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Sample records for cochlear modiolus visualized

  1. MR imaging of the cochlear modiolus after intratympanic administration of Gd-DTPA.

    PubMed

    Kawai, Hisashi; Naganawa, Shinji; Ishihara, Shunichi; Sone, Michihiko; Nakashima, Tsutomu

    2010-01-01

    We evaluated whether enhancement of the cochlear modiolus could be visualized 24 hours after intratympanic injection of gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) using a 3-dimensional real inversion recovery sequence combined with a 32-channel head coil at 3 tesla. Intratympanic injection of Gd-DTPA has been reported for visualizing endolymphatic hydrops in Meniere's disease, and its use has shown communication between the cochlear perilymph and cerebrospinal fluid in the internal auditory canal. Although the cochlear modiolus has been considered the route for this communication, this has not been confirmed through direct visualization of its enhancement. We qualitatively and quantitatively evaluated the presence of contrast enhancement in the modiolus in 19 patients with clinically suspected endolymphatic hydrops or hearing loss who underwent imaging as described above. The contrast ratio (CR) between the cochlear modiolus and cerebellar white matter on the injected side was 1.09+/-1.23, and that on the non-injected side was -0.48+/-0.38 (P<0.01). In all subjects, the CR value was larger on the injected than non-injected side, and enhancement of the cochlear modiolus was also recognized visually. Intratympanic Gd-DTPA can be administered to visualize enhancement of the cochlear modiolus and may thereby reveal its functional anatomy.

  2. Relationship Between Electrode-to-Modiolus Distance and Current Levels for Adults With Cochlear Implants.

    PubMed

    Davis, Timothy J; Zhang, Dongqing; Gifford, Rene H; Dawant, Benoit M; Labadie, Robert F; Noble, Jack H

    2016-01-01

    Electrode-to-modiolus distance is correlated with clinically programmed stimulation levels. Conventional wisdom has long supposed a significant relationship between cochlear implant (CI) stimulation levels and electrode-to-modiolus distance; however, to date, no such formal investigation has been completed. Thus, the purpose of this project was to investigate the relationship between stimulation levels and electrode-to-modiolus distance. A strong correlation between the two would suggest that stimulation levels might be used to estimate electrode-to-modiolus geometry. Electrode-to-modiolus distance was determined via CT imaging using validated CI position analysis software in 137 implanted ears from the three manufacturers holding FDA approval in the United States. Analysis included 2,365 total electrodes, with 1,472 from precurved arrays. Distances were compared to clinically programmed C/M levels that were converted to charge units. Mean modiolar distance with perimodiolar and lateral wall electrodes was 0.47 and 1.15 mm, respectively. Mean suprathreshold charge values were significantly different between each manufacturer. When combining all data, we found a moderate positive correlation (r = 0.367, p < 0.01) that was driven both by the different charge values across companies, and that the company with the highest mean charge values only offers straight electrode arrays. When grouped by electrode type, however, we found a weak correlation (r = 0.12, p < 0.01) for perimodiolar array electrodes only. When considering a single array type from any one manufacturer, only one was observed where distance mildly predicted charge. Our results suggest that electrode distance minimally contributes to the current level required for suprathreshold stimulation.

  3. The Versatile Modiolus Perforator Flap

    PubMed Central

    Gunnarsson, Gudjon Leifur; Thomsen, Jorn Bo

    2016-01-01

    Background: Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our experience using freestyle facial perforator flaps, we have located areas where perforators are consistently found. This study is focused on a particular perforator lateral to the angle of the mouth; the modiolus and the versatile modiolus perforator flap. Methods: A cohort case series of 14 modiolus perforator flap reconstructions in 14 patients and a color Doppler ultrasonography localization of the modiolus perforator in 10 volunteers. Results: All 14 flaps were successfully used to reconstruct the defects involved, and the location of the perforator was at the level of the modiolus as predicted. The color Doppler ultrasonography study detected a sizeable perforator at the level of the modiolus lateral to the angle of the mouth within a radius of 1 cm. This confirms the anatomical findings of previous authors and indicates that the modiolus perforator is a consistent anatomical finding, and flaps based on it can be recommended for several indications from the reconstruction of defects in the perioral area, cheek and nose. Conclusions: The modiolus is a well-described anatomical area containing a sizeable perforator that is consistently present and readily visualized using color Doppler ultrasonography. We have used the modiolus perforator flap successfully for several indications, and it is our first choice for perioral reconstruction. PMID:27257591

  4. [Surgery and electroneurophysiological evaluation for CI case with modiolus ossification].

    PubMed

    Zhang, Daoxing

    2014-08-01

    The purpose of this study is to report surgical skills for CI cases with modiolus ossification and to investigate the relation between post-operational electroneurophysilogical test result and speech recognition result. Further more, we also attempt to confirm indications for CI in this specific population. Based on temporal bone HRCT, 7 subjects were identified as modiolus ossification from 101 cases with cochlear ossification. Modiolus ossification is confirmed by CT scan if CT value in modiolus reaches or exceeds 900 HU with the exception of congenital modiolus ossification or modiolus seal off. Electroneurophysiological test was conducted intra- and pos-operationally speech tests were applied for 7 subjects. Normal impedance value was observed by intro-operational measurement in 7 subjects. EABR test was conducted and negtive response was observed in only 1 subject, while other 6 subjects were confirmed with atypical EABR waves which were observed in apical and middle turn region. Hearing threshold test (in sound field) was applied, no auditory response was recorded for the subject without EABR waveform, while hearing threshold in average for the other 6 subjects was 75 dB. Results of speech tests (Mandarin) were followed as 0 for the one without EABR wave, while 100% (simple finals test) and 30% (simple initials test) for the other 6 subjects. Optimal multichannel CI surgery that inserting and locating electrode array spirally is very frequently interrupted by ossification,which was indentified with atypical EABR wave and relative poor speech recognition results, especially in modiolus ossification case. A post-operative negative EABR response may indicate surgical failure following cochlear implantation.

  5. Modiolus-hugging intracochlear electrode array with shape memory alloy.

    PubMed

    Min, Kyou Sik; Jun, Sang Beom; Lim, Yoon Seob; Park, Se-Ik; Kim, Sung June

    2013-01-01

    In the cochlear implant system, the distance between spiral ganglia and the electrodes within the volume of the scala tympani cavity significantly affects the efficiency of the electrical stimulation in terms of the threshold current level and spatial selectivity. Because the spiral ganglia are situated inside the modiolus, the central axis of the cochlea, it is desirable that the electrode array hugs the modiolus to minimize the distance between the electrodes and the ganglia. In the present study, we propose a shape-memory-alloy-(SMA-) embedded intracochlear electrode which gives a straight electrode a curved modiolus-hugging shape using the restoration force of the SMA as triggered by resistive heating after insertion into the cochlea. An eight-channel ball-type electrode array is fabricated with an embedded titanium-nickel SMA backbone wire. It is demonstrated that the electrode array changes its shape in a transparent plastic human cochlear model. To verify the safe insertion of the electrode array into the human cochlea, the contact pressures during insertion at the electrode tip and the contact pressures over the electrode length after insertion were calculated using a 3D finite element analysis. The results indicate that the SMA-embedded electrode is functionally and mechanically feasible for clinical applications.

  6. Modiolus-Hugging Intracochlear Electrode Array with Shape Memory Alloy

    PubMed Central

    Min, Kyou Sik; Lim, Yoon Seob; Park, Se-Ik; Kim, Sung June

    2013-01-01

    In the cochlear implant system, the distance between spiral ganglia and the electrodes within the volume of the scala tympani cavity significantly affects the efficiency of the electrical stimulation in terms of the threshold current level and spatial selectivity. Because the spiral ganglia are situated inside the modiolus, the central axis of the cochlea, it is desirable that the electrode array hugs the modiolus to minimize the distance between the electrodes and the ganglia. In the present study, we propose a shape-memory-alloy-(SMA-) embedded intracochlear electrode which gives a straight electrode a curved modiolus-hugging shape using the restoration force of the SMA as triggered by resistive heating after insertion into the cochlea. An eight-channel ball-type electrode array is fabricated with an embedded titanium-nickel SMA backbone wire. It is demonstrated that the electrode array changes its shape in a transparent plastic human cochlear model. To verify the safe insertion of the electrode array into the human cochlea, the contact pressures during insertion at the electrode tip and the contact pressures over the electrode length after insertion were calculated using a 3D finite element analysis. The results indicate that the SMA-embedded electrode is functionally and mechanically feasible for clinical applications. PMID:23762181

  7. Commercially important species associated with horse mussel (Modiolus modiolus) biogenic reefs: A priority habitat for nature conservation and fisheries benefits.

    PubMed

    Kent, Flora E A; Mair, James M; Newton, Jason; Lindenbaum, Charles; Porter, Joanne S; Sanderson, William G

    2017-05-15

    Horse mussel reefs (Modiolus modiolus) are biodiversity hotspots afforded protection by Marine Protected Areas (MPAs) in the NE Atlantic. In this study, horse mussel reefs, cobble habitats and sandy habitats were assessed using underwater visual census and drop-down video techniques in three UK regions. Megafauna were enumerated, differences in community composition and individual species abundances were analysed. Samples of conspicuous megafauna were also collected from horse mussel reefs in Orkney for stable isotope analysis. Communities of conspicuous megafauna were different between horse mussel habitats and other habitats throughout their range. Three commercially important species: whelks (Buccinum undatum), queen scallops (Aequipecten opercularis) and spider crabs (Maja brachydactyla) were significantly more abundant (by as much as 20 times) on horse mussel reefs than elsewhere. Isotopic analysis provided insights into their trophic relationship with the horse mussel reef. Protection of M. modiolus habitat can achieve biodiversity conservation objectives whilst benefiting fisheries also. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ

    PubMed Central

    Chikar, Jennifer A.; Batts, Shelley A.; Pfingst, Bryan E.; Raphael, Yehoash

    2009-01-01

    Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament – labeled nerve processes within the scala tympani, and the spatial relationship between them. PMID:19428528

  9. Visual activation of auditory cortex reflects maladaptive plasticity in cochlear implant users.

    PubMed

    Sandmann, Pascale; Dillier, Norbert; Eichele, Tom; Meyer, Martin; Kegel, Andrea; Pascual-Marqui, Roberto Domingo; Marcar, Valentine Leslie; Jäncke, Lutz; Debener, Stefan

    2012-02-01

    Cross-modal reorganization in the auditory cortex has been reported in deaf individuals. However, it is not well understood whether this compensatory reorganization induced by auditory deprivation recedes once the sensation of hearing is partially restored through a cochlear implant. The current study used electroencephalography source localization to examine cross-modal reorganization in the auditory cortex of post-lingually deafened cochlear implant users. We analysed visual-evoked potentials to parametrically modulated reversing chequerboard images between cochlear implant users (n = 11) and normal-hearing listeners (n = 11). The results revealed smaller P100 amplitudes and reduced visual cortex activation in cochlear implant users compared with normal-hearing listeners. At the P100 latency, cochlear implant users also showed activation in the right auditory cortex, which was inversely related to speech recognition ability with the cochlear implant. These results confirm a visual take-over in the auditory cortex of cochlear implant users. Incomplete reversal of this deafness-induced cortical reorganization might limit clinical benefit from a cochlear implant and help explain the high inter-subject variability in auditory speech comprehension.

  10. Electrophysiological evidence for altered visual, but not auditory, selective attention in adolescent cochlear implant users.

    PubMed

    Harris, Jill; Kamke, Marc R

    2014-11-01

    Selective attention fundamentally alters sensory perception, but little is known about the functioning of attention in individuals who use a cochlear implant. This study aimed to investigate visual and auditory attention in adolescent cochlear implant users. Event related potentials were used to investigate the influence of attention on visual and auditory evoked potentials in six cochlear implant users and age-matched normally-hearing children. Participants were presented with streams of alternating visual and auditory stimuli in an oddball paradigm: each modality contained frequently presented 'standard' and infrequent 'deviant' stimuli. Across different blocks attention was directed to either the visual or auditory modality. For the visual stimuli attention boosted the early N1 potential, but this effect was larger for cochlear implant users. Attention was also associated with a later P3 component for the visual deviant stimulus, but there was no difference between groups in the later attention effects. For the auditory stimuli, attention was associated with a decrease in N1 latency as well as a robust P3 for the deviant tone. Importantly, there was no difference between groups in these auditory attention effects. The results suggest that basic mechanisms of auditory attention are largely normal in children who are proficient cochlear implant users, but that visual attention may be altered. Ultimately, a better understanding of how selective attention influences sensory perception in cochlear implant users will be important for optimising habilitation strategies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. The inferior cochlear vein: surgical aspects in cochlear implantation.

    PubMed

    Guo, Rui; Zhang, HongLei; Chen, Wei; Zhu, XiaoQuan; Liu, Wei; Rask-Andersen, Helge

    2016-02-01

    The patency of the inferior cochlear vein (ICV) may be challenged in cochlear implantation (CI) due to its location near the round window (RW). This may be essential to consider during selection of different trajectories for electrode insertion aiming at preserving residual hearing. Venous blood from the human cochlea is drained through the ICV. The vein also drains blood from the modiolus containing the spiral ganglion neurons. Surgical interference with this vein could cause neural damage influencing CI outcome. We analyzed the topographical relationship between the RW and ICV bony channel and cochlear aqueduct (CA) from a surgical standpoint. Archival human temporal bones were further microdissected to visualize the CA and its accessory canals (AC1 and AC2). This was combined with examinations of plastic and silicone molds of the human labyrinth. Metric analyses were made using photo stereomicroscopy documenting the proximal portion of the AC1, the internal aperture of the CA and the RW. The mean distance between the AC1 and the anterior rim of the RW was 0.81 mm in bone specimens and 0.67 mm assessed in corrosion casts. The AC1 runs from the floor of the scala tympani through the otic capsule passing parallel to the CA to the posterior cranial fossa. The mean distance between the CA and AC1 canal was 0.31 and 0.25 mm, respectively.

  12. [Impedance between modiolus and different walls of scala tympani].

    PubMed

    Du, Qiang; Wang, Zhengmin

    2008-10-01

    To compare the impedance between the modiolus and the inner wall of scala tympani with that between the modiolus and the outer wall of scala tympani. The impedances between the modiolus and the inner wall of scala tympani and the impedance between the modiolus and the outer wall of scala tympani were measured, calculated and compared under different stimulating rates 0.1, 1.0, 10.0 kHz. The impedance between the modiolus and the inner wall of scala tympani is less than that between the modiolus and the outer wall of scala tympani (P < 0.05). To effectively stimulate the residual neurons in the spiral ganglion, the electrodes should be kept close to the inner wall of scale tympani.

  13. Visual Cross-Modal Re-Organization in Children with Cochlear Implants

    PubMed Central

    2016-01-01

    Background Visual cross-modal re-organization is a neurophysiological process that occurs in deafness. The intact sensory modality of vision recruits cortical areas from the deprived sensory modality of audition. Such compensatory plasticity is documented in deaf adults and animals, and is related to deficits in speech perception performance in cochlear-implanted adults. However, it is unclear whether visual cross-modal re-organization takes place in cochlear-implanted children and whether it may be a source of variability contributing to speech and language outcomes. Thus, the aim of this study was to determine if visual cross-modal re-organization occurs in cochlear-implanted children, and whether it is related to deficits in speech perception performance. Methods Visual evoked potentials (VEPs) were recorded via high-density EEG in 41 normal hearing children and 14 cochlear-implanted children, aged 5–15 years, in response to apparent motion and form change. Comparisons of VEP amplitude and latency, as well as source localization results, were conducted between the groups in order to view evidence of visual cross-modal re-organization. Finally, speech perception in background noise performance was correlated to the visual response in the implanted children. Results Distinct VEP morphological patterns were observed in both the normal hearing and cochlear-implanted children. However, the cochlear-implanted children demonstrated larger VEP amplitudes and earlier latency, concurrent with activation of right temporal cortex including auditory regions, suggestive of visual cross-modal re-organization. The VEP N1 latency was negatively related to speech perception in background noise for children with cochlear implants. Conclusion Our results are among the first to describe cross modal re-organization of auditory cortex by the visual modality in deaf children fitted with cochlear implants. Our findings suggest that, as a group, children with cochlear implants show

  14. Visual Attention in Children with Normal Hearing, Children with Hearing Aids, and Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Tharpe, Anne Marie; Ashmead, Daniel H.; Rothpletz, Ann M.

    2002-01-01

    This study compared visual attention in 18 prelingually deaf children (half with cochlear implants and half with hearing aids) and 10 normal hearing children. Unlike previous studies, children in all three groups performed similarly on a continuous-performance visual attention task and on a letter cancellation task. Only age and nonverbal…

  15. In situ biodeposition measurements on a Modiolus modiolus (horse mussel) reef provide insights into ecosystem services

    NASA Astrophysics Data System (ADS)

    Kent, Flora E. A.; Last, Kim S.; Harries, Daniel B.; Sanderson, William G.

    2017-01-01

    Horse mussel (Modiolus modiolus) shellfish reefs are a threatened and declining habitat in the North East Atlantic and support high levels of biodiversity. Shellfish can influence the surrounding water column and modify the quality of material that reaches the seabed by filtering water, actively depositing particles and changing the benthic boundary layer due to surface roughness. In the present study M. modiolus biodeposition was measured in a field location for the first time. The results show that M. modiolus enhance sedimentation and contribute to the downward flux of material to the seabed. Approximately 30% of the total sediment deposition was attributed to active filter feeding and overall, the presence of horse mussels enhanced deposition two fold. The results are discussed in terms of the potential for horse mussel reefs to provide ecosystem services to society, through functions such as benthopelagic coupling and sediment stabilisation. Highlighting the societal benefits supplied by marine habitats can help prioritise conservation efforts and feed into the sustainable management of coastal water bodies.

  16. Subcellular Distribution of Heavy Metals in Organs of Bivalve Modiolus Modiolus Living Along a Metal Contamination Gradient

    NASA Astrophysics Data System (ADS)

    Podgurskaya, Olga V.; Kavun, Victor Ya.

    2006-03-01

    Concentration and distribution of Fe, Zn, Cu, Cd, Mn, Pb, Ni among subcellular fractions (cellular membrane structures and cytosol) and Zn, Cu, Cd among cytoplasmic proteins in the kidney and digestive gland of mussel Modiolus modiolus living along a polymetallic concentration gradient were studied. It was found in the kidney of M. modiolus from contaminated sites that the Fe percent increased in the “membrane” fraction, whereas Zn, Pb, Ni and Mn percent increased in the cytosol compared to the kidney of the control mussel. Note kidney cytosol of M. modiolus from clean and contaminated sites sequestered major parts of Cu and Cd. In the digestive gland of M. modiolus from contaminated sites Fe, Zn, Cd, Mn, Ni percent increased in the “membrane” fraction, whereas Cu, Pb percent increased in the cytosol compared to digestive gland of control mussel. Gel-filtration chromatography shows kidney of M. modiolus contains increased metallothionein-like protein levels irrespective of ambient dissolved metal concentrations. It was shown that the metal detoxification system in the kidney and digestive gland of M. modiolus was efficient under extremely high ambient metal levels. However, under complex environmental contamination in the kidney of M. modiolus, the metal detoxification capacity of metallothionein-like proteins was damaged.

  17. Chorioretinal scars and visual deprivation are common in children with cochlear implants after congenital cytomegalovirus infection.

    PubMed

    Teär Fahnehjelm, Kristina; Olsson, Monica; Fahnehjelm, Cecilia; Lewensohn-Fuchs, Ilona; Karltorp, Eva

    2015-07-01

    The aim of this study was to compare visual function and ocular characteristics in children with cochlear implants, due to severe hearing impairment caused by the congenital cytomegalovirus (CMV) infection, with control children fitted with cochlear implants due to connexin 26 mutations (Cx26), a genetic cause of hearing impairment. We carried out ophthalmological assessments, including visual acuity, ocular alignment, Ocular Motor Score, biomicroscopy and fundus photography, on 26 children with congenital CMV (median age 8.3 years, range 1.4-16.7) and 13 Cx26 controls (median age 5.6 years, range 1.7-12.5). We found unilateral chorioretinal macular scars that reduced best-corrected visual acuity ≤0.3 in five (19%) of the children with congenital CMV, but in none of the children with Cx26 (p = 0.15). Ocular motility problems were more common among children with congenital CMV, but the difference was not significant (p = 0.20). The vestibulo-ocular reflex was more frequently pathological in children with congenital CMV (p = 0.011). Ocular complications with central chorioretinal scars and ocular motility disturbances were common in children treated with cochlear implants due to severe hearing impairment caused by the congenital CMV infection. Ophthalmological assessments are advisable in such children for early identification, intervention and follow-up. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  18. Reproduction-related effects of green alga Coccomyxa sp. infestation in the horse mussel Modiolus modiolus.

    PubMed

    Vaschenko, M A; Kovaleva, A L; Syasina, I G; Kukhlevsky, A D

    2013-05-01

    The effects of Coccomyxa sp. infestation on the reproductive characteristics of the horse mussel Modiolus modiolus from the north-western Pacific (Peter the Great Bay, Sea of Japan) are demonstrated in this study. The mussels were collected monthly from May to September of 2009, and the prevalence of females and males with green tissues was 39% and 47%, respectively. Overall, the green alga infection caused a mild effect on gametogenesis in the horse mussel. The dynamics of gonad development in the healthy and infected mussels during the study period was generally similar, with the spawning being partial and occurring from the beginning of June to the first half of September; total spawning was recorded at the end of this period. However, several negative reproduction-related effects of the green alga infestation were observed, i.e., general gonadal underdevelopment, which was apparent from significant decrease in the acinus areas of the ovaries and testes and an increase in the connective tissue layer between the acini, a delay in some stages of the reproductive cycle and production of decreased number of spermatozoa and large vitellogenic oocytes, especially in the early spawning period (June). All of these results suggest a reduced reproductive output for the infected mussels. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Enhanced visual adaptation in cochlear implant users revealed by concurrent EEG-fNIRS.

    PubMed

    Chen, Ling-Chia; Stropahl, Maren; Schönwiesner, Marc; Debener, Stefan

    2017-02-01

    Previous studies have observed lower visual cortex activation for visual processing in cochlear implant (CI) users compared to normal hearing controls, while others reported enhanced visual speechreading abilities in CI users. The present work investigated whether lower visual cortical activation for visual processing can be explained by a more efficient visual sensory encoding in CI users. Specifically, we investigated whether CI users show enhanced stimulus-specific adaptation for visual stimuli compared to controls. Auditory sensory adaptation was also investigated to explore the sensory specificity of the predicted effect. Twenty post-lingually deafened adult CI users and twenty age-matched controls were presented with repeated visual and auditory stimuli during simultaneous acquisition of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). By integrating EEG and fNIRS signals we found significantly enhanced visual adaptation and lower visual cortex activation in CI users compared to controls. That is, responses to repeated visual stimuli decreased more prominently in CI users than in controls. The results suggest that CI users process visual stimuli more efficiently than controls.

  20. Auditory, visual, and auditory-visual perception of emotions by individuals with cochlear implants, hearing AIDS, and normal hearing.

    PubMed

    Most, Tova; Aviner, Chen

    2009-01-01

    This study evaluated the benefits of cochlear implant (CI) with regard to emotion perception of participants differing in their age of implantation, in comparison to hearing aid users and adolescents with normal hearing (NH). Emotion perception was examined by having the participants identify happiness, anger, surprise, sadness, fear, and disgust. The emotional content was placed upon the same neutral sentence. The stimuli were presented in auditory, visual, and combined auditory-visual modes. The results revealed better auditory identification by the participants with NH in comparison to all groups of participants with hearing loss (HL). No differences were found among the groups with HL in each of the 3 modes. Although auditory-visual perception was better than visual-only perception for the participants with NH, no such differentiation was found among the participants with HL. The results question the efficiency of some currently used CIs in providing the acoustic cues required to identify the speaker's emotional state.

  1. Experiments on Auditory-Visual Perception of Sentences by Users of Unilateral, Bimodal, and Bilateral Cochlear Implants

    ERIC Educational Resources Information Center

    Dorman, Michael F.; Liss, Julie; Wang, Shuai; Berisha, Visar; Ludwig, Cimarron; Natale, Sarah Cook

    2016-01-01

    Purpose: Five experiments probed auditory-visual (AV) understanding of sentences by users of cochlear implants (CIs). Method: Sentence material was presented in auditory (A), visual (V), and AV test conditions to listeners with normal hearing and CI users. Results: (a) Most CI users report that most of the time, they have access to both A and V…

  2. Experiments on Auditory-Visual Perception of Sentences by Users of Unilateral, Bimodal, and Bilateral Cochlear Implants

    ERIC Educational Resources Information Center

    Dorman, Michael F.; Liss, Julie; Wang, Shuai; Berisha, Visar; Ludwig, Cimarron; Natale, Sarah Cook

    2016-01-01

    Purpose: Five experiments probed auditory-visual (AV) understanding of sentences by users of cochlear implants (CIs). Method: Sentence material was presented in auditory (A), visual (V), and AV test conditions to listeners with normal hearing and CI users. Results: (a) Most CI users report that most of the time, they have access to both A and V…

  3. Auditory and Visual Electrophysiology of Deaf Children with Cochlear Implants: Implications for Cross-modal Plasticity

    PubMed Central

    Corina, David P.; Blau, Shane; LaMarr, Todd; Lawyer, Laurel A.; Coffey-Corina, Sharon

    2017-01-01

    Deaf children who receive a cochlear implant early in life and engage in intensive oral/aural therapy often make great strides in spoken language acquisition. However, despite clinicians’ best efforts, there is a great deal of variability in language outcomes. One concern is that cortical regions which normally support auditory processing may become reorganized for visual function, leaving fewer available resources for auditory language acquisition. The conditions under which these changes occur are not well understood, but we may begin investigating this phenomenon by looking for interactions between auditory and visual evoked cortical potentials in deaf children. If children with abnormal auditory responses show increased sensitivity to visual stimuli, this may indicate the presence of maladaptive cortical plasticity. We recorded evoked potentials, using both auditory and visual paradigms, from 25 typical hearing children and 26 deaf children (ages 2–8 years) with cochlear implants. An auditory oddball paradigm was used (85% /ba/ syllables vs. 15% frequency modulated tone sweeps) to elicit an auditory P1 component. Visual evoked potentials (VEPs) were recorded during presentation of an intermittent peripheral radial checkerboard while children watched a silent cartoon, eliciting a P1–N1 response. We observed reduced auditory P1 amplitudes and a lack of latency shift associated with normative aging in our deaf sample. We also observed shorter latencies in N1 VEPs to visual stimulus offset in deaf participants. While these data demonstrate cortical changes associated with auditory deprivation, we did not find evidence for a relationship between cortical auditory evoked potentials and the VEPs. This is consistent with descriptions of intra-modal plasticity within visual systems of deaf children, but do not provide evidence for cross-modal plasticity. In addition, we note that sign language experience had no effect on deaf children’s early auditory and visual

  4. Auditory and Visual Electrophysiology of Deaf Children with Cochlear Implants: Implications for Cross-modal Plasticity.

    PubMed

    Corina, David P; Blau, Shane; LaMarr, Todd; Lawyer, Laurel A; Coffey-Corina, Sharon

    2017-01-01

    Deaf children who receive a cochlear implant early in life and engage in intensive oral/aural therapy often make great strides in spoken language acquisition. However, despite clinicians' best efforts, there is a great deal of variability in language outcomes. One concern is that cortical regions which normally support auditory processing may become reorganized for visual function, leaving fewer available resources for auditory language acquisition. The conditions under which these changes occur are not well understood, but we may begin investigating this phenomenon by looking for interactions between auditory and visual evoked cortical potentials in deaf children. If children with abnormal auditory responses show increased sensitivity to visual stimuli, this may indicate the presence of maladaptive cortical plasticity. We recorded evoked potentials, using both auditory and visual paradigms, from 25 typical hearing children and 26 deaf children (ages 2-8 years) with cochlear implants. An auditory oddball paradigm was used (85% /ba/ syllables vs. 15% frequency modulated tone sweeps) to elicit an auditory P1 component. Visual evoked potentials (VEPs) were recorded during presentation of an intermittent peripheral radial checkerboard while children watched a silent cartoon, eliciting a P1-N1 response. We observed reduced auditory P1 amplitudes and a lack of latency shift associated with normative aging in our deaf sample. We also observed shorter latencies in N1 VEPs to visual stimulus offset in deaf participants. While these data demonstrate cortical changes associated with auditory deprivation, we did not find evidence for a relationship between cortical auditory evoked potentials and the VEPs. This is consistent with descriptions of intra-modal plasticity within visual systems of deaf children, but do not provide evidence for cross-modal plasticity. In addition, we note that sign language experience had no effect on deaf children's early auditory and visual ERP

  5. How does visual language affect crossmodal plasticity and cochlear implant success?

    PubMed Central

    Lyness, C.R.; Woll, B.; Campbell, R.; Cardin, V.

