both on the patient and society.…”