    2013-01-01

    Cochlear implants (CI) are the most successful intervention for ameliorating hearing loss in severely or profoundly deaf children. Despite this, educational performance in children with CI continues to lag behind their hearing peers. From animal models and human neuroimaging studies it has been proposed the integrative functions of auditory cortex are compromised by crossmodal plasticity. This has been argued to result partly from the use of a visual language. Here we argue that ‘cochlear implant sensitive periods’ comprise both auditory and language sensitive periods, and thus cannot be fully described with animal models. Despite prevailing assumptions, there is no evidence to link the use of a visual language to poorer CI outcome. Crossmodal reorganisation of auditory cortex occurs regardless of compensatory strategies, such as sign language, used by the deaf person. In contrast, language deprivation during early sensitive periods has been repeatedly linked to poor language outcomes. Language sensitive periods have largely been ignored when considering variation in CI outcome, leading to ill-founded recommendations concerning visual language in CI habilitation. PMID:23999083

  6. Visual attention, behavioral inhibition and speech/language outcomes in deaf children with cochlear implants

    PubMed Central

    Horn, David L.; Davisa, Rebecca A.O.; Pisoni, David B.; Miyamoto, Richard T.

    2012-01-01

    We investigated relations between sustained visual attention, behavioral inhibition skills, and speech–language outcomes in prelingually deaf children who use cochlear implants (CIs) using two computerized continuous performance tasks (CPTs). One test measured their ability to sustain visual attention to a string of numbers and another test measured their ability to delay a behavioral response. Performance on latter task was related to postimplant scores on tests of vocabulary knowledge, language skills, and speech intelligibility. We conclude that behavioral inhibition skills of prelingually deaf children are related to several audiological outcome measures in deaf children with CIs. Our findings suggest that further investigation is warranted into executive functions and subvocal rehearsal skills of deaf children with CIs. PMID:23100855

  7. Buried Alive: The Behavioural Response of the Mussels, Modiolus modiolus and Mytilus edulis to Sudden Burial by Sediment

    PubMed Central

    Hutchison, Zoë L.; Hendrick, Vicki J.; Burrows, Michael T.; Wilson, Ben; Last, Kim S.

    2016-01-01

    Sedimentation in the sea occurs through natural processes, such as wave and tidal action, which can be exacerbated during storms and floods. Changes in terrestrial land use, marine aggregate extraction, dredging, drilling and mining are known to result in substantial sediment deposition. Research suggests that deposition will also occur due to the modern development of marine renewable energy. The response to individual burial under three depths of sediment, three sediment fractions and five burial durations was investigated in two mussel species, Modiolus modiolus and Mytilus edulis in specialist mesocosms. Both mussel species showed substantial mortality, which increased with duration of burial and burial by finer sediment fractions. M. modiolus was better able to survive short periods of burial than M. edulis, but at longer durations mortality was more pronounced. No mortality was observed in M. modiolus in burial durations of eight days or less but by 16 days of burial, over 50% cumulative mortality occurred. Under variable temperature regimes, M. edulis mortality increased from 20% at 8°C to over 60% at 14.5 and 20°C. Only M. edulis was able to emerge from burial, facilitated by increased byssus production, laid mostly on vertical surfaces but also on sediment particles. Emergence was higher from coarse sediment and shallow burials. Byssus production in M. edulis was not related to the condition index of the mussels. Results suggest that even marginal burial would result in mortality and be more pronounced in warm summer periods. Our results suggest that in the event of burial, adult M. modiolus would not be able to emerge from burial unless local hydrodynamics assist, whereas a small proportion of M. edulis may regain contact with the sediment water interface. The physiological stress resulting in mortality, contribution of local hydrodynamics to survival and other ecological pressures such as mussels existing in aggregations, are discussed. PMID:26982582

  8. Buried Alive: The Behavioural Response of the Mussels, Modiolus modiolus and Mytilus edulis to Sudden Burial by Sediment.

    PubMed

    Hutchison, Zoë L; Hendrick, Vicki J; Burrows, Michael T; Wilson, Ben; Last, Kim S

    2016-01-01

    Sedimentation in the sea occurs through natural processes, such as wave and tidal action, which can be exacerbated during storms and floods. Changes in terrestrial land use, marine aggregate extraction, dredging, drilling and mining are known to result in substantial sediment deposition. Research suggests that deposition will also occur due to the modern development of marine renewable energy. The response to individual burial under three depths of sediment, three sediment fractions and five burial durations was investigated in two mussel species, Modiolus modiolus and Mytilus edulis in specialist mesocosms. Both mussel species showed substantial mortality, which increased with duration of burial and burial by finer sediment fractions. M. modiolus was better able to survive short periods of burial than M. edulis, but at longer durations mortality was more pronounced. No mortality was observed in M. modiolus in burial durations of eight days or less but by 16 days of burial, over 50% cumulative mortality occurred. Under variable temperature regimes, M. edulis mortality increased from 20% at 8°C to over 60% at 14.5 and 20°C. Only M. edulis was able to emerge from burial, facilitated by increased byssus production, laid mostly on vertical surfaces but also on sediment particles. Emergence was higher from coarse sediment and shallow burials. Byssus production in M. edulis was not related to the condition index of the mussels. Results suggest that even marginal burial would result in mortality and be more pronounced in warm summer periods. Our results suggest that in the event of burial, adult M. modiolus would not be able to emerge from burial unless local hydrodynamics assist, whereas a small proportion of M. edulis may regain contact with the sediment water interface. The physiological stress resulting in mortality, contribution of local hydrodynamics to survival and other ecological pressures such as mussels existing in aggregations, are discussed.

  9. Enhanced audio-visual interactions in the auditory cortex of elderly cochlear-implant users.

    PubMed

    Schierholz, Irina; Finke, Mareike; Schulte, Svenja; Hauthal, Nadine; Kantzke, Christoph; Rach, Stefan; Büchner, Andreas; Dengler, Reinhard; Sandmann, Pascale

    2015-10-01

    Auditory deprivation and the restoration of hearing via a cochlear implant (CI) can induce functional plasticity in auditory cortical areas. How these plastic changes affect the ability to integrate combined auditory (A) and visual (V) information is not yet well understood. In the present study, we used electroencephalography (EEG) to examine whether age, temporary deafness and altered sensory experience with a CI can affect audio-visual (AV) interactions in post-lingually deafened CI users. Young and elderly CI users and age-matched NH listeners performed a speeded response task on basic auditory, visual and audio-visual stimuli. Regarding the behavioral results, a redundant signals effect, that is, faster response times to cross-modal (AV) than to both of the two modality-specific stimuli (A, V), was revealed for all groups of participants. Moreover, in all four groups, we found evidence for audio-visual integration. Regarding event-related responses (ERPs), we observed a more pronounced visual modulation of the cortical auditory response at N1 latency (approximately 100 ms after stimulus onset) in the elderly CI users when compared with young CI users and elderly NH listeners. Thus, elderly CI users showed enhanced audio-visual binding which may be a consequence of compensatory strategies developed due to temporary deafness and/or degraded sensory input after implantation. These results indicate that the combination of aging, sensory deprivation and CI facilitates the coupling between the auditory and the visual modality. We suggest that this enhancement in multisensory interactions could be used to optimize auditory rehabilitation, especially in elderly CI users, by the application of strong audio-visually based rehabilitation strategies after implant switch-on. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Audio-visual speech intelligibility benefits with bilateral cochlear implants when talker location varies.

    PubMed

    van Hoesel, Richard J M

    2015-04-01

    One of the key benefits of using cochlear implants (CIs) in both ears rather than just one is improved localization. It is likely that in complex listening scenes, improved localization allows bilateral CI users to orient toward talkers to improve signal-to-noise ratios and gain access to visual cues, but to date, that conjecture has not been tested. To obtain an objective measure of that benefit, seven bilateral CI users were assessed for both auditory-only and audio-visual speech intelligibility in noise using a novel dynamic spatial audio-visual test paradigm. For each trial conducted in spatially distributed noise, first, an auditory-only cueing phrase that was spoken by one of four talkers was selected and presented from one of four locations. Shortly afterward, a target sentence was presented that was either audio-visual or, in another test configuration, audio-only and was spoken by the same talker and from the same location as the cueing phrase. During the target presentation, visual distractors were added at other spatial locations. Results showed that in terms of speech reception thresholds (SRTs), the average improvement for bilateral listening over the better performing ear alone was 9 dB for the audio-visual mode, and 3 dB for audition-alone. Comparison of bilateral performance for audio-visual and audition-alone showed that inclusion of visual cues led to an average SRT improvement of 5 dB. For unilateral device use, no such benefit arose, presumably due to the greatly reduced ability to localize the target talker to acquire visual information. The bilateral CI speech intelligibility advantage over the better ear in the present study is much larger than that previously reported for static talker locations and indicates greater everyday speech benefits and improved cost-benefit than estimated to date.

  11. Vestibular, Visual Acuity and Balance Outcomes in Children with Cochlear Implants: A Preliminary Report

    PubMed Central

    Janky, Kristen; Givens, Diane

    2016-01-01

    There is a high incidence of vestibular loss in children with cochlear implants (CCI). However, the relationship between vestibular loss and various outcomes is unknown in children. Objectives 1) determine if age-related changes in peripheral vestibular tests occur; 2) quantify peripheral vestibular function in children with normal hearing (CNH) and CCI; 3) determine if amount of vestibular loss predicts visual acuity and balance performance. Design Eleven CCI and 12 CNH completed the following tests of vestibular function: ocular and cervical vestibular evoked myogenic potential (VEMP) to assess utricle and saccule function, and the video head impulse test (vHIT) to assess semicircular canal function. The relationship between amount of vestibular loss and the following balance and visual acuity outcomes was assessed: dynamic gait index, single leg stance, the sensory organization test, and tests of visual acuity, including dynamic visual acuity and the gaze stabilization test. Results 1) There were no significant age-related changes in peripheral vestibular testing with the exception of the n23 cervical VEMP latency, which was moderately correlated with age; 2) CCI had significantly higher rates of vestibular loss for each test of canal and otolith function; 3) Amount of vestibular loss predicted performance on single leg stance, the dynamic gait index, some conditions of the sensory organization test, and the dynamic visual acuity test. Age was also a contributing factor for predicting the performance of almost all outcomes. Conclusions Preliminarily, children with vestibular loss do not recover naturally to levels of their healthy peers, particularly with activities that utilize vestibular input; they have poorer visual acuity and balance function. PMID:26182202

  12. Minimal effects of visual memory training on the auditory performance of adult cochlear implant users

    PubMed Central

    Oba, Sandra I.; Galvin, John J.; Fu, Qian-Jie

    2014-01-01

    Auditory training has been shown to significantly improve cochlear implant (CI) users’ speech and music perception. However, it is unclear whether post-training gains in performance were due to improved auditory perception or to generally improved attention, memory and/or cognitive processing. In this study, speech and music perception, as well as auditory and visual memory were assessed in ten CI users before, during, and after training with a non-auditory task. A visual digit span (VDS) task was used for training, in which subjects recalled sequences of digits presented visually. After the VDS training, VDS performance significantly improved. However, there were no significant improvements for most auditory outcome measures (auditory digit span, phoneme recognition, sentence recognition in noise, digit recognition in noise), except for small (but significant) improvements in vocal emotion recognition and melodic contour identification. Post-training gains were much smaller with the non-auditory VDS training than observed in previous auditory training studies with CI users. The results suggest that post-training gains observed in previous studies were not solely attributable to improved attention or memory, and were more likely due to improved auditory perception. The results also suggest that CI users may require targeted auditory training to improve speech and music perception. PMID:23516087

  13. Minimal effects of visual memory training on auditory performance of adult cochlear implant users.

    PubMed

    Oba, Sandra I; Galvin, John J; Fu, Qian-Jie

    2013-01-01

    Auditory training has been shown to significantly improve cochlear implant (CI) users' speech and music perception. However, it is unclear whether posttraining gains in performance were due to improved auditory perception or to generally improved attention, memory, and/or cognitive processing. In this study, speech and music perception, as well as auditory and visual memory, were assessed in 10 CI users before, during, and after training with a nonauditory task. A visual digit span (VDS) task was used for training, in which subjects recalled sequences of digits presented visually. After the VDS training, VDS performance significantly improved. However, there were no significant improvements for most auditory outcome measures (auditory digit span, phoneme recognition, sentence recognition in noise, digit recognition in noise), except for small (but significant) improvements in vocal emotion recognition and melodic contour identification. Posttraining gains were much smaller with the nonauditory VDS training than observed in previous auditory training studies with CI users. The results suggest that posttraining gains observed in previous studies were not solely attributable to improved attention or memory and were more likely due to improved auditory perception. The results also suggest that CI users may require targeted auditory training to improve speech and music perception.

  14. Connectivity and Dispersal Patterns of Protected Biogenic Reefs: Implications for the Conservation of Modiolus modiolus (L.) in the Irish Sea.

    PubMed

    Gormley, Kate; Mackenzie, Clara; Robins, Peter; Coscia, Ilaria; Cassidy, Andrew; James, Jenny; Hull, Angela; Piertney, Stuart; Sanderson, William; Porter, Joanne

    2015-01-01

    Biogenic reefs created by Modiolus modiolus (Linnaeus, 1758) (horse mussel reefs) are marine habitats which support high levels of species biodiversity and provide valuable ecosystem services. Currently, M. modiolus reefs are listed as a threatened and/or declining species and habitat in all OSPAR regions and thus are highlighted as a conservation priority under the EU Marine Strategy Framework Directive (MSFD). Determining patterns of larval dispersal and genetic connectivity of remaining horse mussel populations can inform management efforts and is a critical component of effective marine spatial planning (MSP). Larval dispersal patterns and genetic structure were determined for several M. modiolus bed populations in the Irish Sea including those in Wales (North Pen Llŷn), Isle of Man (Point of Ayre) and Northern Ireland (Ards Peninsula and Strangford Lough). Simulations of larval dispersal suggested extant connectivity between populations within the Irish Sea. Results from the genetic analysis carried out using newly developed microsatellite DNA markers were consistent with those of the biophysical model. Results indicated moderately significant differentiation between the Northern Ireland populations and those in the Isle of Man and Wales. Simulations of larval dispersal over a 30 day pelagic larval duration (PLD) suggest that connectivity over a spatial scale of 150km is possible between some source and sink populations. However, it appears unlikely that larvae from Northern Ireland will connect directly with sites on the Llŷn or Isle of Man. It also appears unlikely that larvae from the Llŷn connect directly to any of the other sites. Taken together the data establishes a baseline for underpinning management and conservation of these important and threatened marine habitats in the southern part of the known range.

  15. Connectivity and Dispersal Patterns of Protected Biogenic Reefs: Implications for the Conservation of Modiolus modiolus (L.) in the Irish Sea

    PubMed Central

    Gormley, Kate; Mackenzie, Clara; Robins, Peter; Coscia, Ilaria; Cassidy, Andrew; James, Jenny; Hull, Angela; Piertney, Stuart; Sanderson, William; Porter, Joanne

    2015-01-01

    Biogenic reefs created by Modiolus modiolus (Linnaeus, 1758) (horse mussel reefs) are marine habitats which support high levels of species biodiversity and provide valuable ecosystem services. Currently, M. modiolus reefs are listed as a threatened and/or declining species and habitat in all OSPAR regions and thus are highlighted as a conservation priority under the EU Marine Strategy Framework Directive (MSFD). Determining patterns of larval dispersal and genetic connectivity of remaining horse mussel populations can inform management efforts and is a critical component of effective marine spatial planning (MSP). Larval dispersal patterns and genetic structure were determined for several M. modiolus bed populations in the Irish Sea including those in Wales (North Pen Llŷn), Isle of Man (Point of Ayre) and Northern Ireland (Ards Peninsula and Strangford Lough). Simulations of larval dispersal suggested extant connectivity between populations within the Irish Sea. Results from the genetic analysis carried out using newly developed microsatellite DNA markers were consistent with those of the biophysical model. Results indicated moderately significant differentiation between the Northern Ireland populations and those in the Isle of Man and Wales. Simulations of larval dispersal over a 30 day pelagic larval duration (PLD) suggest that connectivity over a spatial scale of 150km is possible between some source and sink populations. However, it appears unlikely that larvae from Northern Ireland will connect directly with sites on the Llŷn or Isle of Man. It also appears unlikely that larvae from the Llŷn connect directly to any of the other sites. Taken together the data establishes a baseline for underpinning management and conservation of these important and threatened marine habitats in the southern part of the known range. PMID:26625263

  16. Sequence motifs associated with paternal transmission of mitochondrial DNA in the horse mussel, Modiolus modiolus (Bivalvia: Mytilidae).

    PubMed

    Robicheau, Brent M; Breton, Sophie; Stewart, Donald T

    2017-03-20

    In the majority of metazoans paternal mitochondria represent evolutionary dead-ends. In many bivalves, however, this paradigm does not hold true; both maternal and paternal mitochondria are inherited. Herein, we characterize maternal and paternal mitochondrial control regions of the horse mussel, Modiolus modiolus (Bivalvia: Mytilidae). The maternal control region is 808bp long, while the paternal control region is longer at 2.3kb. We hypothesize that the size difference is due to a combination of repeated duplications within the control region of the paternal mtDNA genome, as well as an evolutionarily ancient recombination event between two sex-associated mtDNA genomes that led to the insertion of a second control region sequence in the genome that is now transmitted via males. In a comparison to other mytilid male control regions, we identified two evolutionarily Conserved Motifs, CMA and CMB, associated with paternal transmission of mitochondrial DNA. CMA is characterized by a conserved purine/pyrimidine pattern, while CMB exhibits a specific 13bp nucleotide string within a stem and loop structure. The identification of motifs CMA and CMB in M. modiolus extends our understanding of Sperm Transmission Elements (STEs) that have recently been identified as being associated with the paternal transmission of mitochondria in marine bivalves. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Reproduction of auditory and visual standards in monochannel cochlear implant users.

    PubMed

    Kanabus, Magdalena; Szelag, Elzbieta; Kolodziejczyk, Iwona; Szuchnik, Joanna

    2004-01-01

    The temporal reproduction of standard durations ranging from 1 to 9 seconds was investigated in monochannel cochlear implant (CI) users and in normally hearing subjects for the auditory and visual modality. The results showed that the pattern of performance in patients depended on their level of auditory comprehension. Results for CI users, who displayed relatively good auditory comprehension, did not differ from that of normally hearing subjects for both modalities. Patients with poor auditory comprehension significantly overestimated shorter auditory standards (1, 1.5 and 2.5 s), compared to both patients with good comprehension and controls. For the visual modality the between-group comparisons were not significant. These deficits in the reproduction of auditory standards were explained in accordance with both the attentional-gate model and the role of working memory in prospective time judgment. The impairments described above can influence the functioning of the temporal integration mechanism that is crucial for auditory speech comprehension on the level of words and phrases. We postulate that the deficits in time reproduction of short standards may be one of the possible reasons for poor speech understanding in monochannel CI users.

  18. Cadaveric feasibility study of da Vinci Si-assisted cochlear implant with augmented visual navigation for otologic surgery.

    PubMed

    Liu, Wen P; Azizian, Mahdi; Sorger, Jonathan; Taylor, Russell H; Reilly, Brian K; Cleary, Kevin; Preciado, Diego

    2014-03-01

    To our knowledge, this is the first reported cadaveric feasibility study of a master-slave-assisted cochlear implant procedure in the otolaryngology-head and neck surgery field using the da Vinci Si system (da Vinci Surgical System; Intuitive Surgical, Inc). We describe the surgical workflow adaptations using a minimally invasive system and image guidance integrating intraoperative cone beam computed tomography through augmented reality. To test the feasibility of da Vinci Si-assisted cochlear implant surgery with augmented reality, with visualization of critical structures and facilitation with precise cochleostomy for electrode insertion. Cadaveric case study of bilateral cochlear implant approaches conducted at Intuitive Surgical Inc, Sunnyvale, California. Bilateral cadaveric mastoidectomies, posterior tympanostomies, and cochleostomies were performed using the da Vinci Si system on a single adult human donor cadaveric specimen. Radiographic confirmation of successful cochleostomies, placement of a phantom cochlear implant wire, and visual confirmation of critical anatomic structures (facial nerve, cochlea, and round window) in augmented stereoendoscopy. With a surgical mean time of 160 minutes per side, complete bilateral cochlear implant procedures were successfully performed with no violation of critical structures, notably the facial nerve, chorda tympani, sigmoid sinus, dura, or ossicles. Augmented reality image overlay of the facial nerve, round window position, and basal turn of the cochlea was precise. Postoperative cone beam computed tomography scans confirmed successful placement of the phantom implant electrode array into the basal turn of the cochlea. To our knowledge, this is the first study in the otolaryngology-head and neck surgery literature examining the use of master-slave-assisted cochleostomy with augmented reality for cochlear implants using the da Vinci Si system. The described system for cochleostomy has the potential to improve the

  19. Histomorphologic approach for the modiolus with reference to reconstructive and aesthetic surgery.

    PubMed

    Yu, Sun-Kyoung; Lee, Myoung-Hwa; Kim, Hong-San; Park, Jong-Tae; Kim, Heung-Joong; Kim, Hee-Jin

    2013-07-01

    The modiolus is strongly associated with facial expression, beauty, and aging, and so it is often viewed as the main facial landmark, both functionally and aesthetically. This study examined the modiolus and the surrounding structures histomorphologically with the aim of providing useful information for reconstructive and aesthetic surgery. Nineteen embalmed cadavers (38 hemifaces; 8 males and 11 females; mean age at death, 66.9 years) were examined in this study. For macroscopic observations, the modiolus and facial artery in the perioral region of 28 hemifaces were revealed by meticulous dissection. The modiolus and its surrounding structures were then prepared from 12 hemifaces for routine histology and stained with hematoxylin-eosin and Masson trichrome. A tendinous tissue nodule in the modiolus was found in 21.4% of cases (ie, 6 hemifaces). The facial artery passed approximately 1 mm lateral to the lateral border of the modiolus. In the central region of modiolus, which was an area of convergence of muscle fibers, the tendinous structure appeared as dense irregular collagenous connective tissue. Particularly in the middle layer between the skin and the oral mucosa, it appeared as a dense, compact, and prominent shape horizontally. The finding of the existence of a tendinous structure in the central region of the modiolus, which could act as an anchor for the converging facial muscles, is expected to provide critical information in the field of facial plastic surgery.

  20. Auditory cross-modal reorganization in cochlear implant users indicates audio-visual integration.

    PubMed

    Stropahl, Maren; Debener, Stefan

    2017-01-01

    There is clear evidence for cross-modal cortical reorganization in the auditory system of post-lingually deafened cochlear implant (CI) users. A recent report suggests that moderate sensori-neural hearing loss is already sufficient to initiate corresponding cortical changes. To what extend these changes are deprivation-induced or related to sensory recovery is still debated. Moreover, the influence of cross-modal reorganization on CI benefit is also still unclear. While reorganization during deafness may impede speech recovery, reorganization also has beneficial influences on face recognition and lip-reading. As CI users were observed to show differences in multisensory integration, the question arises if cross-modal reorganization is related to audio-visual integration skills. The current electroencephalography study investigated cortical reorganization in experienced post-lingually deafened CI users (n = 18), untreated mild to moderately hearing impaired individuals (n = 18) and normal hearing controls (n = 17). Cross-modal activation of the auditory cortex by means of EEG source localization in response to human faces and audio-visual integration, quantified with the McGurk illusion, were measured. CI users revealed stronger cross-modal activations compared to age-matched normal hearing individuals. Furthermore, CI users showed a relationship between cross-modal activation and audio-visual integration strength. This may further support a beneficial relationship between cross-modal activation and daily-life communication skills that may not be fully captured by laboratory-based speech perception tests. Interestingly, hearing impaired individuals showed behavioral and neurophysiological results that were numerically between the other two groups, and they showed a moderate relationship between cross-modal activation and the degree of hearing loss. This further supports the notion that auditory deprivation evokes a reorganization of the auditory system even at

  1. Cross-modal plasticity in deaf child cochlear implant candidates assessed using visual and somatosensory evoked potentials.

    PubMed

    Charroó-Ruíz, Lidia E; Picó, Thais; Pérez-Abalo, María C; Hernández, María del Carmen; Bermejo, Sandra; Bermejo, Beatriz; Álvarez, Beatriz; Paz, Antonio S; Rodríguez, Ulises; Sevila, Manuel; Martínez, Yesi; Galán, Lídice

    2013-01-01

    Cross-modal plasticity has been extensively studied in deaf adults with neuroimaging studies, yielding valuable results. A recent study in our laboratory with deaf-blind children found evidence of cross-modal plasticity, revealed in over-representation of median nerve somatosensory evoked potentials (SEP N20) in left hemisphere parietal, temporal and occipital regions. This finding led to asking whether SEP N20 changes are peculiar to deaf-blindness or are also present in sighted deaf children. Assess cross-modal plasticity in deaf child cochlear implant candidates using neurophysiological techniques (visual evoked potentials and median nerve somatosensory evoked potentials). Participants were 14 prelingually deaf children assessed in the Cuban Cochlear Implant Program. Flash visual-evoked potentials and SEP N20 were recorded at 19 scalp recording sites. Topographic maps were obtained and compared to those of control group children with normal hearing. Analysis took into account duration of hearing loss. Topographic maps of flash visual-evoked potentials did not show changes in deaf child cochlear implant candidates. However, SEP N20 from right median nerve stimulation did show changes from expansion of cortical activation into the left temporal region in deaf children aged ≥7 years, which was interpreted as neurophysiological evidence of cross-modal plasticity, not previously described for this technique and type of somatosensory stimulus. We interpret this finding as due in part to duration of deafness, particularly related to handedness, since expansion was selective for the left hemisphere in the children, who were all right-handed. Cortical over-representation of SEP N20 in the left temporal region is interpreted as evidence of cross-modal plasticity that occurs if the deaf child does not receive a cochlear implant early in life-before concluding the critical period of neural development-and relies on sign language for communication.

  2. Cross-Modal Functional Reorganization of Visual and Auditory Cortex in Adult Cochlear Implant Users Identified with fNIRS.

    PubMed

    Chen, Ling-Chia; Sandmann, Pascale; Thorne, Jeremy D; Bleichner, Martin G; Debener, Stefan

    2016-01-01

    Cochlear implant (CI) users show higher auditory-evoked activations in visual cortex and higher visual-evoked activation in auditory cortex compared to normal hearing (NH) controls, reflecting functional reorganization of both visual and auditory modalities. Visual-evoked activation in auditory cortex is a maladaptive functional reorganization whereas auditory-evoked activation in visual cortex is beneficial for speech recognition in CI users. We investigated their joint influence on CI users' speech recognition, by testing 20 postlingually deafened CI users and 20 NH controls with functional near-infrared spectroscopy (fNIRS). Optodes were placed over occipital and temporal areas to measure visual and auditory responses when presenting visual checkerboard and auditory word stimuli. Higher cross-modal activations were confirmed in both auditory and visual cortex for CI users compared to NH controls, demonstrating that functional reorganization of both auditory and visual cortex can be identified with fNIRS. Additionally, the combined reorganization of auditory and visual cortex was found to be associated with speech recognition performance. Speech performance was good as long as the beneficial auditory-evoked activation in visual cortex was higher than the visual-evoked activation in the auditory cortex. These results indicate the importance of considering cross-modal activations in both visual and auditory cortex for potential clinical outcome estimation.

  3. Effects of congruent and incongruent visual cues on speech perception and brain activity in cochlear implant users.

    PubMed

    Song, Jae-Jin; Lee, Hyo-Jeong; Kang, Hyejin; Lee, Dong Soo; Chang, Sun O; Oh, Seung Ha

    2015-03-01

    While deafness-induced plasticity has been investigated in the visual and auditory domains, not much is known about language processing in audiovisual multimodal environments for patients with restored hearing via cochlear implant (CI) devices. Here, we examined the effect of agreeing or conflicting visual inputs on auditory processing in deaf patients equipped with degraded artificial hearing. Ten post-lingually deafened CI users with good performance, along with matched control subjects, underwent H 2 (15) O-positron emission tomography scans while carrying out a behavioral task requiring the extraction of speech information from unimodal auditory stimuli, bimodal audiovisual congruent stimuli, and incongruent stimuli. Regardless of congruency, the control subjects demonstrated activation of the auditory and visual sensory cortices, as well as the superior temporal sulcus, the classical multisensory integration area, indicating a bottom-up multisensory processing strategy. Compared to CI users, the control subjects exhibited activation of the right ventral premotor-supramarginal pathway. In contrast, CI users activated primarily the visual cortices more in the congruent audiovisual condition than in the null condition. In addition, compared to controls, CI users displayed an activation focus in the right amygdala for congruent audiovisual stimuli. The most notable difference between the two groups was an activation focus in the left inferior frontal gyrus in CI users confronted with incongruent audiovisual stimuli, suggesting top-down cognitive modulation for audiovisual conflict. Correlation analysis revealed that good speech performance was positively correlated with right amygdala activity for the congruent condition, but negatively correlated with bilateral visual cortices regardless of congruency. Taken together these results suggest that for multimodal inputs, cochlear implant users are more vision-reliant when processing congruent stimuli and are disturbed

  4. SEASONAL VARIABILTIY LIPIDS, LIPID CLASSES AND PCBS IN INDIGENOUS POPULATIONS OF RIBBED MUSSELS, MODIOLUS DEMISSUS

    EPA Science Inventory

    Two indigenous ribbed mussel (Modiolus demissus) populations were sampled approximately every four weeks during 1997 to investigate the seasonal variability of total lipids, lipid classes, and polychlorinated biphenyl (PCB) concentrations. One population was located in a highly c...

  5. Auditory, Visual, and Auditory-Visual Perception of Emotions by Individuals with Cochlear Implants, Hearing Aids, and Normal Hearing

    ERIC Educational Resources Information Center

    Most, Tova; Aviner, Chen

    2009-01-01

    This study evaluated the benefits of cochlear implant (CI) with regard to emotion perception of participants differing in their age of implantation, in comparison to hearing aid users and adolescents with normal hearing (NH). Emotion perception was examined by having the participants identify happiness, anger, surprise, sadness, fear, and disgust.…

  6. Auditory, Visual, and Auditory-Visual Speech Perception by Individuals with Cochlear Implants versus Individuals with Hearing Aids

    ERIC Educational Resources Information Center

    Most, Tova; Rothem, Hilla; Luntz, Michal

    2009-01-01

    The researchers evaluated the contribution of cochlear implants (CIs) to speech perception by a sample of prelingually deaf individuals implanted after age 8 years. This group was compared with a group with profound hearing impairment (HA-P), and with a group with severe hearing impairment (HA-S), both of which used hearing aids. Words and…

  7. Auditory, Visual, and Auditory-Visual Perception of Emotions by Individuals with Cochlear Implants, Hearing Aids, and Normal Hearing

    ERIC Educational Resources Information Center

    Most, Tova; Aviner, Chen

    2009-01-01

    This study evaluated the benefits of cochlear implant (CI) with regard to emotion perception of participants differing in their age of implantation, in comparison to hearing aid users and adolescents with normal hearing (NH). Emotion perception was examined by having the participants identify happiness, anger, surprise, sadness, fear, and disgust.…

  8. Auditory, Visual, and Auditory-Visual Speech Perception by Individuals with Cochlear Implants versus Individuals with Hearing Aids

    ERIC Educational Resources Information Center

    Most, Tova; Rothem, Hilla; Luntz, Michal

    2009-01-01

    The researchers evaluated the contribution of cochlear implants (CIs) to speech perception by a sample of prelingually deaf individuals implanted after age 8 years. This group was compared with a group with profound hearing impairment (HA-P), and with a group with severe hearing impairment (HA-S), both of which used hearing aids. Words and…

  9. Cochlear Implants

    MedlinePlus

    ... Medical Procedures Implants and Prosthetics Cochlear Implants Cochlear Implants Share Tweet Linkedin Pin it More sharing options ... normal ear, ear with hearing loss, and cochlear implant procedure Welcome to the Food and Drug Administration ( ...

  10. Phylogenetic and morphological characterization of the green alga infesting the horse mussel Modiolus modiolus from Vityaz Bay (Peter the Great Bay, Sea of Japan).

    PubMed

    Syasina, I G; Kukhlevsky, A D; Kovaleva, A L; Vaschenko, M A

    2012-10-01

    In this work, the ultrastructural features and taxonomic position of the green microalga infesting the horse mussel Modiolus modiolus from the north-western Pacific (Vityaz Bay, Peter the Great Bay, Sea of Japan) are reported. Mussels were collected monthly from May to September of 2009. In different months, the prevalence of mussels with green tissues was 16.6-62.5% (mean 43%). The most affected organs were the mantle, digestive gland and gonad. Histological analysis revealed severe infiltration of the connective tissue by hemocytes containing the alga cells. Electron microscopy showed that the alga was morphologically similar to the green algae from the genus Coccomyxa (Chlorophyta: Chlorococcales). Two new primers were designed to generate partial small subunit (SSU) rRNA sequences of the green alga from M. modiolus. Phylogenetic analysis based on the comparison of the SSU rRNA sequences of the trebouxiophyceans confirmed an affiliation of the green alga with the genus Coccomyxa. The sequence (1296 bases) of the green alga from M. modiolus was most closely related to the sequence CPCC 508 (AM981206) (identity 100%), obtained from an acid-tolerant, free-living chlorophyte microalga Coccomyxa sp. and to the sequences EU127470 (identity 99.3%) and EU127471 (identity 99.7%) of the green alga, presumably the true Coccomyxa parasitica, infecting the blue mussel Mytilus edulis from the Flensburg Fjord (North Atlantic). Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Auditory and audio-visual processing in patients with cochlear, auditory brainstem, and auditory midbrain implants: An EEG study.

    PubMed

    Schierholz, Irina; Finke, Mareike; Kral, Andrej; Büchner, Andreas; Rach, Stefan; Lenarz, Thomas; Dengler, Reinhard; Sandmann, Pascale

    2017-04-01

    There is substantial variability in speech recognition ability across patients with cochlear implants (CIs), auditory brainstem implants (ABIs), and auditory midbrain implants (AMIs). To better understand how this variability is related to central processing differences, the current electroencephalography (EEG) study compared hearing abilities and auditory-cortex activation in patients with electrical stimulation at different sites of the auditory pathway. Three different groups of patients with auditory implants (Hannover Medical School; ABI: n = 6, CI: n = 6; AMI: n = 2) performed a speeded response task and a speech recognition test with auditory, visual, and audio-visual stimuli. Behavioral performance and cortical processing of auditory and audio-visual stimuli were compared between groups. ABI and AMI patients showed prolonged response times on auditory and audio-visual stimuli compared with NH listeners and CI patients. This was confirmed by prolonged N1 latencies and reduced N1 amplitudes in ABI and AMI patients. However, patients with central auditory implants showed a remarkable gain in performance when visual and auditory input was combined, in both speech and non-speech conditions, which was reflected by a strong visual modulation of auditory-cortex activation in these individuals. In sum, the results suggest that the behavioral improvement for audio-visual conditions in central auditory implant patients is based on enhanced audio-visual interactions in the auditory cortex. Their findings may provide important implications for the optimization of electrical stimulation and rehabilitation strategies in patients with central auditory prostheses. Hum Brain Mapp 38:2206-2225, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  12. Nuclear entry of hyperbranched polylysine nanoparticles into cochlear cells

    PubMed Central

    Zhang, Weikai; Zhang, Ya; Löbler, Marian; Schmitz, Klaus-Peter; Ahmad, Aqeel; Pyykkö, Ilmari; Zou, Jing

    2011-01-01

    Background: Gene therapy is a potentially effective therapeutic modality for treating sensorineural hearing loss. Nonviral gene delivery vectors are expected to become extremely safe and convenient, and nanoparticles are the most promising types of vectors. However, infrequent nuclear localization in the cochlear cells limits their application for gene therapy. This study aimed to investigate the potential nuclear entry of hyperbranched polylysine nanoparticles (HPNPs) for gene delivery to cochlear targets. Methods: Rat primary cochlear cells and cochlear explants generated from newborn rats were treated with different concentrations of HPNPs. For the in vivo study, HPNPs were administered to the rats’ round window membranes. Subcellular distribution of HPNPs in different cell populations was observed with confocal microscope 24 hours after administration. Results: Nuclear entry was observed in various cochlear cell types in vitro and in vivo. In the primary cochlear cell culture, concentration-dependent internalization was observed. In the cochlear organotypic culture, abundant HPNPs were found in the modiolus, including the spiral ganglion, organ of Corti, and lateral wall tissues. In the in vivo study, a gradient distribution of HPNPs through different layers of the round window membrane was observed. HPNPs were also distributed in the cells of the middle ear tissue. Additionally, efficient internalization of HPNPs was observed in the organ of Corti and spiral ganglion cells. In primary cochlear cells, HPNPs induced higher transfection efficiency than did Lipofectamine™. Conclusion: These results suggest that HPNPs are potentially an ideal carrier for gene delivery into the cochlea. PMID:21468356

  13. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  14. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  15. The use of auditory and visual context in speech perception by listeners with normal hearing and listeners with cochlear implants

    PubMed Central

    Winn, Matthew B.; Rhone, Ariane E.; Chatterjee, Monita; Idsardi, William J.

    2013-01-01

    There is a wide range of acoustic and visual variability across different talkers and different speaking contexts. Listeners with normal hearing (NH) accommodate that variability in ways that facilitate efficient perception, but it is not known whether listeners with cochlear implants (CIs) can do the same. In this study, listeners with NH and listeners with CIs were tested for accommodation to auditory and visual phonetic contexts created by gender-driven speech differences as well as vowel coarticulation and lip rounding in both consonants and vowels. Accommodation was measured as the shifting of perceptual boundaries between /s/ and /∫/ sounds in various contexts, as modeled by mixed-effects logistic regression. Owing to the spectral contrasts thought to underlie these context effects, CI listeners were predicted to perform poorly, but showed considerable success. Listeners with CIs not only showed sensitivity to auditory cues to gender, they were also able to use visual cues to gender (i.e., faces) as a supplement or proxy for information in the acoustic domain, in a pattern that was not observed for listeners with NH. Spectrally-degraded stimuli heard by listeners with NH generally did not elicit strong context effects, underscoring the limitations of noise vocoders and/or the importance of experience with electric hearing. Visual cues for consonant lip rounding and vowel lip rounding were perceived in a manner consistent with coarticulation and were generally used more heavily by listeners with CIs. Results suggest that listeners with CIs are able to accommodate various sources of acoustic variability either by attending to appropriate acoustic cues or by inferring them via the visual signal. PMID:24204359

  16. Relationship between mRNA biomarker candidates and location near a marine municipal wastewater outfall in the benthic indicator species Modiolus modiolus (L.).

    PubMed

    Veldhoen, Nik; Kobylarz, Marek; Lowe, Christopher J; Meloche, Lizanne; deBruyn, Adrian M H; Helbing, Caren C

    2011-09-01

    The deep-sea horse mussel Modiolus modiolus (L.) is a sentinel bivalve species used for the assessment of potential biological exposure to anthropogenic contaminants in benthic environments. Using a combination of endpoints that included gross biological metrics, reproductive status, tissue contaminant load, and mRNA abundance profiles, we characterized variation in the local M. modiolus population situated in different spatial zones relative to a municipal wastewater outfall. Significant differences were observed in reproductive indicators, growth parameters, and abundance of four specific mRNA transcripts representative of stress response or membrane transport (CAT, NET/SCF6, ABCA4 and HSP70) in adductor muscle tissue of animals adjacent to the wastewater outfall. Concentrations of metals and organic chemicals in M. modiolus tissue were generally highest directly at the outfall site with much lower levels at 100-800 m from the outfall. This general pattern did not match the mRNA profiles. HSP70 and ABCA4 mRNA showed increased abundance in all regions adjacent to the municipal outfall compared to the reference site. One site group located within 100-200 m south/south-easterly of the outfall had increased levels of all four transcripts. Some mRNAs showed significant correlations with nickel, arsenic, lead, selenium, copper, and one of thirteen polycyclic aromatic hydrocarbons measured (dibenzo(a,h)-anthracene). Three mRNAs (CAT, NET/SCF6, and ABCA4) were negatively correlated with bis(2-ethylhexyl)phthalate. The data suggest that these benthic organisms are exhibiting biological responses to the outfall and support an alternate interpretation regarding dispersal of contaminants. The potential effects of emerging chemicals of concern entering the receiving environment merits further assessment. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Experiments on Auditory-Visual Perception of Sentences by Users of Unilateral, Bimodal, and Bilateral Cochlear Implants

    PubMed Central

    Liss, Julie; Wang, Shuai; Berisha, Visar; Ludwig, Cimarron; Natale, Sarah Cook

    2016-01-01

    Purpose Five experiments probed auditory-visual (AV) understanding of sentences by users of cochlear implants (CIs). Method Sentence material was presented in auditory (A), visual (V), and AV test conditions to listeners with normal hearing and CI users. Results (a) Most CI users report that most of the time, they have access to both A and V information when listening to speech. (b) CI users did not achieve better scores on a task of speechreading than did listeners with normal hearing. (c) Sentences that are easy to speechread provided 12 percentage points more gain to speech understanding than did sentences that were difficult. (d) Ease of speechreading for sentences is related to phrase familiarity. (e) Users of bimodal CIs benefit from low-frequency acoustic hearing even when V cues are available, and a second CI adds to the benefit of a single CI when V cues are available. (f) V information facilitates lexical segmentation by improving the recognition of the number of syllables produced and the relative strength of these syllables. Conclusions Our data are consistent with the view that V information improves CI users' ability to identify syllables in the acoustic stream and to recognize their relative juxtaposed strengths. Enhanced syllable resolution allows better identification of word onsets, which, when combined with place-of-articulation information from visible consonants, improves lexical access. PMID:27960006

  18. Experiments on Auditory-Visual Perception of Sentences by Users of Unilateral, Bimodal, and Bilateral Cochlear Implants.

    PubMed

    Dorman, Michael F; Liss, Julie; Wang, Shuai; Berisha, Visar; Ludwig, Cimarron; Natale, Sarah Cook

    2016-12-01

    Five experiments probed auditory-visual (AV) understanding of sentences by users of cochlear implants (CIs). Sentence material was presented in auditory (A), visual (V), and AV test conditions to listeners with normal hearing and CI users. (a) Most CI users report that most of the time, they have access to both A and V information when listening to speech. (b) CI users did not achieve better scores on a task of speechreading than did listeners with normal hearing. (c) Sentences that are easy to speechread provided 12 percentage points more gain to speech understanding than did sentences that were difficult. (d) Ease of speechreading for sentences is related to phrase familiarity. (e) Users of bimodal CIs benefit from low-frequency acoustic hearing even when V cues are available, and a second CI adds to the benefit of a single CI when V cues are available. (f) V information facilitates lexical segmentation by improving the recognition of the number of syllables produced and the relative strength of these syllables. Our data are consistent with the view that V information improves CI users' ability to identify syllables in the acoustic stream and to recognize their relative juxtaposed strengths. Enhanced syllable resolution allows better identification of word onsets, which, when combined with place-of-articulation information from visible consonants, improves lexical access.

  19. Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test

    PubMed Central

    Gnanasegaram, Joshua J.; Parkes, William J.; Cushing, Sharon L.; McKnight, Carmen L.; Papsin, Blake C.; Gordon, Karen A.

    2016-01-01

    Vestibular end organ impairment is highly prevalent in children who have sensorineural hearing loss (SNHL) rehabilitated with cochlear implants (CIs). As a result, spatial perception is likely to be impacted in this population. Of particular interest is the perception of visual vertical because it reflects a perceptual tilt in the roll axis and is sensitive to an imbalance in otolith function. The objectives of the present study were thus to identify abnormalities in perception of the vertical plane in children with SNHL and determine whether such abnormalities could be resolved with stimulation from the CI. Participants included 53 children (15.2 ± 4.0 years of age) with SNHL and vestibular loss, confirmed with vestibular evoked myogenic potential (VEMP) testing. Testing protocol was validated in a sample of nine young adults with normal hearing (28.8 ± 7.7 years). Perception of visual vertical was assessed using the static Subjective Visual Vertical (SVV) test performed with and without stimulation in the participants with cochleovestibular loss. Trains of electrical pulses were delivered by an electrode in the left and/or right ear. Asymmetric spatial orientation deficits were found in nearly half of the participants with CIs (24/53 [45%]). The abnormal perception in this cohort was exacerbated by visual tilts in the direction of their deficit. Electric pulse trains delivered using the CI shifted this abnormal perception towards center (i.e., normal; p = 0.007). Importantly, this benefit was realized regardless of which ear was stimulated. These results suggest a role for CI stimulation beyond the auditory system, in particular, for improving vestibular/balance function. PMID:27679562

  20. Consensus panel on a cochlear coordinate system applicable in histological, physiological and radiological studies of the human cochlea

    PubMed Central

    Verbist, Berit M; Skinner, Margaret W; Cohen, Lawrence T; Leake, Patricia A.; James, Chris; Boëx, Colette; Holden, Timothy A; Finley, Charles C; Roland, Peter S; Roland, J. Thomas; Haller, Matt; Patrick, Jim F; Jolly, Claude N; Faltys, Mike A; Briaire, Jeroen J; Frijns, Johan HM

    2010-01-01

    Hypothesis An objective cochlear framework, for evaluation of the cochlear anatomy and description of the position of an implanted cochlear implant electrode, would allow the direct comparison of measures performed within the various sub-disciplines involved in cochlear implant research. Background Research on the human cochlear anatomy in relation to tonotopy and cochlear implantation is conducted by specialists from numerous disciplines such as histologists, surgeons, physicists, engineers, audiologists and radiologists. To allow accurate comparisons between and combinations of previous and forthcoming scientific and clinical studies, cochlear structures and electrode positions must be specified in a consistent manner. Methods Researchers with backgrounds in the various fields of inner ear research as well as representatives of the different manufacturers of cochlear implants (Advanced Bionics Corp, Med-El, Cochlear Corp) were involved in consensus meetings held in Dallas, March 2005 and Asilomar, August 2005. Existing coordinate systems were evaluated and requisites for an objective cochlear framework were discussed. Results The consensus panel agreed upon a 3-dimensional, cylindrical coordinate system of the cochlea using the “Cochlear View” as a basis and choosing a z-axis through the modiolus. The zero reference angle was chosen at the centre of the round window, which has a close relationship to the basal end of the Organ of Corti. Conclusions Consensus was reached on an objective cochlear framework, allowing the outcomes of studies from different fields of research to be compared directly. PMID:20147866

  1. Static and dynamic posture control in postlingual cochlear implanted patients: effects of dual-tasking, visual and auditory inputs suppression

    PubMed Central

    Bernard-Demanze, Laurence; Léonard, Jacques; Dumitrescu, Michel; Meller, Renaud; Magnan, Jacques; Lacour, Michel

    2014-01-01

    Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body's position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. This study was aimed at evaluating the effects of postlingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static (stable platform) and dynamic (platform in translation) conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the CI activated (ON) or not (OFF). Results showed that the postural performance of the CI patients strongly differed from the controls, mainly in the EC condition. The CI patients showed significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk: they behaved dynamically without vision like an inverted pendulum while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well

  2. Cochlear Histopathology as Observed in Two Patients With a Cochlear Implant Electrode With Positioner.

    PubMed

    Kamakura, Takefumi; Nadol, Joseph B

    2016-07-01

    This study reports the cochlear histopathology of two patients who during life underwent cochlear implantation with a positioner. A silastic positioner introduced by the Advanced Bionics Corporation in 1999 was designed to position the electrode of the cochlear implant close to the modiolus. The positioner was recalled in the United States in July 2002 because of an apparent higher incidence of bacterial meningitis in patients in whom the positioner had been placed. Four celloidin-embedded temporal bones from two patients with cochlear implants with a positioner from the temporal bone collection of the Massachusetts Eye and Ear Infirmary were included in the study. In a previous study, we reported histopathologic findings in Patient 1, and in this report, we present the findings in a second case in a 94-year-old woman (Patient 2), and the similarities and differences between the two patients. All four specimens were prepared for histologic study by conventional techniques and 2-D reconstruction. Evidence of insertion trauma was observed in all three implanted specimens. More significant trauma was found in Patient 2 than in Patient 1 including disruption of the osseous spiral lamina and the basilar membrane. In addition, there was more new fibrous tissue and bone in Patient 2 than in Patient 1. There was a large fluid space in all three implanted temporal bones around the electrode and positioner. The findings observed in the two patients may help to explain the increased risk of meningitis in patients implanted with a positioner.

  3. Development of an electrode for the artificial cochlear sensory epithelium.

    PubMed

    Tona, Yosuke; Inaoka, Takatoshi; Ito, Juichi; Kawano, Satoyuki; Nakagawa, Takayuki

    2015-12-01

    An artificial cochlear sensory epithelium has been developed on the basis of a new concept that the piezoelectric membrane, which converts mechanical distortion into electricity, can mimic the function of the inner hair cell and basilar membrane of the mammalian cochlea. Our previous research demonstrated that the piezoelectric membrane generated electrical outputs in response to the sound stimulation after implantation into the guinea pig cochlea, whereas electrodes for the stimulation of spiral ganglion neurons have not been fabricated, and a method to fix the device in the cochlea is also required to show proof-of-concept. In the present study, to achieve proof-of-concept of hearing recovery by implantation of the artificial cochlear sensory epithelium, we fabricated new electrodes that stick into the cochlear modiolus, which also play a role in the fixation of the device in the cochlea. The efficacy of new electrodes for fixation of the device in the cochlea and for the stimulation of spiral ganglion neurons was estimated in guinea pigs. Four weeks after implantation, we confirmed that the devices were in place. Histological analysis of the implanted cochleae revealed inconspicuous fibrosis and scar formation compared with the sham-operated specimens (n = 5 for each). The terminal deoxynucleotidyl transferase dUTP nick end labeling method was used to assess cell death due to surgical procedures in the cochleae that were harvested after 1 day (n = 6) and 7 days (n = 6) of implantation; there was no significant increase in apoptotic cell death in the implanted cochleae compared with sham-operated cochleae. In seven animals, serial measurements of electrically evoked auditory brainstem responses were obtained, with the electrode positioned in the scala tympani and with the electrode inserted into the cochlear modiolus. With the insertion of electrodes into the cochlear modiolus, significant reduction was achieved in the thresholds of electrically evoked auditory

  4. [The non-damaging method for the insertion of a standard electrode for cochlear ossification].

    PubMed

    Diab, Kh M; Daikhes, N A; Pashchinina, O A; Siraeva, A R; Kuznetsov, A O

    2016-01-01

    The objective of the present study was to develop the non-damaging method for the insertion of a standard electrode for cochlear ossification with a view to improving the results of hearing and speech rehabilitation of the patients presenting with grade IV sensorineural impairment of hearing. Twenty preparations of the cadaveric temporal bone were used to investigate topographic and anatomical relationships in the main structures of the middle and internal ears, viz. the second cochlear coil, vestibulum and its windows, processus cochleaformis, spiral lamina, and modiolus. The optimal method for the insertion of a standard electrode into the spiral canal of the cochlea after the removal of the ossified structures is proposed. The optimal site for constructing the second colostomy is determined that allows the spiral plate and modiolus to be maximally preserved. The proposed method was employed to treat 11 patients with grade IV sensorineural impairment of hearing and more than 5 mm ossification of the basal cochlear coil. With this method, it proved possible to insert the maximum number of electrodes into the cochlear spiral canal and thereby to obtain excellent results of hearing and speech rehabilitation in the patients with the ossified cochlea.

  5. Cochlear's unique electrode portfolio now and in the future.

    PubMed

    von Wallenberg, E; Briggs, R

    2014-05-01

    To review Cochlear's electrode portfolio and discuss the merits of current and future straight and perimodiolar electrode arrays. To present an update on implant reliability. Performance and hearing preservation data from studies involving the Slim Straight (CI422), Hybrid L24 and Contour Advance electrode array were reviewed. While several studies in past found little difference in performance outcomes between subjects implanted with perimodiolar and straight arrays, recent studies demonstrated that proximity to the modiolus is correlated with better performance. Hearing threshold increase was lowest with the Hybrid L24, closely followed by the slim straight array and was largest with the Contour Advance array. The CI24RE receiver-stimulator used for the three arrays had a cumulative survival of 99% at eight years post implantation. Combining the hearing preservation benefits of slim straight arrays with perimodiolar proximity is the design objective of Cochlear's next generation electrodes.

  6. Cochlear coordinates in regard to cochlear implantation: a clinically individually applicable 3 dimensional CT-based method.

    PubMed

    Verbist, Berit M; Joemai, Raoul M S; Briaire, Jeroen J; Teeuwisse, Wouter M; Veldkamp, Wouter J H; Frijns, Johan H M

    2010-07-01

    Cochlear implant (CI)/tertiary referral center. Twenty-five patients implanted with an Advanced Bionics HiRes90K HiFocus1J CI. STUDY DESIGN/MAIN OUTCOME MEASURES: A 3-dimensional cylindrical coordinate system is introduced using the basal turn of the cochlea as the x and y planes and the center of the modiolus as the z axis. The 0-degree angle is defined by the most lateral point of the horizontal semicircular canal. It is applied to both preoperative and postoperative computed tomographies in 25 patients. The angular position of the round window is examined. Interobserver reproducibility is tested by localization of all electrode contacts within the coordinate system. To observe realignment over time, electrode coordinates in postoperative images were projected on preoperative images. Additionally, comparison to existing imaging-related coordinate systems was made. The angular position of the center of the round window is 34.6 +/- 0.4 degrees (standard deviation) with an intraclass coefficient of 1.00. The intraclass coefficient for interobserver reproducibility of the 16 electrode contacts ranged from 0.74 to 1 for the rotational angle (phi) and 0.77 to 1 for the distance to the modiolus (rho). In 21 of 25 patients, a perfect match or minimal displacement of up to 3 electrode contacts was seen. Comparison to existing systems showed good correlation. A 3-dimensional cochlear coordinate system easily applicable in clinical patients is described, which fulfills the requirements set by an international consensus.

  7. Visualization of Live Cochlear Stereocilia at a Nanoscale Resolution Using Hopping Probe Ion Conductance Microscopy

    PubMed Central

    Vélez-Ortega, A. Catalina; Frolenkov, Gregory I.

    2016-01-01

    The mechanosensory apparatus that detects sound-induced vibrations in the cochlea is located on the apex of the auditory sensory hair cells and it is made up of actin-filled projections, called stereocilia. In young rodents, stereocilia bundles of auditory hair cells consist of 3 to 4 rows of stereocilia of decreasing height and varying thickness. Morphological studies of the auditory stereocilia bundles in live hair cells have been challenging because the diameter of each stereocilium is near or below the resolution limit of optical microscopy. In theory, scanning probe microscopy techniques, such as atomic force microscopy, could visualize the surface of a living cell at a nanoscale resolution. However, their implementations for hair cell imaging have been largely unsuccessful because the probe usually damages the bundle and disrupts the bundle cohesiveness during imaging. We overcome these limitations by using hopping probe ion conductance microscopy (HPICM), a non-contact scanning probe technique that is ideally suited for the imaging of live cells with a complex topography. Organ of Corti explants are placed in a physiological solution and then a glass nanopipette –which is connected to a 3D-positioning piezoelectric system and to a patch clamp amplifier– is used to scan the surface of the live hair cells at nanometer resolution without ever touching the cell surface. Here we provide a detailed protocol for the imaging of mouse or rat stereocilia bundles in live auditory hair cells using HPICM. We provide information about the fabrication of the nanopipettes, the calibration of the HPICM setup, the parameters we have optimized for the imaging of live stereocilia bundles and, lastly, a few basic image post-processing manipulations. PMID:27259929

  8. Visualization of Live Cochlear Stereocilia at a Nanoscale Resolution Using Hopping Probe Ion Conductance Microscopy.

    PubMed

    Vélez-Ortega, A Catalina; Frolenkov, Gregory I

    2016-01-01

    The mechanosensory apparatus that detects sound-induced vibrations in the cochlea is located on the apex of the auditory sensory hair cells and it is made up of actin-filled projections, called stereocilia. In young rodents, stereocilia bundles of auditory hair cells consist of 3-4 rows of stereocilia of decreasing height and varying thickness. Morphological studies of the auditory stereocilia bundles in live hair cells have been challenging because the diameter of each stereocilium is near or below the resolution limit of optical microscopy. In theory, scanning probe microscopy techniques, such as atomic force microscopy, could visualize the surface of a living cell at a nanoscale resolution. However, their implementations for hair cell imaging have been largely unsuccessful because the probe usually damages the bundle and disrupts the bundle cohesiveness during imaging. We overcome these limitations by using hopping probe ion conductance microscopy (HPICM), a non-contact scanning probe technique that is ideally suited for the imaging of live cells with a complex topography. Organ of Corti explants are placed in a physiological solution and then a glass nanopipette-which is connected to a 3D-positioning piezoelectric system and to a patch clamp amplifier-is used to scan the surface of the live hair cells at nanometer resolution without ever touching the cell surface.Here, we provide a detailed protocol for the imaging of mouse or rat stereocilia bundles in live auditory hair cells using HPICM. We provide information about the fabrication of the nanopipettes, the calibration of the HPICM setup, the parameters we have optimized for the imaging of live stereocilia bundles and, lastly, a few basic image post-processing manipulations.

  9. [Technique of rat cochlea slicing and study of rat spiral ganglion neurons by infrared visual slice patch clamp method].

    PubMed

    Zha, Ding-jun; Lin, Ying; Qiao, Li; Wang, Zhi-ming; Liu, Tao; Li, Yun-qing; Qiu, Jian-hua

    2007-06-01

    To establishing the cochlea slice technique and infrared visual slice patch clamp method in order to observe the electrophysiological characteristics of rat spiral ganglion neurons (SGN) METHODS: SD rats were divided into three groups according to postnatal days old (0-2 d, 3-6 d and 7-14 d). Making slice of SD rat cochlear quickly, using infrared differential interference contrast (IR-DIC) technique, together with slice patch clamp, the electrophysiological characteristics of rat spiral ganglion neurons were observed, and factors which affected the quality of cochlear slice and recording of patch clamp were analyzed. The success rate of 3-6 days SD was the highest, and 2-4 pieces of slice could be made from each cochlea. Cochlea connecting with partial skull and integrity of cochlear hull were the key for making slice, and the angle of modiolus axis should be adjusted to be parallel to the knife and the preparing time should be shorter. The SGN cell of good condition could be easily found and the seal test became easier with the help of infrared visual slice patch clamp method. The rest membrane potential was (-45.6 +/- 5.3) mV (x +/- s, n=52) and the current of Na+ and K+ could be activated. Cochlear slice technique can retain structural integrity, cell viability and their association in cochlea, which suggest that this technique provides carrier for electrophysiological study of rat spiral ganglion neurons, and patch clamp with infrared videomicroscopy method can be used to make direct real-time observation in electrophysiological experiments of SGN, which can provide important technique support and reference for deep study of electrophysiological characteristics of SGN and auditory neurotransmission in cochlea.

  10. Assessment of intracochlear electrode position and correlation with behavioural thresholds in CII and 90K cochlear implants.

    PubMed

    Filipo, R; Mancini, P; Panebianco, V; Viccaro, M; Covelli, E; Vergari, V; Passariello, R

    2008-03-01

    The image quality of 64-MDCT provided excellent definition of the fine osseous structures and individual electrode contacts. Evaluation of electrode distances revealed a more focused stimulation for the Helix contacts, with better optimization of pulse width and frequency of stimulation. A multi-slice CT scan was performed postoperatively to evaluate electrode distance from the modiolus and variability of fitting parameters (M level) for two different types of cochlear implant electrode carriers, CII and 90K implants with 1J and Helix electrode carriers. The electrode's position in different cochlear implant (CI) electrodes, Advanced Bionics 90K 1J and Helix, was assessed postoperatively in 20 adult patients by means of a 64-MDCT scanner. Axial, coronal, and oblique 0.3 mm multiplanar reconstructions (MPRs) were obtained and datasets were analyzed to assess the intracochlear position and distance from the surface of the electrodes to the bony edge of the modiolus. Patients' fitting characteristics were gathered at the time the CT was performed and correlated to intracochlear measurements. Determination of contact distances confirmed smaller average values for the Helix at the apex and medial segments. Helix electrodes were closer to the modiolus in all segments. Likewise, M level determination showed lower values for the Helix carrier, confirming a more focused stimulation and better optimization of pulse width and frequency of stimulation.

  11. McGurk stimuli for the investigation of multisensory integration in cochlear implant users: The Oldenburg Audio Visual Speech Stimuli (OLAVS).

    PubMed

    Stropahl, Maren; Schellhardt, Sebastian; Debener, Stefan

    2017-06-01

    The concurrent presentation of different auditory and visual syllables may result in the perception of a third syllable, reflecting an illusory fusion of visual and auditory information. This well-known McGurk effect is frequently used for the study of audio-visual integration. Recently, it was shown that the McGurk effect is strongly stimulus-dependent, which complicates comparisons across perceivers and inferences across studies. To overcome this limitation, we developed the freely available Oldenburg audio-visual speech stimuli (OLAVS), consisting of 8 different talkers and 12 different syllable combinations. The quality of the OLAVS set was evaluated with 24 normal-hearing subjects. All 96 stimuli were characterized based on their stimulus disparity, which was obtained from a probabilistic model (cf. Magnotti & Beauchamp, 2015). Moreover, the McGurk effect was studied in eight adult cochlear implant (CI) users. By applying the individual, stimulus-independent parameters of the probabilistic model, the predicted effect of stronger audio-visual integration in CI users could be confirmed, demonstrating the validity of the new stimulus material.

  12. Cochlear implant

    MedlinePlus

    ... bilateral cochlear implantation: a review. Curr Opin Otolaryngol Head Neck Surg . 2007;15(5):315-318. PMID: 17823546. ... BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  13. Cochlear Otosclerosis

    PubMed Central

    Cureoglu, Sebahattin; Baylan, Muzeyyen Yildirim; Paparella, Michael M

    2010-01-01

    Purpose of review The aim of this study is to summarize current advances in research and clinical aspects of cochlear otosclerosis. Recent Findings Recent studies have revealed that otosclerosis is a process of bone remodeling that is unique to only the otic capsule. Even though no obvious bone remodeling is seen in the otic capsule under normal conditions, remodeling starts when some molecular factors trigger the capsule in certain patients who have genetic and/or environmental tendencies. Summary Cochlear otosclerosis is defined as otosclerosis located in the otic capsule involving the cochlear endosteum and causing sensorineural hearing loss or mixed type hearing loss. It has been clearly shown that when otosclerosis is sufficiently severe to involve the cochlear endosteum, it usually fixes the stapes as well. PMID:20693902

  14. Cochlear implants.

    PubMed

    Connell, Sarah S; Balkany, Thomas J

    2006-08-01

    Cochlear implants are cost-effective auditory prostheses that safely provide a high-quality sensation of hearing to adults who are severely or profoundly deaf. In the past 5 years, progress has been made in hardware and software design, candidate selection, surgical techniques, device programming, education and rehabilitation,and, most importantly, outcomes. Cochlear implantation in the elderly is well tolerated and provides marked improvement in auditory performance and psychosocial functioning.

  15. Dendrodendritic connections between the cochlear efferent neurons in guinea pig.

    PubMed

    Szabó, Zs; Bácskai, T; Deák, Á; Matesz, K; Veress, G; Sziklai, I

    2011-10-31

    The outer hair cells of organ of Corti are innervated by the efferent neurons of medial olivocochlear neurons (MOC) of the brainstem which modify the cochlear auditory processing and sensitivity. Most of the MOC neurons are excited by a dominant ear and only a small portion of them is excited by both ears resulting in a binaural facilitation. The functional role of the feedback system between the organ of Corti and the cochlear efferent neurons is the protection of the ear from acoustic injury. The rapid impulse propagation in the bilateral olivocochlear system is suggestive of an electrotonic interaction between the bilateral olivocochlear neurons. The morphological background of the MOC pathway is not yet completely characterized. Therefore, we have labeled the bilateral cochlear nerves with different neuronal tracers in guinea pigs. In the anesthetized animals the cochlear nerves were exposed in the basal part of the modiolus and labeled simultaneously with different retrograde fluorescent tracers. By using confocal laser scanning microscope we could detect close appositions between the dendrites of the neurons of bilateral MOC. The distance between the neighboring profiles suggested close membrane appositions without interposing glial elements. These connections might serve as one of the underlying mechanisms of the binaural facilitation mediated by the olivocochlear system. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Morphology of spermatogenic and accessory cells in the mussel Modiolus kurilensis under environmental pollution.

    PubMed

    Yurchenko, Olga V; Vaschenko, Marina A

    2010-08-01

    A comparative light- and electron microscopic study of the male gonads of the bivalve mollusk Modiolus kurilensis from the reference and polluted sites in Amursky Bay (Sea of Japan) was conducted. Testicular acini in the mussels from the reference site had well-ordered structure (vertical spermatogenic columns located among the accessory cells bodies) whereas in the testes of the mollusks from the polluted site, the accessory and spermatogenic cell populations were disarranged. Mussels from the polluted station had about 26% of spermatogenic cells with marginal localization of nuclear chromatin, swollen outer nuclear membrane and heavily vacuolated cytoplasm and about 8% of spermatozoa with transformed or destructed acrosome; in mussels from the reference station, these values were close to zero. The accessory cells in the mussels from the polluted site were underdeveloped, and their phagocytic activity was inhibited. Our ultrastructural observations provide evidence that both spermatogenic and accessory cells are targets of environmental pollution in marine mussels.

  17. Cross-Modal and Intra-Modal Characteristics of Visual Function and Speech Perception Performance in Postlingually Deafened, Cochlear Implant Users

    PubMed Central

    Kim, Min-Beom; Shim, Hyun-Yong; Jin, Sun Hwa; Kang, Soojin; Woo, Jihwan; Han, Jong Chul; Lee, Ji Young; Kim, Martha; Cho, Yang-Sun

    2016-01-01

    Evidence of visual-auditory cross-modal plasticity in deaf individuals has been widely reported. Superior visual abilities of deaf individuals have been shown to result in enhanced reactivity to visual events and/or enhanced peripheral spatial attention. The goal of this study was to investigate the association between visual-auditory cross-modal plasticity and speech perception in post-lingually deafened, adult cochlear implant (CI) users. Post-lingually deafened adults with CIs (N = 14) and a group of normal hearing, adult controls (N = 12) participated in this study. The CI participants were divided into a good performer group (good CI, N = 7) and a poor performer group (poor CI, N = 7) based on word recognition scores. Visual evoked potentials (VEP) were recorded from the temporal and occipital cortex to assess reactivity. Visual field (VF) testing was used to assess spatial attention and Goldmann perimetry measures were analyzed to identify differences across groups in the VF. The association of the amplitude of the P1 VEP response over the right temporal or occipital cortex among three groups (control, good CI, poor CI) was analyzed. In addition, the association between VF by different stimuli and word perception score was evaluated. The P1 VEP amplitude recorded from the right temporal cortex was larger in the group of poorly performing CI users than the group of good performers. The P1 amplitude recorded from electrodes near the occipital cortex was smaller for the poor performing group. P1 VEP amplitude in right temporal lobe was negatively correlated with speech perception outcomes for the CI participants (r = -0.736, P = 0.003). However, P1 VEP amplitude measures recorded from near the occipital cortex had a positive correlation with speech perception outcome in the CI participants (r = 0.775, P = 0.001). In VF analysis, CI users showed narrowed central VF (VF to low intensity stimuli). However, their far peripheral VF (VF to high intensity stimuli) was

  18. Implementation of Image-Guided Cochlear Implant Programming at a Distant Site.

    PubMed

    McRackan, Theodore R; Noble, Jack H; Wilkinson, Eric P; Mills, Dawna; Dietrich, Mary S; Dawant, Benoit M; Gifford, Rene H; Labadie, Robert F

    2017-05-01

    Our objective was to prospectively evaluate implementation of a new cochlear implant (CI) mapping technique, image-guided cochlear implant programming (IGCIP), at a site distant to the site of development. IGCIP consists of identifying the geometric relationship between CI electrodes and the modiolus and deactivating electrodes that interfere with neighboring electrodes. IGCIP maps for 17 ears of 15 adult CI patients were developed at a central image-processing center, Vanderbilt, and implemented at a distant tertiary care center, House Ear Institute. Before IGCIP and again 4 weeks after, qualitative and quantitative measures were made. While there were no statistically significant groupwise differences detected between baseline and IGCIP qualitative or quantitative measures, 11 of the 17 (64.7%) elected to keep the IGCIP map. Computed tomography (CT) image quality appears to be crucial for successful IGCIP, with 100% of those with high-resolution CT scans keeping their maps compared to 53.8% without.

  19. Audiovisual segregation in cochlear implant users.

    PubMed

    Landry, Simon; Bacon, Benoit A; Leybaert, Jacqueline; Gagné, Jean-Pierre; Champoux, François

    2012-01-01

    It has traditionally been assumed that cochlear implant users de facto perform atypically in audiovisual tasks. However, a recent study that combined an auditory task with visual distractors suggests that only those cochlear implant users that are not proficient at recognizing speech sounds might show abnormal audiovisual interactions. The present study aims at reinforcing this notion by investigating the audiovisual segregation abilities of cochlear implant users in a visual task with auditory distractors. Speechreading was assessed in two groups of cochlear implant users (proficient and non-proficient at sound recognition), as well as in normal controls. A visual speech recognition task (i.e. speechreading) was administered either in silence or in combination with three types of auditory distractors: i) noise ii) reverse speech sound and iii) non-altered speech sound. Cochlear implant users proficient at speech recognition performed like normal controls in all conditions, whereas non-proficient users showed significantly different audiovisual segregation patterns in both speech conditions. These results confirm that normal-like audiovisual segregation is possible in highly skilled cochlear implant users and, consequently, that proficient and non-proficient CI users cannot be lumped into a single group. This important feature must be taken into account in further studies of audiovisual interactions in cochlear implant users.

  20. Audiovisual Segregation in Cochlear Implant Users

    PubMed Central

    Landry, Simon; Bacon, Benoit A.; Leybaert, Jacqueline; Gagné, Jean-Pierre; Champoux, François

    2012-01-01

    It has traditionally been assumed that cochlear implant users de facto perform atypically in audiovisual tasks. However, a recent study that combined an auditory task with visual distractors suggests that only those cochlear implant users that are not proficient at recognizing speech sounds might show abnormal audiovisual interactions. The present study aims at reinforcing this notion by investigating the audiovisual segregation abilities of cochlear implant users in a visual task with auditory distractors. Speechreading was assessed in two groups of cochlear implant users (proficient and non-proficient at sound recognition), as well as in normal controls. A visual speech recognition task (i.e. speechreading) was administered either in silence or in combination with three types of auditory distractors: i) noise ii) reverse speech sound and iii) non-altered speech sound. Cochlear implant users proficient at speech recognition performed like normal controls in all conditions, whereas non-proficient users showed significantly different audiovisual segregation patterns in both speech conditions. These results confirm that normal-like audiovisual segregation is possible in highly skilled cochlear implant users and, consequently, that proficient and non-proficient CI users cannot be lumped into a single group. This important feature must be taken into account in further studies of audiovisual interactions in cochlear implant users. PMID:22427963

  1. Examining the electro-neural interface of cochlear implant users using psychophysics, CT scans, and speech understanding.

    PubMed

    Long, Christopher J; Holden, Timothy A; McClelland, Gary H; Parkinson, Wendy S; Shelton, Clough; Kelsall, David C; Smith, Zachary M

    2014-04-01

    This study examines the relationship between focused-stimulation thresholds, electrode positions, and speech understanding in deaf subjects treated with a cochlear implant (CI). Focused stimulation is more selective than monopolar stimulation, which excites broad regions of the cochlea, so may be more sensitive as a probe of neural survival patterns. Focused thresholds are on average higher and more variable across electrodes than monopolar thresholds. We presume that relatively high focused thresholds are the result of larger distances between the electrodes and the neurons. Two factors are likely to contribute to this distance: (1) the physical position of electrodes relative to the modiolus, where the excitable auditory neurons are normally located, and (2) the pattern of neural survival along the length of the cochlea, since local holes in the neural population will increase the distance between an electrode and the nearest neurons. Electrode-to-modiolus distance was measured from high-resolution CT scans of the cochleae of CI users whose focused-stimulation thresholds were also measured. A hierarchical set of linear models of electrode-to-modiolus distance versus threshold showed a significant increase in threshold with electrode-to-modiolus distance (average slope = 11 dB/mm). The residual of these models was hypothesized to reflect neural survival in each subject. Consonant-Nucleus-Consonant (CNC) word scores were significantly correlated with the within-subject variance of threshold (r(2) = 0.82), but not with within-subject variance of electrode distance (r(2) = 0.03). Speech understanding also significantly correlated with how well distance explained each subject's threshold data (r(2) = 0.63). That is, subjects with focused thresholds that were well described by electrode position had better speech scores. Our results suggest that speech understanding is highly impacted by individual patterns of neural survival and that these patterns manifest themselves

  2. The reproductive cycle, condition index and biochemical composition of the horse-bearded mussel Modiolus barbatus

    NASA Astrophysics Data System (ADS)

    Mladineo, Ivona; Peharda, Melita; Orhanović, Stjepan; Bolotin, Jakša; Pavela-Vrančić, Maja; Treursić, Barbara

    2007-09-01

    The horse-bearded mussel Modiolus barbatus (Linneus, 1758) is an important edible bivalve in the Adriatic Sea; its population is especially large in the Mali Ston Bay area, where the species is present at depths up to 8 m. In order to assess the sustainable exploitation rate for this species, as well as to estimate its potential capacity for a sustainable aquaculture production, we determined the species’ reproductive cycle along with its nutrient storage strategy, employing histological and biochemical methods. The population shows significantly more females than males, and no hermaphrodites. The smallest adult individual, an active male, was 16.0 mm in length, suggesting that sexual maturation starts around this length. While the period between January and February is characterized by sexual repose, early and late stages of gametogenesis were found between March and May, and spawning peaked from June till August. The increase of oocyte diameter followed the same trend. A significant positive correlation was observed between gonad index and temperature, and a negative correlation between gonad index and salinity. Oscillations of stored nutrients were tightly coupled with the gametogenic cycle.

  3. An energy budget for the subtidal bivalve Modiolus barbatus (Mollusca) at different temperatures.

    PubMed

    Ezgeta-Balić, D; Rinaldi, A; Peharda, M; Prusina, I; Montalto, V; Niceta, N; Sarà, G

    2011-02-01

    Clearance rates, respiration rates and food absorption efficiencies of the commercially interesting subtidal bivalve Modiolus barbatus were measured at different temperatures under laboratory conditions and scope for growth calculated. Clearance rates were highest at temperatures from 20 °C to 28 °C, whereas respiration rate was maximal at 9 °C and minimal at 26 °C. Highest mean values of absorbed energy occurred at 20 °C and 26 °C. Scope for growth trend had negative values at 9 °C, 15 °C and 28 °C and positive values at temperatures 20 °C and 26 °C. The profitable thermal window for M. barbatus to have energy sufficient for growth and reproduction corresponded to <5 months per year. Seawater temperature increases will potentially impact the eco-physiological responses of subtidal M. barbatus causing life history traits to change with important repercussions for subtidal biodiversity in the Mediterranean. © 2010 Elsevier Ltd. All rights reserved.

  4. Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hasenstab, M. Suzanne; Laughton, Joan

    1991-01-01

    The use of cochlear implants in children with profound bilateral hearing loss is discussed, focusing on how a cochlear implant works; steps in a cochlear implant program (evaluation, surgery, programing, and training); and rehabilitation procedures involved in auditory development and speech development. (JDD)

  5. [Cochlear implants].

    PubMed

    Lehnhardt, E; Battmer, R D; Nakahodo, K; Laszig, R

    1986-07-01

    Since the middle of 1984, the HNO-Klinik der Medizinischen Hochschule Hannover has provided deaf adults with a 22-channel cochlear implant (CI) device of Clark-NUCLEUS. The digital working system consists of an implantable stimulator/receiver and an externally worn speech processor. Energy and signals are transmitted transcutaneously via a transmitter coil. During the prevailing 26 operations (April 1986) the electrode array could be inserted at least 17 mm into the cochlea. The threshold and comfort levels of all patients were adjusted very quickly; the dynamic range usually grows during the first postoperative weeks. The individual rehabilitation results vary greatly, but all patients show a significant increase of vowel and consonant comprehension while using the speech processor and an improvement of words understood per minute in speech tracking from lip-reading alone to lip-reading with speech processor. Four months after surgery seven of 17 patients (group I) are able to understand on average 42.7 words per minute by speech tracking without lip-reading. Six patients (group II) recognise 69.2% of vowels and 42.5% of consonants by speech processor alone. Four patients (group III) can correctly repeat only vowels (52.3%) without lip-reading, but using the speech processor together with lip reading they have an improvement in consonant understanding of 37.9% and under freefield conditions they are able to understand up to 17.8% numbers of the Freiburg speech test.

  6. Cochlear Implantation in Children with Cochlear Malformation.

    PubMed

    Saikawa, Etsuko; Takano, Kenichi; Ogasawara, Noriko; Tsubomatsu, Chieko; Takahashi, Nozomi; Shirasaki, Hideaki; Himi, Tetsuo

    2016-01-01

    Cochlear implantation (CI) has proven to be an effective treatment for severe bilateral sensorineural hearing loss (SNHL). Inner ear malformation is a rare anomaly and occurs in approximately 20% of cases with congenital SNHL. In cases with cochlear malformation, CI can be successfully performed in nearly all patients, the exceptions being those with complete labyrinthine and cochlear aplasia. It is important to evaluate the severity of inner ear deformity and other associated anomalies during the preimplantation radiological assessment in order to identify any complication that may potentially occur during the surgery and subsequent patient management.

  7. Development of HEATHER for cochlear implant stimulation using a new modeling workflow.

    PubMed

    Tran, Phillip; Sue, Andrian; Wong, Paul; Li, Qing; Carter, Paul

    2015-02-01

    The current conduction pathways resulting from monopolar stimulation of the cochlear implant were studied by developing a human electroanatomical total head reconstruction (namely, HEATHER). HEATHER was created from serially sectioned images of the female Visible Human Project dataset to encompass a total of 12 different tissues, and included computer-aided design geometries of the cochlear implant. Since existing methods were unable to generate the required complexity for HEATHER, a new modeling workflow was proposed. The results of the finite-element analysis agree with the literature, showing that the injected current exits the cochlea via the modiolus (14%), the basal end of the cochlea (22%), and through the cochlear walls (64%). It was also found that, once leaving the cochlea, the current travels to the implant body via the cranial cavity or scalp. The modeling workflow proved to be robust and flexible, allowing for meshes to be generated with substantial user control. Furthermore, the workflow could easily be employed to create realistic anatomical models of the human head for different bioelectric applications, such as deep brain stimulation, electroencephalography, and other biophysical phenomena.

  8. [Possible reasons for cerebrospinal fluid gusher in cochlear implantation with inner ear abnormality].

    PubMed

    Sun, S P; Lu, W; Men, X M; Zuo, B; Lei, Y B

    2017-04-07

    Objective: To discuss the possible reasons for cerebrospinal fluid (CSF) gusher in cochlear implantation (CI) with inner ear abnormality. Method: A retrospective analysis was performed on 340 cases who underwent CI from January 2013 to December 2016 in Division of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University. Among them, 96 cases had inner ear abnormalities. Imaging examinations were performed on these patients, and classification of inner ear malformation was done according to the results. Results: Among the cases with inner ear abnormality, 9.4% (9/96) suffered from CSF gusher during CI. The inner ear abnormalities were found to be as follows: 3 cases had incomplete partition type Ⅰ; 1 case had incomplete partition type Ⅰ with semicircular canal dysplasia; 1 case had common cavity deformity; 1 case had enlarged vestibular aqueducts and common cavity deformity; 2 cases had Mondini deformity. All of these cases had bony defect in the fundus of the internal acoustic meatus observed on CT scans. Another case was type 1 cochlear aqueduct with round window aplasia. Conclusions: Defects in the modiolus or fundus of the internal acoustic meatus is the main reason for CSF gusher during CI. A patent cochlear aqueduct is another possible reason.

  9. [Cochlear implant in adults].

    PubMed

    Bouccara, D; Mosnier, I; Bernardeschi, D; Ferrary, E; Sterkers, O

    2012-03-01

    Cochlear implant in adults is a procedure, dedicated to rehabilitate severe to profound hearing loss. Because of technological progresses and their applications for signal strategies, new devices can improve hearing, even in noise conditions. Binaural stimulation, cochlear implant and hearing aid or bilateral cochlear implants are the best opportunities to access to better level of comprehension in all conditions and space localisation. By now minimally invasive surgery is possible to preserve residual hearing and use a double stimulation modality for the same ear: electrical for high frequencies and acoustic for low frequencies. In several conditions, cochlear implant is not possible due to cochlear nerve tumour or major malformations of the inner ear. In these cases, a brainstem implantation can be considered. Clinical data demonstrate that improvement in daily communication, for both cochlear and brainstem implants, is correlated with cerebral activation of auditory cortex.

  10. Olivocochlear innervation maintains the normal modiolar-pillar and habenular-cuticular gradients in cochlear synaptic morphology.

    PubMed

    Yin, Yanbo; Liberman, Leslie D; Maison, Stéphane F; Liberman, M Charles

    2014-08-01

    Morphological studies of inner hair cell (IHC) synapses with cochlear nerve terminals have suggested that high- and low-threshold fibers differ in the sizes of their pre- and postsynaptic elements as well as the position of their synapses around the hair cell circumference. Here, using high-power confocal microscopy, we measured sizes and spatial positions of presynaptic ribbons, postsynaptic glutamate receptor (GluR) patches, and olivocochlear efferent terminals at eight locations along the cochlear spiral in normal and surgically de-efferented mice. Results confirm a prior report suggesting a modiolar > pillar gradient in ribbon size and a complementary pillar > modiolar gradient in GluR-patch size. We document a novel habenular < cuticular gradient in GluR patch size and a complementary cuticular < habenular gradient in olivocochlear innervation density. All spatial gradients in synaptic elements collapse after cochlear de-efferentation, suggesting a major role of olivocochlear efferents in maintaining functional heterogeneity among cochlear nerve fibers. Our spatial analysis also suggests that adjacent IHCs may contain a different synaptic mix, depending on whether their tilt in the radial plane places their synaptic pole closer to the pillar cells or to the modiolus.

  11. Coordinated movement of the three rows of outer hair cells is essential for cochlear amplification

    NASA Astrophysics Data System (ADS)

    Murakoshi, Michio; Suzuki, Sho; Wada, Hiroshi

    2015-12-01

    The process known as cochlear amplification is realized by coordinated movement of the outer hair cells (OHCs) in response to changes in their membrane potential. In this process, the displacement amplitude of the basilar membrane (BM) is thought to be increased, thereby leading to the high sensitivity, wide dynamic range and sharp frequency selectivity of our hearing. Unfortunately, however, OHCs are vulnerable to noise exposure, ototoxic acid, aging and so on. Previous studies have shown that exposure to intense noise causes functional loss of OHCs from the innermost row (i.e., close to the modiolus) to the outermost row (i.e., close to the cochlear wall). On the contrary, by other traumatic stimuli such as ototoxic acid, aging and ischemia, such loss of OHCs has been reported to occur from the outermost row toward the innermost row. However, how the cochlear amplification changes when coordinated movement of OHCs is impaired, that is when the OHCs in one, two or all three rows have become dysfunctional, remains unclear. In the present study, therefore, a finite element (FE) model of the gerbil cochlea, which takes the motility of OHCs into account, was developed based on our previous FE model. Using this model, changes in the displacement amplitude of the BM due to the functional loss of OHCs in one, two or all three rows were investigated and the effects of incoordination of the three rows of OHCs on cochlear amplification were estimated. Results showed that the displacement amplitude of the BM significantly decreased when either the innermost row or the outermost row of OHCs lost its function, suggesting that all three rows of OHCs are required for cochlear amplification.

  12. Metabolic and molecular stress responses of sublittoral bearded horse mussel Modiolus barbatus to warming sea water: implications for vertical zonation.

    PubMed

    Anestis, Andreas; Pörtner, Hans O; Lazou, Antigone; Michaelidis, Basile

    2008-09-01

    The present study set out to investigate the thermal limits of the Mediterranean bivalve Modiolus barbatus, acclimated to various temperatures, and includes a comparison of laboratory determined limits with its temperature-dependent restriction to deeper water layers in its natural habitat. Thermal responses and limits were determined by integrating information from various levels of biological organization, including the expression of Hsp70 and Hsp90, the phosphorylation of stress-activated protein kinases, p38 mitogen-activated protein kinase (p38 MAPK) and cJun-N-terminal kinases (JNKs) as well as metabolic adjustments. The latter were assessed by examining temperature effects on the activity of the key glycolytic enzyme pyruvate kinase (PK). The expression of Hsp70 and Hsp90 was activated when mussels were acclimated to temperatures above 20 degrees C. Increased phosphorylation of p38 MAPK and JNKs at about the same temperatures indicate activation of MAPK signaling cascades and their potential involvement in the induction of Hsp genes. As indicated by the activity of PK, Modiolus barbatus maintains some aerobic capacity when acclimated to temperatures up to 24 degrees C, while further warming probably caused metabolic depression and a shift from aerobic to anaerobic metabolism. An increase in mortality occurred in parallel, during acclimation to temperatures above 24 degrees C. Our results indicate that both the biochemical stress indicators and metabolic status respond in parallel once hypoxemia becomes extreme. Comparison with our previous study of thermal limits and vertical distribution in M. galloprovincialis dwelling in shallow waters emphasizes the relevance of maintained aerobic scope over that of passive tolerance for permanent vertical zonation at higher temperatures in the field. These findings and conclusions are in line with the concept of oxygen and capacity limited thermal tolerance and the associated systemic to molecular hierarchy of thermal

  13. Relational Learning in Children with Deafness and Cochlear Implants

    ERIC Educational Resources Information Center

    Almeida-Verdu, Ana Claudia; Huziwara, Edson M.; de Souza, Deisy G.; de Rose, Julio C.; Bevilacqua, Maria Cecilia; Lopes, Jair, Jr.; Alves, Cristiane O.; McIlvane, William J.

    2008-01-01

    This four-experiment series sought to evaluate the potential of children with neurosensory deafness and cochlear implants to exhibit auditory-visual and visual-visual stimulus equivalence relations within a matching-to-sample format. Twelve children who became deaf prior to acquiring language (prelingual) and four who became deaf afterwards…

  14. Trends in Cochlear Implants

    PubMed Central

    Zeng, Fan-Gang

    2004-01-01

    More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

  15. Cochlear Macromechanical Modelling

    NASA Astrophysics Data System (ADS)

    Wilson, Timothy Alan

    Contemporary research into the manifestations and origins of nonlinear, active cochlear processes often takes place in a context in which linear, passive cochlear mechanics are poorly understood and poorly communicated. The distinctions among models of one-, two-, and three-dimensional fluid motion in the cochlear scala--models popularized by (among others) Zwislocki, Ranke, and Steele, respectively --are confounded by fuzzy use of terms such as "long-wave model" or "short-wave model." Models are frequently evaluated by comparing their place responses with experimentally observed frequency responses; their global impedance parameters are sometimes chosen solely to secure fit to some local measurement. And Steele's WKB (phase-integral) approach is treated, more often than not, as just another technique for solving cochlear dynamical equations, rather than as a conceptual framework yielding significant insight into cochlear phenomena. In this thesis, I present cochlear dynamical equations for one-, two-, and three-dimensional fluid motion in a box-cochlea model, and I discuss the conditions under which such fluid motion is appropriately described as long wave, short wave, or as something in between. I describe the phase-integral approximate solution to these equations and discuss the utility of this framework for explaining cochlear phenomena. I develop generalized representations for both cochlear-partition impedance and cochlear-gain response that highlight the distinctions and similarities between the place response at a single frequency and the frequency response at a single place. The generalized representations clarify which aspects of partition impedance determine global phenomena, such as cochlear maps, and which aspects determine local features, such as magnitude -response peakiness and phase-response steepness. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253 -1690.).

  16. Cochlear implants in young children.

    PubMed

    Niparko, John K; Blankenhorn, Rebecca

    2003-01-01

    The cochlear implant is best characterized as a device that provides access to the sound environment. The device enables the hearing pathway to respond to environmental and speech sounds, providing informational cues from the surroundings and from others that may escape visual detection. As the developmental effects of a profound hearing loss are multiple, cochlear implants have been applied to ever younger children in an attempt to promote a more normal level of developmental learning through audition. In deafness, transducer elements of the inner ear fail to trigger auditory nerve afferent nerves in the presence of sound input. However, large reserves of afferent fibers exist even in the auditory nerve of a profoundly deaf patient. Furthermore, these nerve fibers retain the ability to respond to prosthetic activation. Through developmental learning in the early, formative years, auditory centers of the brain appear capable of processing information from the implant to provide speech comprehension and oral language development. Multichannel implants have replaced original single channel designs. multichannel devices enable larger percentages of recipients to recognize the spoken word without visual cues because they provide spectral information in addition to temporal and intensity cues. Testing under conditions of auditory (implant)-only input reveals significant open-set speech understanding capabilities in more than 75% of children after three years of device use. The benefit provided by implants may vary with a number of conditions including: hearing history, age of deafness onset, age at implantation, etiology of deafness, linguistic abilities, and the presence of a motivated system of support of oral language development. Patient variables should be given individual consideration in judging candidacy for a cochlear implant and in planning rehabilitative and education services after surgery and activation of the device. Copyright 2003 Wiley-Liss, Inc.

  17. Cochlear bionic acoustic metamaterials

    NASA Astrophysics Data System (ADS)

    Ma, Fuyin; Wu, Jiu Hui; Huang, Meng; Fu, Gang; Bai, Changan

    2014-11-01

    A design of bionic acoustic metamaterial and acoustic functional devices was proposed by employing the mammalian cochlear as a prototype. First, combined with the experimental data in previous literatures, it is pointed out that the cochlear hair cells and stereocilia cluster are a kind of natural biological acoustic metamaterials with the negative stiffness characteristics. Then, to design the acoustic functional devices conveniently in engineering application, a simplified parametric helical structure was proposed to replace actual irregular cochlea for bionic design, and based on the computational results of such a bionic parametric helical structure, it is suggested that the overall cochlear is a local resonant system with the negative dynamic effective mass characteristics. There are many potential applications in the bandboard energy recovery device, cochlear implant, and acoustic black hole.

  18. Glycine immunoreactivity of multipolar neurons in the ventral cochlear nucleus which project to the dorsal cochlear nucleus.

    PubMed

    Doucet, J R; Ross, A T; Gillespie, M B; Ryugo, D K

    1999-06-14

    Certain distinct populations of neurons in the dorsal cochlear nucleus are inhibited by a neural source that is responsive to a wide range of acoustic frequencies. In this study, we examined the glycine immunoreactivity of two types of ventral cochlear nucleus neurons (planar and radiate) in the rat which project to the dorsal cochlear nucleus (DCN) and thus, might be responsible for this inhibition. Previously, we proposed that planar neurons provided a tonotopic and narrowly tuned input to the DCN, whereas radiate neurons provided a broadly tuned input and thus, were strong candidates as the source of broadband inhibition (Doucet and Ryugo [1997] J. Comp. Neurol. 385:245-264). We tested this idea by combining retrograde labeling and glycine immunohistochemical protocols. Planar and radiate neurons were first retrogradely labeled by injecting biotinylated dextran amine into a restricted region of the dorsal cochlear nucleus. The labeled cells were visualized using streptavidin conjugated to indocarbocyanine (Cy3), a fluorescent marker. Sections that contained planar or radiate neurons were then processed for glycine immunocytochemistry using diaminobenzidine as the chromogen. Immunostaining of planar neurons was light, comparable to that of excitatory neurons (pyramidal neurons in the DCN), whereas immunostaining of radiate neurons was dark, comparable to that of glycinergic neurons (cartwheel cells in the dorsal cochlear nucleus and principal cells in the medial nucleus of the trapezoid body). These results are consistent with the hypothesis that radiate neurons in the ventral cochlear nucleus subserve the wideband inhibition observed in the dorsal cochlear nucleus.

  19. Nasalance in Cochlear Implantees

    PubMed Central

    Sreedevi, N; Lepcha, Anjali; Mathew, John

    2015-01-01

    Objectives Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. Methods Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. Results Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. Conclusion The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees. PMID:26330912

  20. New expectations: pediatric cochlear implantation in Japan.

    PubMed

    Oliver, Janette

    2013-03-01

    responsibility for early intervention, educational choices and referral for cochlear implantation. In the past 98% of schools for children with hearing loss have used communication methods relying mostly on visual cues. In recent years, however, there has been a shift toward 'inclusive' mainstream education. Between 2008 and 2011 the number of children with cochlear implants in special needs schools increased to 16%. It is now estimated that 67% of children with cochlear implants may now be in mainstream schools. There is still the need for support services for these implanted children attending mainstream schools, with adequate provision of resources. Cochlear Implantation has had a significant role in changing the medical management and education of children in Japan with hearing loss. Much remains to be done, though the situation has greatly improved in recent years and continues to do so.

  1. A Psychophysics experimental software to evaluate electrical pitch discrimination in Nucleus cochlear implanted patients

    NASA Astrophysics Data System (ADS)

    Pérez Zaballos, M. T.; Ramos de Miguel, A.; Killian, M.; Ramos Macías, A.

    2016-02-01

    Multichannel electrode array design in cochlear implants has evolved into two major categories: straight and perimodiolar electrodes. When implanted, the former lies along the outer wall of the scala tympani, while the later are located closer to the modiolus, where the neural ends are. Therefore, a perimodiolar position of the electrode array could be expected to result in reduced stimulus thresholds and stimulating currents, increased dynamic range, and more localized stimulation of the neural elements. However, their advantage for pitch discrimination has not been conclusively stated. Therefore, in order to study electrode independence, a psychophysical software has been developed, making use of Nucleus Implant Communicator tools provided by Cochlear company under a research agreement. The application comprises a graphical interface to facilitate its use, since previous software has always required some type of computer language skills. It allows for customization of electrical pulse parameters, measurement of threshold and comfort levels, loudness balancing and alternative forced choice experiments to determine electrode discrimination in Nucleus© users.

  2. Insertion trauma of a cochlear implant electrode array with Nitinol inlay.

    PubMed

    Rau, Thomas S; Harbach, Lenka; Pawsey, Nick; Kluge, Marcel; Erfurt, Peter; Lenarz, Thomas; Majdani, Omid

    2016-11-01

    The integration of a shape memory actuator is a potential mechanism to achieve a consistent perimodiolar position after electrode insertion during cochlear implant surgery. After warming up, and therefore activation of the shape memory effect, the electrode array will change from a straight configuration into a spiral shaped one leading to a final position close to the modiolus. The aim of this study was to investigate whether the integration of an additional thin wire (referred to as an "inlay") made of Nitinol, a well-established shape memory alloy, in a conventional hearing preservation electrode array will affect the insertion behaviour in terms of increased risk of insertion trauma. Six conventional Hybrid-L electrode arrays (Cochlear Ltd., Sydney, Australia) were modified to incorporate a wire inlay made of Nitinol. The diameter of the wires was 100 µm with a tapered tip region. Electrodes were inserted into human temporal bone specimens using a standard surgical approach. After insertion and embedding in epoxy resin, histological sections were prepared to evaluate insertion trauma. Insertion was straightforward and no difficulties were observed. The addition of a shape memory wire, thin but also strong enough to curl the electrode array, does not result in histologically detectable insertion trauma. Atraumatic insertion seems possible.

  3. Cochlear implantation in congenital cochlear abnormalities.

    PubMed

    Ahmad, R L; Lokman, S

    2005-08-01

    Many children have benefited from cochlear implant device including those with congenital malformation of the inner ear. The results reported in children with malformed cochlea are very encouraging. We describe 2 cases of Mondini's malformation with severe sensorineural hearing loss. Cochlear implantation was performed and both of them underwent post-implantation speech rehabilitation. Post-implantation, both of them were noted to respond to external sound. But the second case developed facial twitching a few months after the device was switched on. It is important to evaluate the severity of the inner ear deformity and the other associated anomalies in pre-implantation radiological assessment in order to identify the problem that may complicate the surgery and subsequent patient management.

  4. [Biomaterials in cochlear implants].

    PubMed

    Stöver, T; Lenarz, T

    2009-05-01

    Cochlear implants (CI) represent the "gold standard" for the treatment of congenitally deaf children and postlingually deafened adults. Thus, cochlear implantation is a success story of new bionic prosthesis development. Owing to routine application of cochlear implants in adults but also in very young children (below the age of one), high demands are placed on the implants. This is especially true for biocompatibility aspects of surface materials of implant parts which are in contact with the human body. In addition, there are various mechanical requirements which certain components of the implants must fulfil, such as flexibility of the electrode array and mechanical resistance of the implant housing. Due to the close contact of the implant to the middle ear mucosa and because the electrode array is positioned in the perilymphatic space via cochleostomy, there is a potential risk of bacterial transferral along the electrode array into the cochlea. Various requirements that have to be fulfilled by cochlear implants, such as biocompatibility, electrode micromechanics, and although a very high level of technical standards has been carried out there is still demand for the improvement of implants as well as of the materials used for manufacturing, ultimately leading to increased implant performance. General considerations of material aspects related to cochlear implants as well as potential future perspectives of implant development will be discussed.

  5. X-ray microtomographic confirmation of the reliability of CBCT in identifying the scalar location of cochlear implant electrode after round window insertion.

    PubMed

    Zou, Jing; Hannula, Markus; Lehto, Kalle; Feng, Hao; Lähelmä, Jaakko; Aula, Antti S; Hyttinen, Jari; Pyykkö, Ilmari

    2015-08-01

    Cone-beam computed tomography (CBCT) plays a key role in cochlear implantation in both planning implantation before surgery and quality control during surgery due to the high spatial resolution and convenience of application in the operation theater. We recently designed a novel, highresolution cone-beam acquisition system that has been tested in temporal bones with cochlear implantation to identify the scalar localization of the electrode arrays. The current study aimed to verify the reliability of the experimental CBCT set-up using high-resolution in vitro X-ray microtomography (μCT) imaging as a reference. Nine human temporal bones were studied by inserting a straight electrode of a cochlear implant using the round window approach followed by sequential imaging using experimental CBCT and μCT with and without 1% iodine as the contrast agent. In the CBCT images, the electrodes were located in the scala tympani and near the lateral wall in all temporal bones. In the μCT images, the cochlear fine structures, including Reissner's membrane, stria vascularis, spiral ligament, basilar membrane, spiral limbus, osseous spiral lamina, and Rosenthal's canal that hosts the spiral ganglion cells, were clearly delineated; the electrode array avoided the lateral wall of the scala tympani in the hook region and then ran along the lateral wall of the scala tympani without any exception, a feature that was also detected in a temporal bone with ruptures in the basilar and Reissner's membranes. In conclusion, the current in vitro μCT imaging system produced high-quality images that could demonstrate the fine cochlear structures faithfully and verify the reliability of a novel experimental CBCT set-up aimed for clinical application in identifying the scalar localization of the electrode array. The straight electrode is safe for cochlear structures with low risk of translocation and is suitable for atraumatic implantation, although a large gap between the contacts and the

  6. [Bilateral cochlear implantation].

    PubMed

    Kronenberg, Jona; Migirov, Lela; Taitelbaum-Swead, Rikey; Hildesheimer, Minka

    2010-06-01

    Cochlear implant surgery became the standard of care in hearing rehabilitation of patients with severe to profound sensorineural hearing loss. This procedure may alter the lives of children and adults enabling them to integrate with the hearing population. In the past, implantation was performed only in one ear, despite the fact that binaural hearing is superior to unilateral, especially in noisy conditions. Cochlear implantation may be performed sequentially or simultaneously. The "sensitive period" of time between hearing loss and implantation and between the two implantations, when performed sequentially, significantly influences the results. Shorter time spans between implantations improve the hearing results after implantation. Hearing success after implantation is highly dependent on the rehabilitation process which includes mapping, implant adjustments and hearing training. Bilateral cochlear implantation in children is recommended as the proposed procedure in spite of the additional financial burden.

  7. The Use of a Nasolabial Island Flap in Vestibulo-sulcoplasty in a Patient with Recurrent Depressed Scar on the Modiolus

    PubMed Central

    Tuncel, Umut; Turan, Aydın; Kostakoğlu, Naci

    2012-01-01

    A 56-year-old woman with a recurrent depressed scar of the commissure, treated with a nasolabial island flap, is presented. On examination, the scar was located on the right modiolus involving the right upper gingivobuccal sulcus. A history of recurrent canine abscess was obtained. After excision of the scar and release of the vestibular fold, reconstruction of the defect was performed with a nasolabial island flap from the same side. The postoperative course was uneventful, with a good aesthetic and functional outcome. PMID:23066468

  8. Effect of shorter pulse duration in cochlear neural activation with an 810-nm near-infrared laser.

    PubMed

    Wang, Jingxuan; Tian, Lan; Lu, Jianren; Xia, Ming; Wei, Ying

    2017-02-01

    Optical neural stimulation in the cochlea has been presented as an alternative technique to the electrical stimulation due to its potential in spatially selectivity enhancement. So far, few studies have selected the near-infrared (NIR) laser in cochlear neural stimulation and limited optical parameter space has been examined. This paper focused on investigating the optical parameter effect on NIR stimulation of auditory neurons, especially under shorter pulse durations. The spiral ganglion neurons in the cochlea of deafened guinea pigs were stimulated with a pulsed 810-nm NIR laser in vivo. The laser radiation was delivered by an optical fiber and irradiated towards the modiolus. Optically evoked auditory brainstem responses (OABRs) with various optical parameters were recorded and investigated. The OABRs could be elicited with the cochlear deafened animals by using the 810-nm laser in a wide pulse duration ranged from 20 to 1000 μs. Results showed that the OABR intensity increased along with the increasing laser radiant exposure of limited range at each specific pulse duration. In addition, for the pulse durations from 20 to 300 μs, the OABR intensity increased monotonically along with the pulse duration broadening. While for pulse durations above 300 μs, the OABR intensity basically kept stable with the increasing pulse duration. The 810-nm NIR laser could be an effective stimulus in evoking the cochlear neuron response. Our experimental data provided evidence to optimize the pulse duration range, and the results suggested that the pulse durations from 20 to 300 μs could be the optimized range in cochlear neural activation with the 810-nm-wavelength laser.

  9. Cochlear Implantation in Neurobrucellosis

    PubMed Central

    Bajin, Münir Demir; Savaş, Özden; Aslan, Filiz; Sennaroğlu, Levent

    2016-01-01

    Background: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation. Case Report: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members’ statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving. Conclusion: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results. PMID:26966626

  10. Questioning cochlear amplification

    NASA Astrophysics Data System (ADS)

    van der Heijden, Marcel; Versteegh, Corstiaen P. C.

    2015-12-01

    Thirty years ago it was hypothesized that motile processes inject mechanical energy into cochlear traveling waves. This mechanical amplification, alternatively described as negative damping, is invoked to explain both the sensitivity and the nonlinear compression of cochlear responses. There is a recent trend to present cochlear amplification as an established fact, even though the evidence is at most circumstantial and several thorny problems have remained unresolved. We analyze several of these issues, and present new basilar membrane recordings that allowed us to quantify cochlear energy flow. Specifically, we address the following questions: (1) Does auditory sensitivity require narrowband amplification? (2) Has the "RC problem" (lowpass filtering of outer hair cell receptor potential) been resolved? (3) Can OHC motility improve auditory sensitivity? (4) Is there a net power gain between neighboring locations on the basilar membrane? The analyses indicate that mechanical amplification in the cochlea is neither necessary nor useful, and that realizing it by known forms of motility would reduce sensitivity rather than enhance it. Finally, our experimental data show that the peaking of the traveling wave is realized by focusing the acoustic energy rather than amplifying it. (Abbreviations. BM: basilar membrane; CF: characteristic frequency; IHC: inner hair cell; ME: middle ear; MT; mechanotransducer; OHC: outer hair cell; SPL: sound pressure level.)

  11. The early history of the cochlear implant: a retrospective.

    PubMed

    Mudry, Albert; Mills, Mara

    2013-05-01

    Histories of cochlear implant (CI) technology have often been inaccurate owing to the confusion of terms and anatomical situations or to biased reporting. This retrospective, published shortly after the death of inventor William F. House-and more than 50 years after placement of the first CI-offers a precise account of the early experimental period. To clarify the first steps in the development of the CI, ie, an electrical stimulating device partially inserted into the cochlea. Literature review based on published data, oral history material, interviews, and written contact with protagonists. The first CI was implanted by William House and John Doyle of Los Angeles, California, in 1961. In 1964, Blair Simmons and Robert White of Stanford University, Stanford, California, placed a 6-channel electrode through the promontory and vestibule directly into the modiolus. The next step in the development of the CI was its clinical trial on a cohort of patients. Robin Michelson, Robert Schindler, and Michael Merzenich at the University of California, San Francisco, conducted these experiments in 1970 and 1971. In 1973, the first international conference on the "electrical stimulation of the acoustic nerve as a treatment for profound sensorineural deafness in man" was organized in San Francisco. At the same time, Claude Henry Chouard in France and Graeme Clark in Australia began their research. The final step in the establishment of CI as a clinically feasible technology involved the independent evaluation of implant users. The first such evaluation-the result of a 1975 request from the National Institutes of Health-was published in 1977 by Robert Bilger and coworkers at the University of Pittsburgh, Pittsburgh, Pennsylvania. Inspired by French experiments with electrode implantation at the VIII nerve, the initial practical development of the CI is nonetheless a Californian story, divided between the House group at Los Angeles and teams at Stanford University and UCSF.

  12. Concept Formation Skills in Long-Term Cochlear Implant Users

    ERIC Educational Resources Information Center

    Castellanos, Irina; Kronenberger, William G.; Beer, Jessica; Colson, Bethany G.; Henning, Shirley C.; Ditmars, Allison; Pisoni, David B.

    2015-01-01

    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e.,…

  13. Reading Comprehension of Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Vermeulen, Anneke M.; van Bon, Wim; Schreuder, Rob; Knoors, Harry; Snik, Ad

    2007-01-01

    The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (CI) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was expected to surpass that in deaf children without…

  14. Reading Comprehension of Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Vermeulen, Anneke M.; van Bon, Wim; Schreuder, Rob; Knoors, Harry; Snik, Ad

    2007-01-01

    The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (CI) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was expected to surpass that in deaf children without…

  15. Concept Formation Skills in Long-Term Cochlear Implant Users

    ERIC Educational Resources Information Center

    Castellanos, Irina; Kronenberger, William G.; Beer, Jessica; Colson, Bethany G.; Henning, Shirley C.; Ditmars, Allison; Pisoni, David B.

    2015-01-01

    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e.,…

  16. New expectations: Pediatric cochlear implantation in Japan

    PubMed Central

    Oliver, Janette

    2013-01-01

    preschool hearing impaired education centers have had most of the responsibility for early intervention, educational choices and referral for cochlear implantation. In the past 98% of schools for children with hearing loss have used communication methods relying mostly on visual cues. In recent years, however, there has been a shift toward ‘inclusive’ mainstream education. Between 2008 and 2011 the number of children with cochlear implants in special needs schools increased to 16%. It is now estimated that 67% of children with cochlear implants may now be in mainstream schools. There is still the need for support services for these implanted children attending mainstream schools, with adequate provision of resources. Conclusion Cochlear Implantation has had a significant role in changing the medical management and education of children in Japan with hearing loss. Much remains to be done, though the situation has greatly improved in recent years and continues to do so. PMID:23453147

  17. Exploring perspectives on cochlear implants and language acquisition within the deaf community.

    PubMed

    Gale, Elaine

    2011-01-01

    Cochlear implants generated intense debate almost immediately following their introduction in the 1980s. Today, with a vast number of deaf individuals with cochlear implants, the debate about the cochlear implant device and mode of communication continues. Q-methodology was used in this study to explore cochlear implants and language acquisition perspectives within the deaf community. Thirty respondents sorted 33 statements, which were collected from professional literature and mainstream media, into a forced-choice, quasi-normal template. A by-person factor analysis of the Q-sorts revealed 5 model viewpoints: (a) American Sign Language advocate, (b) bilingual advocate, (c) cochlear implant advocate, (d) diverse options advocate, and (e) English visually advocate. Even though the results indicate 5 distinct perspectives, the Q-method also revealed similarities among them. The results also show that there seems to be some agreement on using a bilingual approach, although the perspectives seem to disagree on which language should be acquired first.

  18. Physiopathology of the Cochlear Microcirculation

    PubMed Central

    Shi, Xiaorui

    2011-01-01

    Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature. PMID:21875658

  19. Perilymph Osmolality Modulates Cochlear Function

    PubMed Central

    Choi, Chul-Hee; Oghalai, John S.

    2013-01-01

    Objectives/Hypothesis The cochlear amplifier is required for the exquisite sensitivity of mammalian hearing. Outer hair cells underlie the cochlear amplifier and they are unique in that they maintain an intracellular turgor pressure. Changing the turgor pressure of an isolated outer hair cells through osmotic challenge modulates its ability to produce electromotile force. We sought to determine the effect of osmotic challenge on cochlear function. Study Design In vivo animal study. Methods Hypotonic and hypertonic artificial perilymph was perfused through the scala tympani of anesthetized guinea pigs. Cochlear function was assessed by measuring the compound action potential, distortion product otoacoustic emissions, the cochlear microphonic, and the endocochlear potential. Results Hypotonic perilymph decreased and hypertonic perilymph increased compound action potential and distortion product otoacoustic emission thresholds in a dose-dependent and reversible manner. The cochlear microphonic quadratic distortion product magnitude increased after hypotonic perfusion and decreased with hypertonic perfusion. There were no changes in the stimulus intensity growth curve of the low-frequency cochlear microphonic. The endocochlear potential was not affected by perilymph osmolality. Conclusions These data demonstrate that perilymph osmolality can modulate cochlear function and are consistent with what would be expected if outer hair cells turgor pressure changes the gain of the cochlear amplifier in vivo. PMID:18607303

  20. Modelling Cochlear Mechanics

    PubMed Central

    Elliott, Stephen J.; Teal, Paul D.

    2014-01-01

    The cochlea plays a crucial role in mammal hearing. The basic function of the cochlea is to map sounds of different frequencies onto corresponding characteristic positions on the basilar membrane (BM). Sounds enter the fluid-filled cochlea and cause deflection of the BM due to pressure differences between the cochlear fluid chambers. These deflections travel along the cochlea, increasing in amplitude, until a frequency-dependent characteristic position and then decay away rapidly. The hair cells can detect these deflections and encode them as neural signals. Modelling the mechanics of the cochlea is of help in interpreting experimental observations and also can provide predictions of the results of experiments that cannot currently be performed due to technical limitations. This paper focuses on reviewing the numerical modelling of the mechanical and electrical processes in the cochlea, which include fluid coupling, micromechanics, the cochlear amplifier, nonlinearity, and electrical coupling. PMID:25136555

  1. Cochlear implantation in patients with bilateral cochlear trauma.

    PubMed

    Serin, Gediz Murat; Derinsu, Ufuk; Sari, Murat; Gergin, Ozgül; Ciprut, Ayça; Akdaş, Ferda; Batman, Cağlar

    2010-01-01

    Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected. Copyright 2010. Published by Elsevier Inc.

  2. [Neurotology and cochlear implants].

    PubMed

    Merchán, Miguel A

    2015-05-01

    In this review we analyse cochlear implantation in terms of the fundamental aspects of the functioning of the auditory system. Concepts concerning neuronal plasticity applied to electrical stimulation in perinatal and adult deep hypoacusis are reviewed, and the latest scientific bases that justify early implantation following screening for congenital deafness are discussed. Finally, this review aims to serve as an example of the importance of fostering the sub-specialty of neurotology in our milieu, with the aim of bridging some of the gaps between specialties and thus improving both the knowledge in the field of research on auditory pathologies and in the screening of patients. The objectives of this review, targeted above all towards specialists in the field of otorhinolaryngology, are to analyse some significant neurological foundations in order to reach a better understanding of the clinical events that condition the indications and the rehabilitation of patients with cochlear implants, as well as to use this means to foster the growth of the sub-specialty of neurotology.

  3. Linear cochlear mechanics.

    PubMed

    Zweig, George

    2015-08-01

    An active, three-dimensional, short-wavelength model of cochlear mechanics is derived from an older, one-dimensional, long-wavelength model containing time-delay forces. Remarkably, the long-wavelength model with nonlocal temporal interactions behaves like a short-wavelength model with instantaneous interactions. The cochlear oscillators are driven both by the pressure and its time derivative, the latter presumably a proxy for forces contributed by outer hair cells. The admittance in the short-wavelength region is used to find an integral representation of the transfer function valid for all wavelengths. There are only two free parameters: the pole position in the complex frequency plane of the admittance, and the slope of the transfer-function phase at low frequencies. The new model predicts a dip in amplitude and a corresponding rapid drop in phase, past the peak of the traveling wave. Linear models may be compared by their wavelengths, and if they have the same dimension, by the singularity structure of their admittances.

  4. Relational Learning in Children with Deafness and Cochlear Implants

    PubMed Central

    Almeida-Verdu, Ana Claudia; Huziwara, Edson M; de Souza, Deisy G; de Rose, Julio C; Bevilacqua, Maria CecÍlia; Lopes, Jair; Alves, Cristiane O; McIlvane, William J

    2008-01-01

    This four-experiment series sought to evaluate the potential of children with neurosensory deafness and cochlear implants to exhibit auditory–visual and visual–visual stimulus equivalence relations within a matching-to-sample format. Twelve children who became deaf prior to acquiring language (prelingual) and four who became deaf afterwards (postlingual) were studied. All children learned auditory–visual conditional discriminations and nearly all showed emergent equivalence relations. Naming tests, conducted with a subset of the children, showed no consistent relationship to the equivalence-test outcomes. This study makes several contributions to the literature on stimulus equivalence. First, it demonstrates that both pre- and postlingually deaf children can acquire auditory–visual equivalence relations after cochlear implantation, thus demonstrating symbolic functioning. Second, it directs attention to a population that may be especially interesting for researchers seeking to analyze the relationship between speaker and listener repertoires. Third, it demonstrates the feasibility of conducting experimental studies of stimulus control processes within the limitations of a hospital, which these children must visit routinely for the maintenance of their cochlear implants. PMID:18540222

  5. Visualizing Cochlear Mechanics Using Confocal Microscopy

    NASA Astrophysics Data System (ADS)

    Ulfendahl, M.; Boutet de Monvel, J.; Fridberger, A.

    2003-02-01

    The sound-evoked vibration pattern of the hearing organ is based on complex mechanical interactions between different cellular structures. To explore the structural changes occurring within the organ of Corti during basilar-membrane motion, stepwise alterations of the scala tympani pressure were applied in an in vitro preparation of the guinea-pig temporal bone. Confocal images were acquired at each pressure level. In this way, the motion of several structures could be simultaneously observed with high resolution in a nearly intact system. Images were analyzed using a novel wavelet-based optical-flow estimation algorithm. Under the present experimental conditions, the reticular lamina moved as a stiff plate with a center of rotation in the region of the inner hair cells. The outer hair cells appeared non-rigid and the basal, synaptic regions of these cells displayed significant radial motion indicative of cellular bending and internal shearing.

  6. Bilateral cochlear implantation: current concepts.

    PubMed

    Eapen, Rose J; Buchman, Craig A

    2009-10-01

    The goal of this review is to examine the most recent literature exploring the indications, outcomes, and long-term benefit of bilateral cochlear implantation in children and adults. The indications for cochlear implantation have expanded, as many unilaterally implanted individuals are able to achieve open-set word recognition. Despite the benefits seen in unilateral implantation, many individuals have difficulty perceiving speech in noisy environments. Bilateral cochlear implantation has made great strides in providing individuals access to sound information from both ears, allowing improved speech perception in quiet and in noise, as well as sound localization. Recently, the House Cochlear Implant study group released a position statement in which the group strongly endorsed bilateral cochlear implantation. Improved speech perception in quiet has also been demonstrated by many groups with bilateral implantation. Improved sound localization abilities have been shown to be dependent on interaural level differences. The binaural benefits of head shadow and summation have been long shown in bilaterally implanted individuals. Recently, a growth in squelch has been seen in these individuals likely as a result of increased experience with both implants. This may indicate neural integration of the inputs over time. The literature supports the binaural benefit of bilateral cochlear implantation with demonstrated improved speech perception outcomes in quiet and in noise, sound localization data, and subjective benefits.

  7. Cochlear implants and medical tourism.

    PubMed

    McKinnon, Brian J; Bhatt, Nishant

    2010-09-01

    To compare the costs of medical tourism in cochlear implant surgery performed in India as compared to the United States. In addition, the cost savings of obtaining cochlear implant surgery in India were compare d to those of other surgical interventions obtained as a medical tourist. Searches were conducted on Medline and Google using the search terms: 'medical tourism', 'medical offshoring', 'medical outsourcing', 'cochlear implants' and 'cochlear implantation'. The information regarding cost of medical treatment was obtained from personal communication with individuals familiar with India's cochlear implantation medical tourism industry. The range of cost depended on length of stay as well as the device chosen. Generally the cost, inclusive of travel, surgery and device, was in the range of $21,000-30,000, as compared to a cost range of $40,000-$60,000 in the US. With the escalating cost of healthcare in the United States, it is not surprising that some patients would seek to obtain surgical care overseas at a fraction of the cost. Participants in medical tourism often have financial resources, but lack health insurance coverage. While cardiovascular and orthopedic surgery performed outside the United States in India at centers that cater to medical tourists are often performed at one-quarter to one-third of the cost that would have been paid in the United States, the cost differential for cochlear implants is not nearly as favorable.

  8. A phone-assistive device based on Bluetooth technology for cochlear implant users.

    PubMed

    Qian, Haifeng; Loizou, Philipos C; Dorman, Michael F

    2003-09-01

    Hearing-impaired people, and particularly hearing-aid and cochlear-implant users, often have difficulty communicating over the telephone. The intelligibility of telephone speech is considerably lower than the intelligibility of face-to-face speech. This is partly because of lack of visual cues, limited telephone bandwidth, and background noise. In addition, cellphones may cause interference with the hearing aid or cochlear implant. To address these problems that hearing-impaired people experience with telephones, this paper proposes a wireless phone adapter that can be used to route the audio signal directly to the hearing aid or cochlear implant processor. This adapter is based on Bluetooth technology. The favorable features of this new wireless technology make the adapter superior to traditional assistive listening devices. A hardware prototype was built and software programs were written to implement the headset profile in the Bluetooth specification. Three cochlear implant users were tested with the proposed phone-adapter and reported good speech quality.

  9. Degradation of labial information modifies audiovisual speech perception in cochlear-implanted children.

    PubMed

    Huyse, Aurélie; Berthommier, Frédéric; Leybaert, Jacqueline

    2013-01-01

    The aim of the present study was to examine audiovisual speech integration in cochlear-implanted children and in normally hearing children exposed to degraded auditory stimuli. Previous studies have shown that speech perception in cochlear-implanted users is biased toward the visual modality when audition and vision provide conflicting information. Our main question was whether an experimentally designed degradation of the visual speech cue would increase the importance of audition in the response pattern. The impact of auditory proficiency was also investigated. A group of 31 children with cochlear implants and a group of 31 normally hearing children matched for chronological age were recruited. All children with cochlear implants had profound congenital deafness and had used their implants for at least 2 years. Participants had to perform an /aCa/ consonant-identification task in which stimuli were presented randomly in three conditions: auditory only, visual only, and audiovisual (congruent and incongruent McGurk stimuli). In half of the experiment, the visual speech cue was normal; in the other half (visual reduction) a degraded visual signal was presented, aimed at preventing lipreading of good quality. The normally hearing children received a spectrally reduced speech signal (simulating the input delivered by the cochlear implant). First, performance in visual-only and in congruent audiovisual modalities were decreased, showing that the visual reduction technique used here was efficient at degrading lipreading. Second, in the incongruent audiovisual trials, visual reduction led to a major increase in the number of auditory based responses in both groups. Differences between proficient and nonproficient children were found in both groups, with nonproficient children's responses being more visual and less auditory than those of proficient children. Further analysis revealed that differences between visually clear and visually reduced conditions and between

  10. Cochlear implant simulator for surgical technique analysis

    NASA Astrophysics Data System (ADS)

    Turok, Rebecca L.; Labadie, Robert F.; Wanna, George B.; Dawant, Benoit M.; Noble, Jack H.

    2014-03-01

    Cochlear Implant (CI) surgery is a procedure in which an electrode array is inserted into the cochlea. The electrode array is used to stimulate auditory nerve fibers and restore hearing for people with severe to profound hearing loss. The primary goals when placing the electrode array are to fully insert the array into the cochlea while minimizing trauma to the cochlea. Studying the relationship between surgical outcome and various surgical techniques has been difficult since trauma and electrode placement are generally unknown without histology. Our group has created a CI placement simulator that combines an interactive 3D visualization environment with a haptic-feedback-enabled controller. Surgical techniques and patient anatomy can be varied between simulations so that outcomes can be studied under varied conditions. With this system, we envision that through numerous trials we will be able to statistically analyze how outcomes relate to surgical techniques. As a first test of this system, in this work, we have designed an experiment in which we compare the spatial distribution of forces imparted to the cochlea in the array insertion procedure when using two different but commonly used surgical techniques for cochlear access, called round window and cochleostomy access. Our results suggest that CIs implanted using round window access may cause less trauma to deeper intracochlear structures than cochleostomy techniques. This result is of interest because it challenges traditional thinking in the otological community but might offer an explanation for recent anecdotal evidence that suggests that round window access techniques lead to better outcomes.

  11. The contribution of short-term memory capacity to reading ability in adolescents with cochlear implants.

    PubMed

    Edwards, Lindsey; Aitkenhead, Lynne; Langdon, Dawn

    2016-11-01

    This study aimed to establish the relationship between short-term memory capacity and reading skills in adolescents with cochlear implants. A between-groups design compared a group of young people with cochlear implants with a group of hearing peers on measures of reading, and auditory and visual short-term memory capacity. The groups were matched for non-verbal IQ and age. The adolescents with cochlear implants were recruited from the Cochlear Implant Programme at a specialist children's hospital. The hearing participants were recruited from the same schools as those attended by the implanted adolescents. Participants were 18 cochlear implant users and 14 hearing controls, aged between 12 and 18 years. All used English as their main language and had no significant learning disability or neuro-developmental disorder. Short-term memory capacity was assessed in the auditory modality using Forward and Reverse Digit Span from the WISC IV UK, and visually using Forward and Reverse Memory from the Leiter-R. Individual word reading, reading comprehension and pseudoword decoding were assessed using the WIAT II UK. A series of ANOVAs revealed that the adolescents with cochlear implants had significantly poorer auditory short-term memory capacity and reading skills (on all measures) compared with their hearing peers. However, when Forward Digit Span was entered into the analyses as a covariate, none of the differences remained statistically significant. Deficits in immediate auditory memory persist into adolescence in deaf children with cochlear implants. Short-term auditory memory capacity is an important neurocognitive process in the development of reading skills after cochlear implantation in childhood that remains evident in later adolescence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Outcome of cochlear implantation in children with cochlear malformations.

    PubMed

    Bille, Jesper; Fink-Jensen, Vibeke; Ovesen, Therese

    2015-03-01

    The objective of the study was the evaluation of outcomes of cochlear implantation (CI) in children with cochlear malformations. A retrospective case-control study was conducted in a tertiary referral centre. The patients were children with inner ear malformation judged by high-resolution computed tomography and magnetic resonance imaging treated with uni- or bilateral CI and a follow-up period of at least 3 years. They were matched with a control group of children operated for other reasons. The patients were operated by one of two surgeons using similar techniques including a standard perimodiolar electrode in all cases. The intervention was therapeutic and rehabilitative. The main outcome measures were category of auditory performance (CAP) and speech intelligibility rating (SIR). Eighteen children were diagnosed with cochlear malformations (12 % of children receiving CI). No statistical differences regarding CAP and SIR scores were found between the two groups. Only one child was diagnosed with a common cavity and performed below average. Children with auditory neuropathy performed beyond average. Children with cochlear malformations performed equally to children without malformation in the long term. Standard perimodiolar electrodes can be used despite cochlear malformations. The most important factors determining the outcome is the age of the child at the time of implantation and duration of hearing loss before CI. Awareness towards an increased risk of complications in case of inner ear malformations is recommended.

  13. Cochlear microphonic broad tuning curves

    NASA Astrophysics Data System (ADS)

    Ayat, Mohammad; Teal, Paul D.; Searchfield, Grant D.; Razali, Najwani

    2015-12-01

    It is known that the cochlear microphonic voltage exhibits much broader tuning than does the basilar membrane motion. The most commonly used explanation for this is that when an electrode is inserted at a particular point inside the scala media, the microphonic potentials of neighbouring hair cells have different phases, leading to cancelation at the electrodes location. In situ recording of functioning outer hair cells (OHCs) for investigating this hypothesis is exceptionally difficult. Therefore, to investigate the discrepancy between the tuning curves of the basilar membrane and those of the cochlear microphonic, and the effect of phase cancellation of adjacent hair cells on the broadness of the cochlear microphonic tuning curves, we use an electromechanical model of the cochlea to devise an experiment. We explore the effect of adjacent hair cells (i.e., longitudinal phase cancellation) on the broadness of the cochlear microphonic tuning curves in different locations. The results of the experiment indicate that active longitudinal coupling (i.e., coupling with active adjacent outer hair cells) only slightly changes the broadness of the CM tuning curves. The results also demonstrate that there is a π phase difference between the potentials produced by the hair bundle and the soma near the place associated with the characteristic frequency based on place-frequency maps (i.e., the best place). We suggest that the transversal phase cancellation (caused by the phase difference between the hair bundle and the soma) plays a far more important role than longitudinal phase cancellation in the broadness of the cochlear microphonic tuning curves. Moreover, by increasing the modelled longitudinal resistance resulting the cochlear microphonic curves exhibiting sharper tuning. The results of the simulations suggest that the passive network of the organ of Corti determines the phase difference between the hair bundle and soma, and hence determines the sharpness of the

  14. Myths about Cochlear Implants: A Family Perspective.

    ERIC Educational Resources Information Center

    Luetke-Stahlman, B.

    1994-01-01

    A parent of two young children who received cochlear implant surgery addresses common myths about this procedure including "deaf people don't support the use of cochlear implants,""if you choose cochlear implant surgery, you are choosing the hearing world,""hearing parents are not qualified to decide," and "the deaf child him/herself should…

  15. Nonverbal Cognition in Deaf Children Following Cochlear Implantation: Motor Sequencing Disturbances Mediate Language Delays

    PubMed Central

    Conway, Christopher M.; Karpicke, Jennifer; Anaya, Esperanza M.; Henning, Shirley C.; Kronenberger, William G.; Pisoni, David B.

    2012-01-01

    We assessed profoundly deaf children with cochlear implants (CIs) (N = 24) and age-matched normal-hearing children (N = 31) on several nonverbal cognition measures: motor sequencing, tactile discrimination, response inhibition, visual-motor integration, and visual-spatial processing. The results revealed that the children with CIs showed disturbances solely on motor sequencing and that performance on this task was significantly correlated with scores on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF–4). These findings suggest that a period of auditory deprivation before cochlear implantation affects motor sequencing skills, which in turn may mediate the language delays displayed by some deaf children with CIs. PMID:21347923

  16. Nonverbal cognition in deaf children following cochlear implantation: motor sequencing disturbances mediate language delays.

    PubMed

    Conway, Christopher M; Karpicke, Jennifer; Anaya, Esperanza M; Henning, Shirley C; Kronenberger, William G; Pisoni, David B

    2011-01-01

    We assessed profoundly deaf children with cochlear implants (CIs) (N = 24) and age-matched normal-hearing children (N = 31) on several nonverbal cognition measures: motor sequencing, tactile discrimination, response inhibition, visual-motor integration, and visual-spatial processing. The results revealed that the children with CIs showed disturbances solely on motor sequencing and that performance on this task was significantly correlated with scores on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF-4). These findings suggest that a period of auditory deprivation before cochlear implantation affects motor sequencing skills, which in turn may mediate the language delays displayed by some deaf children with CIs.

  17. Cochlear implantation in Cockayne syndrome: our experience of two cases with different outcomes.

    PubMed

    Morris, David P; Alian, Wael; Maessen, Heather; Creaser, Cathy; Demmons-O'Brien, Stephanie; Van Wijhe, Rene; Bance, Manohar

    2007-05-01

    Cockayne syndrome is a rare autosomal recessive defect in DNA repair resulting in a classic facies with potential visual and auditory impairment. The hearing loss begins peripherally and may become central as the condition progresses. Coexisting sensory deprivation from visual impairment and the possibility of progressive deterioration in mental function conspire with a lack of published experience to produce many challenges for the cochlear implant team. To the best of our knowledge, we present the first case reports with documented follow-up of cochlear implantation in two patients with different manifestations of Cockayne syndrome.

  18. Cochlear implantation updates: the Dallas Cochlear Implant Program.

    PubMed

    Tobey, Emily A; Britt, Lana; Geers, Ann; Loizou, Philip; Loy, Betty; Roland, Peter; Warner-Czyz, Andrea; Wright, Charles G

    2012-06-01

    This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between the University of Texas at Dallas, the University of Texas Southwestern Medical Center, and Children's Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies, and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants. American Academy of Audiology.

  19. Cochlear Implantation Updates: The Dallas Cochlear Implant Program

    PubMed Central

    Tobey, Emily A.; Britt, Lana; Geers, Ann; Loizou, Philip; Loy, Betty; Roland, Peter; Warner-Czyz, Andrea; Wright, Charles G.

    2013-01-01

    This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between The University of Texas at Dallas, The University of Texas Southwestern Medical Center and Children’s Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants. PMID:22668764

  20. Cued speech for enhancing speech perception and first language development of children with cochlear implants.

    PubMed

    Leybaert, Jacqueline; LaSasso, Carol J

    2010-06-01

    Nearly 300 million people worldwide have moderate to profound hearing loss. Hearing impairment, if not adequately managed, has strong socioeconomic and affective impact on individuals. Cochlear implants have become the most effective vehicle for helping profoundly deaf children and adults to understand spoken language, to be sensitive to environmental sounds, and, to some extent, to listen to music. The auditory information delivered by the cochlear implant remains non-optimal for speech perception because it delivers a spectrally degraded signal and lacks some of the fine temporal acoustic structure. In this article, we discuss research revealing the multimodal nature of speech perception in normally-hearing individuals, with important inter-subject variability in the weighting of auditory or visual information. We also discuss how audio-visual training, via Cued Speech, can improve speech perception in cochlear implantees, particularly in noisy contexts. Cued Speech is a system that makes use of visual information from speechreading combined with hand shapes positioned in different places around the face in order to deliver completely unambiguous information about the syllables and the phonemes of spoken language. We support our view that exposure to Cued Speech before or after the implantation could be important in the aural rehabilitation process of cochlear implantees. We describe five lines of research that are converging to support the view that Cued Speech can enhance speech perception in individuals with cochlear implants.

  1. Cued Speech for Enhancing Speech Perception and First Language Development of Children With Cochlear Implants

    PubMed Central

    Leybaert, Jacqueline; LaSasso, Carol J.

    2010-01-01

    Nearly 300 million people worldwide have moderate to profound hearing loss. Hearing impairment, if not adequately managed, has strong socioeconomic and affective impact on individuals. Cochlear implants have become the most effective vehicle for helping profoundly deaf children and adults to understand spoken language, to be sensitive to environmental sounds, and, to some extent, to listen to music. The auditory information delivered by the cochlear implant remains non-optimal for speech perception because it delivers a spectrally degraded signal and lacks some of the fine temporal acoustic structure. In this article, we discuss research revealing the multimodal nature of speech perception in normally-hearing individuals, with important inter-subject variability in the weighting of auditory or visual information. We also discuss how audio-visual training, via Cued Speech, can improve speech perception in cochlear implantees, particularly in noisy contexts. Cued Speech is a system that makes use of visual information from speechreading combined with hand shapes positioned in different places around the face in order to deliver completely unambiguous information about the syllables and the phonemes of spoken language. We support our view that exposure to Cued Speech before or after the implantation could be important in the aural rehabilitation process of cochlear implantees. We describe five lines of research that are converging to support the view that Cued Speech can enhance speech perception in individuals with cochlear implants. PMID:20724357

  2. Successful cochlear implantation in a child with Keratosis, Icthiosis and Deafness (KID) Syndrome and Dandy-Walker malformation.

    PubMed

    Cushing, Sharon L; MacDonald, Laurie; Propst, Evan J; Sharma, Alok; Stockley, Tracy; Blaser, Susan L; James, Adrian L; Papsin, Blake C

    2008-05-01

    Keratosis, Icthiosis, and Deafness (KID) Syndrome is a rare congenital disorder associated with dominant connexin 26 mutations, affecting epidermis, corneal epithelium, and inner ear. Given eventual visual impairment, cochlear implantation is an important consideration despite an increased risk of wound complications. We present a child with KID Syndrome and bilateral profound sensorineural hearing loss associated with a novel heterozygous missense D50A connexin 26 mutation (c.149A > C). Imaging revealed mild cochlear malformation and Dandy-Walker malformation. She received a cochlear implant at the age of 12 months, using a small incision approach. Following an immediate minor wound infection, implantation has been successful without further complication over 4 years.

  3. IMPORTANCE OF COCHLEAR HEALTH FOR IMPLANT FUNCTION

    PubMed Central

    Pfingst, Bryan E.; Zhou, Ning; Colesa, Deborah J.; Watts, Melissa M.; Strahl, Stefan B.; Garadat, Soha N.; Schvartz-Leyzac, Kara C.; Budenz, Cameron L.; Raphael, Yehoash; Zwolan, Teresa A.

    2014-01-01

    Amazing progress has been made in providing useful hearing to hearing-impaired individuals using cochlear implants, but challenges remain. One such challenge is understanding the effects of partial degeneration of the auditory nerve, the target of cochlear implant stimulation. Here we review studies from our human and animal laboratories aimed at characterizing the health of the implanted cochlea and the auditory nerve. We use the data on cochlear and neural health to guide rehabilitation strategies. The data also motivate the development of tissue-engineering procedures to preserve or build a healthy cochlea and improve performance obtained by cochlear implant recipients or eventually replace the need for a cochlear implant. PMID:25261772

  4. [Progress and challenges in optical cochlear implant].

    PubMed

    Zhang, Kaiyin; Guo, He; Wu, Shan; Wu, Yanning; Zhao, Shutao; Wang, Qiuling

    2016-01-01

    Optical cochlear implant has been occuring as a new cochlear implant which utilizes laser pulses to stimulate hearing. Compared to electronic cochlear implant, it has demonstrated higher spatial selectivity and less radiation scattering, which could lead to higher fidelity cochlear prostheses. At present, most investigations have focused on experiments in vivo. Although a lot of exciting results have been obtained, the mechanisms of laser stimulation is still open. In this paper, a brief review on the recent new findings of optical cochlear implant is given, and possible mechanisms are discussed. In the end, new experimental proposals are suggested which could help to explore the mechanisms of laser-cochlea stimulation.

  5. Brain plasticity under cochlear implant stimulation.

    PubMed

    Kral, Andrej; Tillein, Jochen

    2006-01-01

    The benefit of cochlear implantation crucially depends on the ability of the brain to learn to classify neural activity evoked by the cochlear implant. Brain plasticity is a complex property with massive developmental changes after birth. The present paper reviews the experimental work on auditory plasticity and focuses on the plasticity required for adaptation to cochlear implant stimulation. It reviews the data on developmental sensitive periods in auditory plasticity of hearing, hearing-impaired and deaf, cochlear-implanted, animals. Based on the analysis of the above findings in animals and comparable data from humans, a cochlear implantation within the first 2 years of age is recommended.

  6. Nonlinear cochlear mechanics.

    PubMed

    Zweig, George

    2016-05-01

    An earlier paper characterizing the linear mechanical response of the organ of Corti [J. Acoust. Soc. Am. 138, 1102-1121 (2015)] is extended to the nonlinear domain. Assuming the existence of nonlinear oscillators nonlocally coupled through the pressure they help create, the oscillator equations are derived and examined when the stimuli are modulated tones and clicks. The nonlinearities are constrained by the requirements of oscillator stability and the invariance of zero crossings in the click response to changes in click amplitude. The nonlinear oscillator equations for tones are solved in terms of the fluid pressure that drives them, and its time derivative, presumably a proxy for forces created by outer hair cells. The pressure equation is reduced to quadrature, the integrand depending on the oscillators' responses. The resulting nonlocally coupled nonlinear equations for the pressure, and oscillator amplitudes and phases, are solved numerically in terms of the fluid pressure at the stapes. Methods for determining the nonlinear damping directly from measurements are described. Once the oscillators have been characterized from their tone and click responses, the mechanical response of the cochlea to natural sounds may be computed numerically. Signal processing inspired by cochlear mechanics opens up a new area of nonlocal nonlinear time-frequency analysis.

  7. Biomaterials in cochlear implants

    PubMed Central

    Stöver, Timo; Lenarz, Thomas

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103

  8. [Do children with cochlear implants read or write differently?: literacy acquisition after cochlear implantation].

    PubMed

    Fiori, A; Reichmuth, K; Matulat, P; Schmidt, C-M; Am Zehnhoff-Dinnesen, A

    2010-09-01

    Despite the fact that literacy acquisition in hearing impaired children is frequently hampered, reading and writing competences continue not to be regularly evaluated and documented in children fitted with cochlear implants (CI). In this 2-year longitudinal study literacy acquisition in children fitted with CI was investigated. In total, 18 pre- and primary school children fitted with CI who had suffered prelingual deafness were examined. Subjects' ages at CI fitting ranged from 0.9 to 5.9 years; they were raised orally and monolingual German and showed normal intellectual achievement. Familial risk of developing dyslexia was ruled out. To assess subjects' literacy acquisition precursor and partial abilities in reading and writing according to dual route and developmental models were examined three times within 2 years. Precursor abilities included development of vocabulary and phonological awareness. Partial abilities were mastery in sublexical and lexical word processing in reading and writing as well as auditory and visual working memory. Subjects showed a broad range in performance regarding vocabulary development as well as literacy. Discrepant results in terms of age equivalent visual and underachievement in auditory working memory as well as good achievement in implicit phonological awareness and weakness in explicit demands on phoneme analysis and manipulation of phonemes can be described. Indications were that subjects tended towards lip reading the instructor's item presentation. Performance in the administered writing test reveals a preference for lexical word processing, whereas sublexical word processing seems to make relatively higher demands on subjects. Easier processing of visual information in partial and precursor abilities are consistent with a tendency to prefer a visual-lexical processing strategy. The presented study stresses the importance of generally assessing reading and writing skills when evaluating language development in children

  9. Cochlear implantation in superficial siderosis.

    PubMed

    Kim, Chong-Sun; Song, Jae-Jun; Park, Min-Hyun; Kim, Young Ho; Koo, Ja-Won

    2006-08-01

    Superficial siderosis (SS) of the central nervous system has been thought to be a rare condition that generates progressive hearing loss, ataxia, pyramidal signs, and dementia. The main cause of hearing loss by SS is thought to be neuronal. Because there is no histopathologic report of the human temporal bone in SS, there is a debate about the possibility of cochlear involvement. We present a 25-year-old man who was investigated for bilateral progressive sensorineural hearing loss and vestibular failure after head trauma. On brain MRI, SS of the central nervous system was detected. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) showed no response on both sides. However, integrity of the eighth nerve was proved by the electrical ABR test on the right side and the patient benefited significantly from cochlear implantation. The sensorineural hearing loss in SS seems to be related to cochlear damage as well as neuronal damage. So, cochlear implantation would be a hearing rehabilitation modality for the sensorineural hearing loss caused by SS.

  10. Advancing Binaural Cochlear Implant Technology

    PubMed Central

    McAlpine, David

    2015-01-01

    This special issue contains a collection of 13 papers highlighting the collaborative research and engineering project entitled Advancing Binaural Cochlear Implant Technology—ABCIT—as well as research spin-offs from the project. In this introductory editorial, a brief history of the project is provided, alongside an overview of the studies. PMID:26721929

  11. Cochlear implant optimized noise reduction

    NASA Astrophysics Data System (ADS)

    Mauger, Stefan J.; Arora, Komal; Dawson, Pam W.

    2012-12-01

    Noise-reduction methods have provided significant improvements in speech perception for cochlear implant recipients, where only quality improvements have been found in hearing aid recipients. Recent psychoacoustic studies have suggested changes to noise-reduction techniques specifically for cochlear implants, due to differences between hearing aid recipient and cochlear implant recipient hearing. An optimized noise-reduction method was developed with significantly increased temporal smoothing of the signal-to-noise ratio estimate and a more aggressive gain function compared to current noise-reduction methods. This optimized noise-reduction algorithm was tested with 12 cochlear implant recipients over four test sessions. Speech perception was assessed through speech in noise tests with three noise types; speech-weighted noise, 20-talker babble and 4-talker babble. A significant speech perception improvement using optimized noise reduction over standard processing was found in babble noise and speech-weighted noise and over a current noise-reduction method in speech-weighted noise. Speech perception in quiet was not degraded. Listening quality testing for noise annoyance and overall preference found significant improvements over the standard processing and over a current noise-reduction method in speech-weighted and babble noise types. This optimized method has shown significant speech perception and quality improvements compared to the standard processing and a current noise-reduction method.

  12. Cochlear implant optimized noise reduction.

    PubMed

    Mauger, Stefan J; Arora, Komal; Dawson, Pam W

    2012-12-01

    Noise-reduction methods have provided significant improvements in speech perception for cochlear implant recipients, where only quality improvements have been found in hearing aid recipients. Recent psychoacoustic studies have suggested changes to noise-reduction techniques specifically for cochlear implants, due to differences between hearing aid recipient and cochlear implant recipient hearing. An optimized noise-reduction method was developed with significantly increased temporal smoothing of the signal-to-noise ratio estimate and a more aggressive gain function compared to current noise-reduction methods. This optimized noise-reduction algorithm was tested with 12 cochlear implant recipients over four test sessions. Speech perception was assessed through speech in noise tests with three noise types; speech-weighted noise, 20-talker babble and 4-talker babble. A significant speech perception improvement using optimized noise reduction over standard processing was found in babble noise and speech-weighted noise and over a current noise-reduction method in speech-weighted noise. Speech perception in quiet was not degraded. Listening quality testing for noise annoyance and overall preference found significant improvements over the standard processing and over a current noise-reduction method in speech-weighted and babble noise types. This optimized method has shown significant speech perception and quality improvements compared to the standard processing and a current noise-reduction method.

  13. Cerebrospinal Fluid Leak in Cochlear Implantation: Enlarged Cochlear versus Enlarged Vestibular Aqueduct (Common Cavity Excluded)

    PubMed Central

    Polizzi, Valeria; Formigoni, Patrizia; Russo, Carmela; Tribi, Lorenzo

    2016-01-01

    Objective. To share our experience of cerebrospinal fluid gusher in cochlear implantation in patients with enlarged cochlear or vestibular aqueduct. Study Design. Case series with comparison and a review of the literature. Methods. A retrospective study was performed. Demographic and radiological results of patients with enlarged cochlear aqueduct or enlarged vestibular aqueduct in 278 consecutive cochlear implant recipients, including children and adults, were evaluated between January 2000 and December 2015. Results. Six patients with enlarged cochlear aqueduct and eight patients with enlarged vestibular aqueduct were identified. Cerebrospinal fluid gusher occurs in five subjects with enlarged cochlear aqueduct and in only one case of enlarged vestibular aqueduct. Conclusion. Based on these findings, enlarged cochlear aqueduct may be the best risk predictor of cerebrospinal fluid gusher at cochleostomy during cochlear implant surgery despite enlarged vestibular aqueduct. PMID:27847516

  14. Comparison of PCB and trace metal bioaccumulation in the blue mussel, Mytilus edulis, and the ribbed mussel, Modiolus demissus, in New Bedford Harbor, Massachusetts

    SciTech Connect

    Nelson, W.G.; Bergen, B.J.; Cobb, D.J.

    1995-03-01

    The accumulation of PCBs and trace metals was compared at 14-d intervals between two filter-feeding bivalves, the blue mussel, Mytilus edulis, and the ribbed mussel, Modiolus demissus, after deployment in New Bedford Harbor, Massachusetts, for up to 56 d. Contaminant uptake in deployed organisms also was compared with indigenous ribbed mussels. Significant mortality occurred in blue mussels after 28 d, when water temperatures exceeded 25 C. Therefore, tissue-residue comparisons between species are presented only up to day 28, while those between deployed and indigenous ribbed mussels continue to day 56. Results indicated that total PCB tissue residues and congener distributions were not statistically different in the two mussel species on day 28. Total PCB concentrations in both deployed mussel species reached approximately 30 {mu}g g{sup {minus}1} dry weight by day 28. Additionally, total PCB concentrations and congener distributions in the deployed ribbed mussels were not statistically different from the indigenous ribbed mussels on day 28, demonstrating that steady state was attained within 28 d. With respect to metal uptake, no single accumulation pattern occurred for the eight metals quantified. After 28 d, lead, cadmium, and iron concentrations in deployed blue and ribbed mussels were statistically similar. However, nickel and zinc accumulations were significantly greater in the blue mussels, and copper, chromium, and manganese were accumulated to significantly higher concentrations in the ribbed mussels. The comparison between the ribbed mussels indicated that cadmium and lead concentrations were significantly higher in indigenous than in deployed mussels after 28 d.

  15. Cochlear Implantation in Older Adults

    PubMed Central

    Lin, Frank R.; Chien, Wade W.; Li, Lingsheng; Niparko, John K.; Francis, Howard W.

    2012-01-01

    Cochlear implants allow individuals with severe-to-profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation is approximately 150,000 and will continue to increase with the aging of the population. Should cochlear implantation (CI) be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12 year experience with cochlear implantation in adults ≥60 years (n = 445) at Johns Hopkins to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that cochlear implantation in adults ≥60 years consistently improved speech understanding scores with a mean increase of 60. 0% (S. D. 24. 1) on HINT sentences in quiet . The magnitude of the gain in speech scores was negatively associated with age at implantation such that for every increasing year of age at CI the gain in speech scores was 1. 3 percentage points less (95% CI: 0. 6 – 1. 9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40–60%) had significantly greater post-CI speech scores by a mean of 10. 0 percentage points (95% CI: 0. 4 – 19. 6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after cochlear implantation with possible implications for current Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into

  16. Music Perception with Cochlear Implants: A Review

    PubMed Central

    McDermott, Hugh J.

    2004-01-01

    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

  17. Deaf Parents of Cochlear-Implanted Children: Beliefs on Bimodal Bilingualism

    ERIC Educational Resources Information Center

    Mitchiner, Julie Cantrell

    2015-01-01

    This study investigated 17 Deaf families in North America with cochlear-implanted children about their attitudes, beliefs, and practices on bimodal bilingualism (defined as using both a visual/manual language and an aural/oral language) in American Sign Language (ASL) and English. A survey and follow-up interviews with 8 families were conducted.…

  18. Deaf Parents of Cochlear-Implanted Children: Beliefs on Bimodal Bilingualism

    ERIC Educational Resources Information Center

    Mitchiner, Julie Cantrell

    2015-01-01

    This study investigated 17 Deaf families in North America with cochlear-implanted children about their attitudes, beliefs, and practices on bimodal bilingualism (defined as using both a visual/manual language and an aural/oral language) in American Sign Language (ASL) and English. A survey and follow-up interviews with 8 families were conducted.…

  19. The Effect of Technology and Testing Environment on Speech Perception Using Telehealth with Cochlear Implant Recipients

    ERIC Educational Resources Information Center

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.; Valente, Daniel L.; McCreery, Ryan W.; Diaz, Gina R.; Sanford, Todd; Harpster, Roger

    2012-01-01

    Purpose: In this study, the authors evaluated the effect of remote system and acoustic environment on speech perception via telehealth with cochlear implant recipients. Method: Speech perception was measured in quiet and in noise. Systems evaluated were Polycom visual concert (PVC) and a hybrid presentation system (HPS). Each system was evaluated…

  20. The Effect of Technology and Testing Environment on Speech Perception Using Telehealth with Cochlear Implant Recipients

    ERIC Educational Resources Information Center

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.; Valente, Daniel L.; McCreery, Ryan W.; Diaz, Gina R.; Sanford, Todd; Harpster, Roger

    2012-01-01

    Purpose: In this study, the authors evaluated the effect of remote system and acoustic environment on speech perception via telehealth with cochlear implant recipients. Method: Speech perception was measured in quiet and in noise. Systems evaluated were Polycom visual concert (PVC) and a hybrid presentation system (HPS). Each system was evaluated…

  1. Cross-Modal Reorganization and Speech Perception in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Doucet, M. E.; Bergeron, F.; Lassonde, M.; Ferron, P.; Lepore, F.

    2006-01-01

    Recent work suggests that once the auditory cortex of deaf persons has been reorganized by cross-modal plasticity, it can no longer respond to signals from a cochlear implant (CI) installed subsequently. To further examine this issue, we compared the evoked potentials involved in the processing of visual stimuli between CI users and hearing…

  2. Cochlear implantation for symptomatic hereditary deafness.

    PubMed

    Nishizaki, K; Fukushiama, K; Oda, Y; Masuda, A; Hayashi, S; Nagayasu, N; Yoshino, T; Kashihara, K; Takahashi, K; Masuda, Y

    1999-01-01

    Recently, the effectiveness of cochlear implantation for hereditary deafness has been reported. We performed cochlear implantation for two patients with symptomatic hereditary deafness. Deafness in one patient was thought to be a result of albinism-deafness syndrome and in the other patient, a result of chronic progressive external ophthalmoplegia syndrome. Since their speech perception abilities improved dramatically, we believe that cochlear implantation should be actively performed for these two syndromes.

  3. [Our experience with bilateral cochlear implantation].

    PubMed

    Carmel, Eldar; Taitelbaum-Swead, Ricky; Migirov, Lela; Hildesheimer, Minka; Kronenberg, Jona

    2008-03-01

    Cochlear implantation is a standard method of hearing rehabilitation among patients with severe to profound bilateral sensorineural hearing loss. In recent years there have been an increasing number of studies showing superior hearing with bilateral cochlear implantation in comparison with a unilateral procedure. In this study we present our experience with 15 patients, children and adults, who had bilateral cochlear implant surgery. Speech perception test results demonstrated a hearing benefit in bilateral cochlear implantation in comparison with a unilateral device, mainly by improvement in the identification of speech in noise tests.

  4. Cochlear implant in incomplete partition type I.

    PubMed

    Berrettini, S; Forli, F; De Vito, A; Bruschini, L; Quaranta, N

    2013-02-01

    In this investigation, we report on 4 patients affected by incomplete partition type I submitted to cochlear implant at our institutions. Preoperative, surgical, mapping and follow-up issues as well as results in cases with this complex malformation are described. The cases reported in the present study confirm that cochlear implantation in patients with incomplete partition type I may be challenging for cochlear implant teams. The results are variable, but in many cases satisfactory, and are mainly related to the surgical placement of the electrode and residual neural nerve fibres. Moreover, in some cases the association of cochlear nerve abnormalities and other disabilities may significantly affect results.

  5. Increased cross-modal functional connectivity in cochlear implant users.

    PubMed

    Chen, Ling-Chia; Puschmann, Sebastian; Debener, Stefan

    2017-08-30

    Previous studies have reported increased cross-modal auditory and visual cortical activation in cochlear implant (CI) users, suggesting cross-modal reorganization of both visual and auditory cortices in CI users as a consequence of sensory deprivation and restoration. How these processes affect the functional connectivity of the auditory and visual system in CI users is however unknown. We here investigated task-induced intra-modal functional connectivity between hemispheres for both visual and auditory cortices and cross-modal functional connectivity between visual and auditory cortices using functional near infrared spectroscopy in post-lingually deaf CI users and age-matched normal hearing controls. Compared to controls, CI users exhibited decreased intra-modal functional connectivity between hemispheres and increased cross-modal functional connectivity between visual and left auditory cortices for both visual and auditory stimulus processing. Importantly, the difference between cross-modal functional connectivity for visual and for auditory stimuli correlated with speech recognition outcome in CI users. Higher cross-modal connectivity for auditory than for visual stimuli was associated with better speech recognition abilities, pointing to a new pattern of functional reorganization that is related to successful hearing restoration with a CI.

  6. Cochlear implantation following cerebellar surgery.

    PubMed

    Saeed, Shahad; Mawman, Deborah; Green, Kevin

    2011-08-01

    Cochlear implantation in patients with known central nervous system conditions can result in wide-ranging outcomes. The aim of this study is to report two cases of cochlear implantation outcomes in patients with acquired cerebellar ataxia following cerebellar surgery. The first is a female implanted with the Nucleus 24 implant in September 2000 and the second is a male implanted with a MED-EL Sonata Flexsoft electro-acoustic stimulation in July 2009. Programming these patients resulted in significant non-auditory stimulation which resulted in less than optimum map fittings. The patients did not gain any open set speech perception benefit although both of them gained an awareness of sound with the device. However, patient 2 elected to become a non-user because of the limited benefit.

  7. 3D optical coherence tomography image registration for guiding cochlear implant insertion

    NASA Astrophysics Data System (ADS)

    Cheon, Gyeong-Woo; Jeong, Hyun-Woo; Chalasani, Preetham; Chien, Wade W.; Iordachita, Iulian; Taylor, Russell; Niparko, John; Kang, Jin U.

    2014-03-01

    In cochlear implant surgery, an electrode array is inserted into the cochlear canal to restore hearing to a person who is profoundly deaf or significantly hearing impaired. One critical part of the procedure is the insertion of the electrode array, which looks like a thin wire, into the cochlear canal. Although X-ray or computed tomography (CT) could be used as a reference to evaluate the pathway of the whole electrode array, there is no way to depict the intra-cochlear canal and basal turn intra-operatively to help guide insertion of the electrode array. Optical coherent tomography (OCT) is a highly effective way of visualizing internal structures of cochlea. Swept source OCT (SSOCT) having center wavelength of 1.3 micron and 2D Galvonometer mirrors was used to achieve 7-mm depth 3-D imaging. Graphics processing unit (GPU), OpenGL, C++ and C# were integrated for real-time volumetric rendering simultaneously. The 3D volume images taken by the OCT system were assembled and registered which could be used to guide a cochlear implant. We performed a feasibility study using both dry and wet temporal bones and the result is presented.

  8. Voice and Pronunciation of Cochlear Implant Speakers

    ERIC Educational Resources Information Center

    Horga, Damir; Liker, Marko

    2006-01-01

    Patients with cochlear implants have the ability to exercise auditory control over their own speech production and over the speech of others, which is important for the development of speech control. In the present investigation three groups of 10 subjects were compared. The groups comprised: (1) cochlear implant users, (2) profoundly deaf using…

  9. Deafblind People's Experiences of Cochlear Implantation

    ERIC Educational Resources Information Center

    Soper, Janet

    2006-01-01

    Cochlear implants are electronic devices that create the sensation of hearing in those who cannot obtain any benefit from conventional hearing aids. This article examines the experience of cochlear implantation in a select group of individuals with acquired deafblindness, focusing on three key themes: access to communication, information and…

  10. Cochlear Implants: The Young People's Perspective

    ERIC Educational Resources Information Center

    Wheeler, Alexandra; Archbold, Sue; Gregory, Susan; Skipp, Amy

    2007-01-01

    Cochlear implantation is a relatively new procedure, which has already had significant impact on the lives of many profoundly deaf children and adults, in providing useful hearing to those unable to benefit significantly from hearing aids. After 16 years of cochlear implantation in the United Kingdom, there is now a body of evidence covering a…

  11. The spatial pattern of cochlear amplification.

    PubMed

    Fisher, Jonathan A N; Nin, Fumiaki; Reichenbach, Tobias; Uthaiah, Revathy C; Hudspeth, A J

    2012-12-06

    Sensorineural hearing loss, which stems primarily from the failure of mechanosensory hair cells, changes the traveling waves that transmit acoustic signals along the cochlea. However, the connection between cochlear mechanics and the amplificatory function of hair cells remains unclear. Using an optical technique that permits the targeted inactivation of prestin, a protein of outer hair cells that generates forces on the basilar membrane, we demonstrate that these forces interact locally with cochlear traveling waves to achieve enormous mechanical amplification. By perturbing amplification in narrow segments of the basilar membrane, we further show that a cochlear traveling wave accumulates gain as it approaches its peak. Analysis of these results indicates that cochlear amplification produces negative damping that counters the viscous drag impeding traveling waves; targeted photoinactivation locally interrupts this compensation. These results reveal the locus of amplification in cochlear traveling waves and connect the characteristics of normal hearing to molecular forces.

  12. The Spatial Pattern of Cochlear Amplification

    PubMed Central

    Fisher, Jonathan A.N.; Nin, Fumiaki; Reichenbach, Tobias; Uthaiah, Revathy C.; Hudspeth, A.J.

    2012-01-01

    SUMMARY Sensorineural hearing loss, which stems primarily from the failure of mechanosensory hair cells, changes the traveling waves that transmit acoustic signals along the cochlea. However, the connection between cochlear mechanics and the amplificatory function of hair cells remains unclear. Using an optical technique that permits the targeted inactivation of prestin, a protein of outer hair cells that generates forces on the basilar membrane, we demonstrate that these forces interact locally with cochlear traveling waves to achieve enormous mechanical amplification. By perturbing amplification in narrow segments of the basilar membrane, we further show that a cochlear traveling wave accumulates gain as it approaches its peak. Analysis of these results indicates that cochlear amplification produces negative damping that counters the viscous drag impeding traveling waves; targeted photoinactivation locally interrupts this compensation. These results reveal the locus of amplification in cochlear traveling waves and connect the characteristics of normal hearing to molecular forces. PMID:23217746

  13. Importance of cochlear health for implant function.

    PubMed

    Pfingst, Bryan E; Zhou, Ning; Colesa, Deborah J; Watts, Melissa M; Strahl, Stefan B; Garadat, Soha N; Schvartz-Leyzac, Kara C; Budenz, Cameron L; Raphael, Yehoash; Zwolan, Teresa A

    2015-04-01

    Amazing progress has been made in providing useful hearing to hearing-impaired individuals using cochlear implants, but challenges remain. One such challenge is understanding the effects of partial degeneration of the auditory nerve, the target of cochlear implant stimulation. Here we review studies from our human and animal laboratories aimed at characterizing the health of the implanted cochlea and the auditory nerve. We use the data on cochlear and neural health to guide rehabilitation strategies. The data also motivate the development of tissue-engineering procedures to preserve or build a healthy cochlea and improve performance obtained by cochlear implant recipients or eventually replace the need for a cochlear implant. This article is part of a Special Issue entitled .

  14. Two-Photon Microscopy Allows Imaging and Characterization of Cochlear Microvasculature In Vivo

    PubMed Central

    Bertlich, Mattis; Weiss, Bernhard; Dietzel, Steffen; Canis, Martin

    2015-01-01

    Impairment of cochlear blood flow has been discussed as factor in the pathophysiology of various inner ear disorders. However, the microscopic study of cochlear microcirculation is limited due to small scale and anatomical constraints. Here, two-photon fluorescence microscopy is applied to visualize cochlear microvessels. Guinea pigs were injected with Fluorescein isothiocyanate- or Texas red-dextrane as plasma marker. Intravital microscopy was performed in four animals and explanted cochleae from four animals were studied. The vascular architecture of the cochlea was visualized up to a depth of 90.0 ± 22.7 μm. Imaging yielded a mean contrast-to-noise ratio (CNR) of 3.3 ± 1.7. Mean diameter in vivo was 16.5 ± 6.0 μm for arterioles and 8.0 ± 2.4 μm for capillaries. In explanted cochleae, the diameter of radiating arterioles and capillaries was measured with 12.2 ± 1.6 μm and 6.6 ± 1.0 μm, respectively. The difference between capillaries and arterioles was statistically significant in both experimental setups (P < 0.001 and P = 0.022, two-way ANOVA). Measured vessel diameters in vivo and ex vivo were in agreement with published data. We conclude that two-photon fluorescence microscopy allows the investigation of cochlear microvessels and is potentially a valuable tool for inner ear research. PMID:25883941

  15. Implicit Sequence Learning in Deaf Children with Cochlear Implants

    PubMed Central

    Conway, Christopher M.; Pisoni, David B.; Anaya, Esperanza M.; Karpicke, Jennifer; Henning, Shirley C.

    2010-01-01

    Deaf children with cochlear implants (CIs) represent an intriguing opportunity to study neurocognitive plasticity and reorganization when sound is introduced following a period of auditory deprivation early in development. Although it is common to consider deafness as affecting hearing alone, it may be the case that auditory deprivation leads to more global changes in neurocognitive function. In this paper, we investigate implicit sequence learning abilities in deaf children with CIs using a novel task that measured learning through improvement to immediate serial recall for statistically-consistent visual sequences. The results demonstrated two key findings. First, the deaf children with CIs showed disturbances in their visual sequence learning abilities relative to the typically-developing normal-hearing children. Second, sequence learning was significantly correlated with a standardized measure of language outcome in the CI children. These findings suggest that a period of auditory deprivation has secondary effects related to general sequencing deficits, and that disturbances in sequence learning may at least partially explain why some deaf children still struggle with language following cochlear implantation. PMID:21159089

  16. Cochlear amplification: A moderated discussion

    NASA Astrophysics Data System (ADS)

    Elliott, Stephen; Grosh, Karl; Puria, Sunil

    2015-12-01

    The following is an edited transcript of a recorded discussion session on the topic of "Cochlear Amplification". The discussion, moderated by the authors, took place at the 12th International Workshop on the Mechanics of Hearing held at Cape Sounio, Greece, in June 2014. All participants knew that the session was being recorded. In view of both the spontaneous nature of the discussion and the editing, however, this transcript may not represent the considered or final views of the participants, and may not represent a consensus of experts in the field. The reader is advised to consult additional independent publications.

  17. Cochlear Implant Using Neural Prosthetics

    NASA Astrophysics Data System (ADS)

    Gupta, Shweta; Singh, Shashi kumar; Dubey, Pratik Kumar

    2012-10-01

    This research is based on neural prosthetic device. The oldest and most widely used of these electrical, and often computerized, devices is the cochlear implant, which has provided hearing to thousands of congenitally deaf people in this country. Recently, the use of the cochlear implant is expanding to the elderly, who frequently suffer major hearing loss. More cutting edge are artificial retinas, which are helping dozens of blind people see, and ìsmartî artificial arms and legs that amputees can maneuver by thoughts alone, and that feel more like real limbs.Research, which curiosity led to explore frog legs dancing during thunderstorms, a snail shapedorgan in the inner ear, and how various eye cells react to light, have fostered an understanding of how to ìtalkî to the nervous system. That understanding combined with the miniaturization of electronics and enhanced computer processing has enabled prosthetic devices that often can bridge the gap in nerve signaling that is caused by disease or injury.

  18. A chinchilla nonlinear cochlear filterbank

    NASA Astrophysics Data System (ADS)

    Lopez-Najera, Alberto; Lopez-Poveda, Enrique A.; Meddis, Ray

    2002-05-01

    A dual-resonance nonlinear (DRNL) filter [Meddis et al., J. Acoust. Soc. Am. 106, 2852-2861 (2001)] was fitted to model chinchilla cochlear responses to tonal stimuli at individual sites along the basilar membrane (BM) with best frequencies (BF) of 0.8, 5.5, 7.25, 9.75, 10.0, 12.0, and 14.0 kHz. At each BF, parameters were obtained for the DRNL filter to reproduce input/output and tuning curves. The match between the model and the experimental data is almost perfect for frequencies near BF. Quantitatively, the model response gets worse (but is still reasonable) for frequencies well below and well above BF. These discrepancies are discussed in terms of the middle-ear function, which proves critical. The model responses to clicks, AM, multicomponent, and Schroder-phase stimuli were also compared against experimental data. Results show that the architecture of the DRNL filter seems suitable to reproduce this wide range of phenomena. Strategies are discussed for developing a chinchilla nonlinear cochlear filterbank from current parameters. [Work supported by the Consejería de Sanidad of the Junta de Comunidades of Castilla, La Mancha.

  19. Cortical Plasticity after Cochlear Implantation

    PubMed Central

    Petersen, B.; Gjedde, A.; Wallentin, M.; Vuust, P.

    2013-01-01

    The most dramatic progress in the restoration of hearing takes place in the first months after cochlear implantation. To map the brain activity underlying this process, we used positron emission tomography at three time points: within 14 days, three months, and six months after switch-on. Fifteen recently implanted adult implant recipients listened to running speech or speech-like noise in four sequential PET sessions at each milestone. CI listeners with postlingual hearing loss showed differential activation of left superior temporal gyrus during speech and speech-like stimuli, unlike CI listeners with prelingual hearing loss. Furthermore, Broca's area was activated as an effect of time, but only in CI listeners with postlingual hearing loss. The study demonstrates that adaptation to the cochlear implant is highly related to the history of hearing loss. Speech processing in patients whose hearing loss occurred after the acquisition of language involves brain areas associated with speech comprehension, which is not the case for patients whose hearing loss occurred before the acquisition of language. Finally, the findings confirm the key role of Broca's area in restoration of speech perception, but only in individuals in whom Broca's area has been active prior to the loss of hearing. PMID:24377050

  20. Cochlear implant in Cogan's syndrome.

    PubMed

    Vishwakarma, Rajesh; Shawn, T Joseph

    2007-10-01

    Post-lingual deafness is a stressful condition which is rendered even more painful by the sudden emotional isolation that the patient suffers. Cogan's syndrome is a rare autoimmune cause for post-lingual deafness characterized by non-syphilitic interstitial keratitis, bilateral audio vestibular deficiencies and systemic vasculitis. World over very few cases of Cogan's syndrome have been reported. Cochlear implant surgery in such a patient is a challenging but highly satisfactory experience due to the multitude of clinical problems the patient faces. This demands a proper work up, meticulous surgery and stringent post-operative follow-up. Here we present a patient with atypical Cogan's syndrome, diabetes mellitus and hypothyroidism. She went into a major depression with suicidal tendency following the complete loss of hearing. We performed cochlear implant surgery in this patient, but not before facing several clinical obstacles, helped by a dedicated team consisting of a rheumatologist, endocrinologist, neurophysician, psychiatrist, anaesthetists and audiologist. The results are extremely satisfying for the patient and all the people involved. This case underlines the prime importance of hearing in maintaining the psychological well being of a human being.

  1. Cochlear implantation: a biomechanical prosthesis for hearing loss

    PubMed Central

    Yawn, Robert; Hunter, Jacob B.; Sweeney, Alex D.

    2015-01-01

    Cochlear implants are a medical prosthesis used to treat sensorineural deafness, and one of the greatest advances in modern medicine. The following article is an overview of cochlear implant technology. The history of cochlear implantation and the development of modern implant technology will be discussed, as well as current surgical techniques. Research regarding expansion of candidacy, hearing preservation cochlear implantation, and implantation for unilateral deafness are described. Lastly, innovative technology is discussed, including the hybrid cochlear implant and the totally implantable cochlear implant. PMID:26097718

  2. Language Processing in Children with Cochlear Implants: A Preliminary Report on Lexical Access for Production and Comprehension

    ERIC Educational Resources Information Center

    Schwartz, Richard G.; Steinman, Susan; Ying, Elizabeth; Mystal, Elana Ying; Houston, Derek M.

    2013-01-01

    In this plenary paper, we present a review of language research in children with cochlear implants along with an outline of a 5-year project designed to examine the lexical access for production and recognition. The project will use auditory priming, picture naming with auditory or visual interfering stimuli (Picture-Word Interference and…

  3. Language Processing in Children with Cochlear Implants: A Preliminary Report on Lexical Access for Production and Comprehension

    ERIC Educational Resources Information Center

    Schwartz, Richard G.; Steinman, Susan; Ying, Elizabeth; Mystal, Elana Ying; Houston, Derek M.

    2013-01-01

    In this plenary paper, we present a review of language research in children with cochlear implants along with an outline of a 5-year project designed to examine the lexical access for production and recognition. The project will use auditory priming, picture naming with auditory or visual interfering stimuli (Picture-Word Interference and…

  4. Cochlear Implants: Who Are They For?

    MedlinePlus

    ... people who never had any hearing at all. Communication training Cochlear implants can't restore "normal" hearing. ... interpret sound. The amount of time needed for communication training or rehabilitation varies from a few months ...

  5. Benefits and Risks of Cochlear Implants

    MedlinePlus

    ... What are the Risks of Cochlear Implants? General Anesthesia Risks General anesthesia is drug-induced sleep. The drugs, such as ... differently. For most people, the risk of general anesthesia is very low. However, for some people with ...

  6. Educational Challenges for Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Chute, Patricia M.; Nevins, Mary Ellen

    2003-01-01

    This article addresses educational challenges for children with severe to profound hearing loss who receive cochlear implants. Despite the implants, these children face acoustic challenges, academic challenges, attention challenges, associative challenges, and adjustment challenges. (Contains references.) (Author/DB)

  7. Melodic contour identification by cochlear implant listeners.

    PubMed

    Galvin, John J; Fu, Qian-Jie; Nogaki, Geraldine

    2007-06-01

    While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users' ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the "root note" of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However, MCI performance was

  8. Melodic Contour Identification by Cochlear Implant Listeners

    PubMed Central

    Galvin, John J.; Fu, Qian-Jie; Nogaki, Geraldine

    2013-01-01

    Objective While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users’ ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. Methods For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the “root note” of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. Results Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However

  9. Massive Tension Pneumocephalus Following Cochlear Implant Surgery.

    PubMed

    Di Lella, Filippo; D'Angelo, Giulia; Iaccarino, Ilaria; Piccinini, Silvia; Negri, Maurizio; Vincenti, Vincenzo

    2016-10-01

    To report clinical presentation, management and outcomes of a rare complication of cochlear implant surgery. A 68-year-old man, affected by profound bilateral deafness because of superficial cerebral hemosiderosis, presented to Authors' Department 8 days after cochlear implant surgery with vomiting, fever, and mental confusion. Brain computed tomographic (CT) scan showed a massive collection of intracranial air from an osteodural defect in the right tegmen mastoideum because of repeated nose blowing in the postoperative period. A multilayer reconstruction of the tegmen with obliteration of the mastoid cavity using abdominal subcutaneous adipose tissue was performed, preserving the cochlear implant in place. Following surgery the patient showed rapid neurological improvement and CT scan performed 2 days later showed complete resolution of the intracranial air collection. He is currently using the cochlear implant with open set performances. Pneumocephalus is a rare complication of cochlear implant surgery. In patients with severe neurological signs following cochlear implantation (CI), pneumocephalus should be suspected. Drilling of mastoid air cells may expose dura mater and positive high pressure events may break meningeal layers and force air into the cranial cavity.

  10. Informed Consent, Deaf Culture, and Cochlear Implants.

    PubMed

    Pass, Lauren; Graber, Abraham D

    2015-01-01

    While cochlear implantation is now considered routine in many parts of the world, the debate over how to ethically implement this technology continues. One's stance on implantation often hinges on one's understanding of deafness. On one end of the spectrum are those who see cochlear implants as a much needed cure for an otherwise intractable disability. On the other end of the spectrum are those who view the Deaf as members of a thriving culture and see the cochlear implant as an attempt to eliminate this culture. Rather than take a stance in this debate, we will argue that the informed consent process for cochlear implantation must include access to Deaf perspectives. Deaf individuals know best what it is like to be a member of the Deaf community; the reasonable person would put significant weight on the testimony of Deaf individuals when considering whether to undergo cochlear implantation. The reasonable person standard determines what information careproviders must present as part of the informed consent process; thus, informed consent for cochlear implantation requires access to the testimony of Deaf individuals.

  11. [Cochlear implantation through the middle fossa approach].

    PubMed

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  12. Cochlear implants in Belgium: Prevalence in paediatric and adult cochlear implantation.

    PubMed

    De Raeve, L

    2016-06-01

    Belgium, and especially the northern region called Flanders, has been a centre of expertise in cochlear implants and early hearing screening for many years. Cochlear implants are reimbursed by the Belgian National Institute for Health and Disability (BNIHD) Insurance in adults and in children since October 1994. More than 20 years later, we would like to measure the prevalence of cochlear implants in adults and in children till now. Based on scientific research data on the prevalence of severe to profound hearing loss in adults and in children and on the number of implantations from the data of the BNIHD, we could measure the percentages of paediatric and adult CI users in comparing to the number of CI candidates. The degree of utilisation of cochlear implantation varies considerably between the paediatric and the adult population. On average, 78% of deaf children are receiving cochlear implants, but in adults only 6.6% of CI candidates are receiving one. There are big differences in Belgium in utilisation of cochlear implants between adults and children. Because of the underutilisation of cochlear implants, especially in adults, we have to work on raising the general awareness of the benefits of cochlear implants, and its improvement in quality of life, based on cost-effectiveness data and on guidelines for good clinical practice. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Reading comprehension of deaf children with cochlear implants.

    PubMed

    Vermeulen, Anneke M; van Bon, Wim; Schreuder, Rob; Knoors, Harry; Snik, Ad

    2007-01-01

    The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (CI) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was expected to surpass that in deaf children without implants, partly via improved visual word recognition. Reading comprehension scores of children with implants were significantly better than those of deaf children without implants, although the performance in implant users was substantially lagging behind that in hearing children. Visual word recognition was better in children with CIs than in children without implants, in secondary education only. No difference in visual word recognition was found between the children with CIs and the hearing children, whereas the deaf children without implants showed a slightly poorer performance. The difference in reading comprehension performance of the deaf children with and without CIs remained present when visual word recognition was controlled for. This indicates that other reading-related skills were also contributing to the improved reading comprehension skills of deaf children with CIs.

  14. Optimizing cochlear implant speech performance.

    PubMed

    Skinner, Margaret W

    2003-09-01

    Results of studies performed in our laboratory suggest that cochlear implant recipients understand speech best if the following speech processor parameters are individually chosen for each person: minimum and maximum stimulation levels on each electrode in the speech processor program (MAP), stimulation rate, and speech coding strategy. If these and related parameters are chosen to make soft sounds (from approximately 100 to 6,000 Hz) audible at as close to 20 dB hearing level as possible and loud sounds not too loud, recipients have the opportunity to hear speech in everyday life situations that are of key importance to children who are learning language and to all recipients in terms of ease of communication.

  15. Parents' narratives on cochlear implantation: reconstructing the experience of having a child with cochlear implant.

    PubMed

    Peñaranda, Augusto; Suárez, Roberto M; Niño, Natalia M; Aparicio, Maria Leonor; García, Juan Manuel; Barón, Clemencia

    2011-08-01

    This paper discusses parents' narratives on cochlear implantation in Bogotá, Colombia using a qualitative approach. The main research objective was to identify how parents perceived the processes of diagnosis of their child's hearing loss, making the decision for cochlear implantation and the post-surgery period. All participants were hearing couples (n = 13) with similar socio-cultural backgrounds whose children had undergone cochlear implant surgery. Results show why cochlear implants are a very highly valued technological device with great symbolic power for parents. The study also deals with how perceptions about oral/sign language and disability, as well as social expectations for their children's lifetime opportunities, determine how the parents themselves have experienced their journey through the process of their children's cochlear implantation.

  16. Comparison of the effects of four different cochlear implant electrodes on intra-cochlear pressure in a model.

    PubMed

    Todt, Ingo; Mittmann, Marlene; Ernst, Arneborg; Mittmann, Philipp

    2017-03-01

    Based on this model experiment, a small tip and low volume electrode show lowest intra-cochlear pressure values. Insertional support by a tool minimizes fast pressure changes. Higher electrodes volumes affect slow and fast pressure changes as well. Insertion causing low intra-cochlear pressure is assumed to be important for atraumatic cochlear implant surgery to preserve residual hearing. Cochlear implant electrodes differ in terms of parameters like tip size, length, volume, and technique of insertion. The aim of this study was to observe the effect of different cochlear implant electrodes on insertional intra-cochlear pressure in a cochlear model. Cochlear implant electrode insertions were performed in an artificial cochlear model and intra-cochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlear model to follow the maximum values, temporal changes, maximum amplitude, and frequency of changes in intra-cochlear pressure. Insertions were performed with four different electrodes (Advanced Bionics 1j, Helix, HFMS, and LW23). This study found statistically significant differences in the occurrence of initial maximum pressure values correlating with the electrode tip size. The different electrodes and the technique of insertion significantly affected the occurrence of maximum value, amplitude, and frequency of intra-cochlear pressure occurrence.

  17. Vowel acquisition by prelingually deaf children with cochlear implants

    NASA Astrophysics Data System (ADS)

    Bouchard, Marie-Eve; Le Normand, Marie-Thérèse; Ménard, Lucie; Goud, Marilyne; Cohen, Henri

    2004-05-01

    Phonetic transcriptions (study 1) and acoustic analysis (study 2) were used to clarify the nature and rhythm of vowel acquisition following the cochlear implantation of prelingually deaf children. In the first study, seven children were divided according to their degree of hearing loss (DHL): DHL I: 90-100 dB of hearing loss, 1 children; DHL II: 100-110 dB, 3 children; and DHL III: over 110 dB, 3 children. Spontaneous speech productions were recorded and videotaped 6 and 12 months postsurgery and vowel inventories were obtained by listing all vowels that occurred at least twice in the child's repertoire at the time of recording. Results showed that degree of hearing loss and age at implantation have a significant impact on vowel acquisition. Indeed, DHL I and II children demonstrated more diversified as well as more typical pattern of acquisition. In the second study, the values of the first and second formants were extracted. The results suggest evolving use of the acoustic space, reflecting the use of auditory feedback to produce the three phonological features exploited to contrast French vowels (height, place of articulation, and rounding). The possible influence of visual feedback before cochlear implant is discussed.

  18. Cochlear implanted children present vocal parameters within normal standards.

    PubMed

    de Souza, Lourdes Bernadete Rocha; Bevilacqua, Maria Cecília; Brasolotto, Alcione Ghedini; Coelho, Ana Cristina

    2012-08-01

    to compare acoustic and perceptual parameters regarding the voice of cochlear implanted children, with normal hearing children. this is a cross-sectional, quantitative and qualitative study. Thirty six cochlear implanted children aged between 3 y and 3 m to 5 y and 9 m and 25 children with normal hearing, aged between 3 y and 11 m and 6 y and 6 m, participated in this study. The recordings and the acoustics analysis of the sustained vowel/a/and spontaneous speech were performed using the PRAAT program. The parameters analyzed for the sustained vowel were the mean of the fundamental frequency, jitter, shimmer and harmonic-to-noise ratio (HNR). For the spontaneous speech, the minimum and maximum frequencies and the number of semitones were extracted. The perceptual analysis of the speech material was analyzed using visual-analogical scales of 100 points, composing the aspects related to the overall severity of the vocal deviation, roughness, breathiness, strain, pitch, loudness and resonance deviation, and instability. This last parameter was only analyzed for the sustained vowel. The results demonstrated that the majority of the vocal parameters analyzed in the samples of the implanted children disclosed values similar to those obtained by the group of children with normal hearing. implanted children who participate in a (re) habilitation and follow-up program, can present vocal characteristics similar to those vocal characteristics of children with normal hearing. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Cochlear implantation in children and adults in Switzerland.

    PubMed

    Brand, Yves; Senn, Pascal; Kompis, Martin; Dillier, Norbert; Allum, John H J

    2014-02-04

    The cochlear implant (CI) is one of the most successful neural prostheses developed to date. It offers artificial hearing to individuals with profound sensorineural hearing loss and with insufficient benefit from conventional hearing aids. The first implants available some 30 years ago provided a limited sensation of sound. The benefit for users of these early systems was mostly a facilitation of lip-reading based communication rather than an understanding of speech. Considerable progress has been made since then. Modern, multichannel implant systems feature complex speech processing strategies, high stimulation rates and multiple sites of stimulation in the cochlea. Equipped with such a state-of-the-art system, the majority of recipients today can communicate orally without visual cues and can even use the telephone. The impact of CIs on deaf individuals and on the deaf community has thus been exceptional. To date, more than 300,000 patients worldwide have received CIs. In Switzerland, the first implantation was performed in 1977 and, as of 2012, over 2,000 systems have been implanted with a current rate of around 150 CIs per year. The primary purpose of this article is to provide a contemporary overview of cochlear implantation, emphasising the situation in Switzerland.

  20. Low Levels of Insurance Reimbursement Impede Access to Cochlear Implants

    DTIC Science & Technology

    2007-11-02

    Low Levels of Insurance Reimbursement Impede Access to Cochlear Implants Cochlear implants enable many severely to profoundly hearing-impaired...a cochlear implant device and required professional services, can cost more than $40,000. But studies by other organizations show that the benefits of...using the technology generally outweigh the treatment costs. About 3,000 people received cochlear implants in the United States in 1999—a number

  1. [Cochlear implantation in far advanced otosclerosis: series of four cases].

    PubMed

    Yılmaz, İsmail; Akdoğan, M Volkan; Özer, Fulya; Yavuz, Haluk; Çadırcı, Cabbar; Özlüoğlu, Levent N N

    2016-01-01

    In this article, we present four patients who underwent cochlear implantation due to far advanced otosclerosis. Preoperative evaluations, intraoperative findings, complications, and postoperative benefits were analyzed. Cochlear implantation is a treatment option providing excellent audiological results for rehabilitation of patients with far advanced otosclerosis. However, facial nerve stimulation after cochlear implantation is observed more frequently in patients with otosclerosis. Also, caution should be paid in patients with otosclerosis in terms of cochlear ossification and inconsistent results.

  2. Pediatric cochlear implantation in auditory neuropathy.

    PubMed

    Madden, Colm; Hilbert, Lisa; Rutter, Michael; Greinwald, John; Choo, Daniel

    2002-03-01

    Auditory neuropathy (AN) is characterized by varying degrees of sensorineural hearing loss, an absent or severely abnormal auditory brainstem response, and normal otoacoustic emissions. The nomenclature for this condition reflects the concept that the site of lesion is proximal to the cochlea (e.g., cochlear nerve). Given this hypothesis, it is reasonable to expect limited benefit from cochlear implantation in patients with AN. However, a growing body of evidence shows the striking benefits of cochlear implantation in AN. To explore this topic, we reviewed our population of children with AN and, specifically, the performance results in those children having undergone cochlear implantation. A retrospective case review of those patients diagnosed with AN from 1993 to 2001. A tertiary pediatric referral center. A diagnosis of AN reported from the Center for Hearing and Deafness Research, Cincinnati, OH, database. Eighteen patients were diagnosed with AN (11 girls, 7 boys), with 3 sets of siblings, including 1 set of identical twins. Four patients with AN underwent implantation in the previous 5 years. Twelve out of the 18 patients had classic risk factors for AN (e.g., prematurity and hyperbilirubinemia). The degree of hearing loss varied in our patients, with a majority showing severe to profound deficits. All children with implants showed improvement in auditory and verbal development, but this improvement was variable. The success of cochlear implantation in these patients suggests that some children with AN have an auditory system lesion that can be compensated for by cochlear implantation. This implies either an inner hair cell or inner hair cell-cochlear nerve junctional pathology that can be overcome by direct electrical stimulation.

  3. Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation

    PubMed Central

    Bento, Ricardo Ferreira; Monteiro, Tatiana Alves; Bittencourt, Aline Gomes; Goffi-Gomez, Maria Valeria Schmidt; de Brito, Rubens

    2013-01-01

    Summary Introduction: Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. Objectives: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. Resumed Report: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. Conclusion: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients. PMID:25992034

  4. Detection of Cochlear Amplification and Its Activation

    PubMed Central

    Dong, Wei; Olson, Elizabeth S.

    2013-01-01

    The operation of the mammalian cochlea relies on a mechanical traveling wave that is actively boosted by electromechanical forces in sensory outer hair cells (OHCs). This active cochlear amplifier produces the impressive sensitivity and frequency resolution of mammalian hearing. The cochlear amplifier has inspired scientists since its discovery in the 1970s, and is still not well understood. To explore cochlear electromechanics at the sensory cell/tissue interface, sound-evoked intracochlear pressure and extracellular voltage were measured using a recently developed dual-sensor with a microelectrode attached to a micro-pressure sensor. The resulting coincident in vivo observations of OHC electrical activity, pressure at the basilar membrane and basilar membrane displacement gave direct evidence for power amplification in the cochlea. Moreover, the results showed a phase shift of voltage relative to mechanical responses at frequencies slightly below the peak, near the onset of amplification. Based on the voltage-force relationship of isolated OHCs, the shift would give rise to effective OHC pumping forces within the traveling wave peak. Thus, the shift activates the cochlear amplifier, serving to localize and thus sharpen the frequency region of amplification. These results are the most concrete evidence for cochlear power amplification to date and support OHC somatic forces as its source. PMID:23972858

  5. Considering optogenetic stimulation for cochlear implants.

    PubMed

    Jeschke, Marcus; Moser, Tobias

    2015-04-01

    Electrical cochlear implants are by far the most successful neuroprostheses and have been implanted in over 300,000 people worldwide. Cochlear implants enable open speech comprehension in most patients but are limited in providing music appreciation and speech understanding in noisy environments. This is generally considered to be due to low frequency resolution as a consequence of wide current spread from stimulation contacts. Accordingly, the number of independently usable stimulation channels is limited to less than a dozen. As light can be conveniently focused, optical stimulation might provide an alternative approach to cochlear implants with increased number of independent stimulation channels. Here, we focus on summarizing recent work on optogenetic stimulation as one way to develop optical cochlear implants. We conclude that proof of principle has been presented for optogenetic stimulation of the cochlea and central auditory neurons in rodents as well as for the technical realization of flexible μLED-based multichannel cochlear implants. Still, much remains to be done in order to advance the technique for auditory research and even more for eventual clinical translation. This article is part of a Special Issue entitled .

  6. Target structures for cochlear infrared neural stimulation

    PubMed Central

    Young, Hunter K.; Tan, Xiaodong; Xia, Nan; Richter, Claus-Peter

    2015-01-01

    Abstract. Infrared neural stimulation (INS) is a method to depolarize neurons with infrared light. While consensus exists that heating of the target structure is essential, subsequent steps that result in the generation of an action potential are controversially discussed in the literature. The question of whether cochlear INS is an acoustic event has not been clarified. Results have been published that could be explained solely by an acoustic event. However, data exist that do not support an acoustical stimulus as the dominant factor in cochlear INS. We review the different findings that have been suggested for the mechanism of INS. Furthermore, we present the data that clarify the role of an acoustical event in cochlear INS. Masking experiments have been performed in hearing, hearing impaired, and severely hearing impaired animals. In normal hearing animals, the laser response could be masked by the acoustic stimulus. Once thresholds to acoustic stimuli were elevated, the ability to acoustically mask the INS response gradually disappeared. Thresholds for acoustic stimuli were significantly elevated in animals with compromised cochlear function, while the thresholds for optical stimulation remained largely unchanged. The results suggest that the direct interaction between the radiation and the target structure dominates cochlear INS. PMID:26158006

  7. Target structures for cochlear infrared neural stimulation.

    PubMed

    Young, Hunter K; Tan, Xiaodong; Xia, Nan; Richter, Claus-Peter

    2015-04-01

    Infrared neural stimulation (INS) is a method to depolarize neurons with infrared light. While consensus exists that heating of the target structure is essential, subsequent steps that result in the generation of an action potential are controversially discussed in the literature. The question of whether cochlear INS is an acoustic event has not been clarified. Results have been published that could be explained solely by an acoustic event. However, data exist that do not support an acoustical stimulus as the dominant factor in cochlear INS. We review the different findings that have been suggested for the mechanism of INS. Furthermore, we present the data that clarify the role of an acoustical event in cochlear INS. Masking experiments have been performed in hearing, hearing impaired, and severely hearing impaired animals. In normal hearing animals, the laser response could be masked by the acoustic stimulus. Once thresholds to acoustic stimuli were elevated, the ability to acoustically mask the INS response gradually disappeared. Thresholds for acoustic stimuli were significantly elevated in animals with compromised cochlear function, while the thresholds for optical stimulation remained largely unchanged. The results suggest that the direct interaction between the radiation and the target structure dominates cochlear INS.

  8. Detection of cochlear amplification and its activation.

    PubMed

    Dong, Wei; Olson, Elizabeth S

    2013-08-20

    The operation of the mammalian cochlea relies on a mechanical traveling wave that is actively boosted by electromechanical forces in sensory outer hair cells (OHCs). This active cochlear amplifier produces the impressive sensitivity and frequency resolution of mammalian hearing. The cochlear amplifier has inspired scientists since its discovery in the 1970s, and is still not well understood. To explore cochlear electromechanics at the sensory cell/tissue interface, sound-evoked intracochlear pressure and extracellular voltage were measured using a recently developed dual-sensor with a microelectrode attached to a micro-pressure sensor. The resulting coincident in vivo observations of OHC electrical activity, pressure at the basilar membrane and basilar membrane displacement gave direct evidence for power amplification in the cochlea. Moreover, the results showed a phase shift of voltage relative to mechanical responses at frequencies slightly below the peak, near the onset of amplification. Based on the voltage-force relationship of isolated OHCs, the shift would give rise to effective OHC pumping forces within the traveling wave peak. Thus, the shift activates the cochlear amplifier, serving to localize and thus sharpen the frequency region of amplification. These results are the most concrete evidence for cochlear power amplification to date and support OHC somatic forces as its source.

  9. The cochlear implant as a tinnitus treatment.

    PubMed

    Vallés-Varela, Héctor; Royo-López, Juan; Carmen-Sampériz, Luis; Sebastián-Cortés, José M; Alfonso-Collado, Ignacio

    2013-01-01

    Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  10. Intraoperative Real-time Cochlear Response Telemetry Predicts Hearing Preservation in Cochlear Implantation.

    PubMed

    Campbell, Luke; Kaicer, Arielle; Sly, David; Iseli, Claire; Wei, Benjamin; Briggs, Robert; O'Leary, Stephen

    2016-04-01

    To monitor cochlear function during cochlear implantation and determine correlations with postoperative acoustic hearing. Cochlear response telemetry measures cochlear function directly from cochlear implant electrodes. We have adapted this system to provide real-time cochlear response telemetry (RT-CRT) monitoring of a patient's acoustic hearing as the cochlear implant electrode array is inserted. Eighteen subjects (1 child and 17 adults) with sloping high frequency hearing loss were implanted with Cochlear Ltd slim straight arrays (CI422/CI522). Tone bursts (500 Hz, 100-110 dB) were presented at 14 Hz continuously during the array insertion. RT-CRT amplitudes were correlated with surgical manoeuvres recorded on the video from the operating microscope and with postoperative pure tone audiograms. Despite an excellent overall rate of complete or partial hearing preservation (79%), RT-CRT identified that in 47% of these implantations there was transient or permanent reduction in the amplitude of the cochlear microphonic (CM). Patients with a preserved CM at the end of insertion had on average 15 dB better low-frequency hearing preservation. The CM amplitude was most vulnerable during the last few millimeters of insertion or when inadvertent movement of the array occurred after full insertion. Physical contact/elevation of the basilar membrane is hypothesized as a likely mechanism of hearing loss rather than overt physical trauma. RT-CRT can be used to predict early postoperative hearing loss and to potentially refine surgical technique. In the future, feedback of RT-CRT may prove to be a valuable tool for maximizing preservation of residual hearing or providing feedback on electrode contact with the basilar membrane.

  11. Cochlear implantation in older adults.

    PubMed

    Lin, Frank R; Chien, Wade W; Li, Lingsheng; Clarrett, Danisa M; Niparko, John K; Francis, Howard W

    2012-09-01

    Cochlear implants allow individuals with severe to profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation (CI) is approximately 150,000 and will continue to increase with the aging of the population. Should CI be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12-year experience with CI in adults aged ≥60 years (n = 445) at Johns Hopkins Medical Institutions to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that CI in adults aged ≥60 years consistently improved speech understanding scores, with a mean increase of 60.0% (SD 24.1) on HINT (Hearing in Noise Test) sentences in quiet. The magnitude of the gain in speech scores was negatively associated with age at implantation, such that for every increasing year of age at CI the gain in speech scores was 1.3 percentage points less (95% confidence interval [95% CI], 0.6-1.9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40% and 60%) had significantly greater post-CI speech scores by a mean of 10.0 percentage points (95% CI, 0.4-19.6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after CI, with possible implications for current United States Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take

  12. [Surgery of the cochlear implant: complications].

    PubMed

    Cavallé, L; Morera, C; Capella, B; Pérez, H

    1996-01-01

    From 1991 to 1994 13 patients underwent cochlear implant in our Department. The surgical results and complications in this group of patients are reviewed. In all cases the cochlear implant was successful and no major complications were recorded. The most common problems was transient dizziness or imbalance. Other complications were minor facial nerve stimulation during the programming of the device, dehiscence of the suture in the tragal region, problems in the insertion of the electrodes in the scala tympani and a case that needed reimplantation due to technical problems with the device. We consider that a proper selection of cases and a precise surgical technique are essential in order to achieve the adaptation of the cochlear implant and avoid pitfalls.

  13. Voice and pronunciation of cochlear implant speakers.

    PubMed

    Horga, Damir; Liker, Marko

    2006-01-01

    Patients with cochlear implants have the ability to exercise auditory control over their own speech production and over the speech of others, which is important for the development of speech control. In the present investigation three groups of 10 subjects were compared. The groups comprised: (1) cochlear implant users, (2) profoundly deaf using traditional hearing aids, and (3) hearing controls. The subjects in three groups were matched in age. While repeating after a model the subjects were recorded and the following linguistic voice variables were analysed: (1) vowel formant space, (2) voice vs. voiceless difference, (3) closure duration and VOT, (4) word accent production, (5) sentence stress production, (6) voice quality, (7) pronunciation quality. Acoustic analysis and perceptual assessment by phoneticians showed that in great majority of variables, subjects with cochlear implants performed better than the profoundly deaf subjects with traditional hearing-aids.

  14. Medial Cochlear Efferent Function: A Theoretical Analysis

    NASA Astrophysics Data System (ADS)

    Mountain, David C.

    2011-11-01

    Since the discovery of the cochlear efferent system, many hypotheses have been put forth for its function. These hypotheses for its function range from protecting the cochlea from over stimulation to improving the detection of sounds in noise. It is known that the medial efferent system innervates the outer hair cells and that stimulation of this system reduces basilar membrane and auditory nerve sensitivity which suggests that this system acts to decrease the gain of the cochlear amplifier. Here I present modeling results as well as analysis of published experimental data that suggest that the function of the medial efferent reflex is to decrease the cochlear amplifier gain by just the right amount so that the nonlinearity in the basilar membrane response lines up perfectly with the inner hair cell nonlinear transduction process to produce a hair cell receptor potential that is proportional to the logarithm of the sound pressure level.

  15. Electrophonic hearing and cochlear implants.

    PubMed

    Risberg, A; Agelfors, E; Lindström, B; Bredberg, G

    1990-01-01

    It has been difficult to explain the good speech understanding obtained by some cochlear implant patients fitted with a single-channel electrode and analog transmissions of the speech signal (Vienna/3M implant). It has also been difficult to explain the variation in results reported by different groups using the same implant. One hypothesis asserts that the above differences can be explained by the observation that electric stimulation with an implanted electrode might result in two different auditory sensations, the first resulting from the stimulation of the remaining hair cells (electrophonic component) and the second from the electric stimulation of the auditory nerve (electro-neural component). The two sensations are very different. As a result of different definitions of total deafness (functional or threshold definition), patients with remaining hair cells are operated on by some groups, but not by other groups. Some published results from different studies are discussed with reference to the above hypothesis and the possible consequences for the selection of the patients, the use of extra- or intracochlear electrodes, and the selection of the speech coding strategy are discussed.

  16. Cochlear molecules and hereditary deafness.

    PubMed

    Yan, Denise; Liu, Xue-Zhong

    2008-05-01

    Remarkable progress has been made in the past decade in identifying genes involved with deafness in man and mouse. The identification of these genes and functional analysis of the proteins they encode are paving the way towards a better understanding of the physiology and pathophysiology of the auditory system. Given the complexity of auditory transduction and diversity of cochlear structures, it is not surprising that an estimate of at least 1 percent of human protein-coding genes are involved in perception of sound. Over 400 distinct syndromes of which hearing loss is a component have been reported (www.ncbi.nlm.nih.gov/omim). Approximately 113 loci for monogenic disorders for which hearing loss is the only manifestation and therefore is nonsyndromic, have been mapped to the human genome (http:webhost.ua.ac.be/hhh/). As of August 2007, there are approximately 46 genes identified from these loci. Here, we review some of the major advances in our knowledge of auditory function within an evolving understanding of the structure and regulation of the machinery of hearing.

  17. Understanding music with cochlear implants.

    PubMed

    Bruns, Lisa; Mürbe, Dirk; Hahne, Anja

    2016-08-25

    Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building.

  18. Understanding music with cochlear implants

    PubMed Central

    Bruns, Lisa; Mürbe, Dirk; Hahne, Anja

    2016-01-01

    Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building. PMID:27558546

  19. Localization model for cochlear implants

    NASA Astrophysics Data System (ADS)

    Miller, Douglas A.; Matin, Mohammad A.

    2011-09-01

    Normal hearing persons are able to localize the direction of sounds better using both ears than when listening with only one ear. Localization ability is dependent on auditory system perception of interaural differences in time, intensity, and phase. Interaural timing differences (ITDs) provide information for locating direction of low and mid frequency sounds, while interaural level differences (ILDs), which occur because of the horizontal plane shadowing effect of the head, provide information for locating direction of higher frequency sounds. The head related transfer function (HRTF) contains characteristic information important for acoustic localization. Models based on HRTFs take into account head shadow, torso, and pinna effects, and their impact on interaural frequency, level, and timing differences. Cochlear implants (CIs) have proven a successful treatment for persons with bilateral severe to profound hearing loss. A problem is that only some ITD and ILD cues are maintained with CI sound processing, and the microphone position alters the acoustic cues. The relative impact of differences in physical cues received by the auditory system with bilateral CIs versus differences in the ability of the damaged auditory nervous system to process bilateral inputs is not yet clear. The model presented in this paper was constructed as a step toward answering this question, and is intended to serve as a tool for future development of more optimal signal processing algorithms that may provide better localization ability for persons with bilateral CIs.

  20. Musical experience sharpens human cochlear tuning.

    PubMed

    Bidelman, Gavin M; Nelms, Caitlin; Bhagat, Shaum P

    2016-05-01

    The mammalian cochlea functions as a filter bank that performs a spectral, Fourier-like decomposition on the acoustic signal. While tuning can be compromised (e.g., broadened with hearing impairment), whether or not human cochlear frequency resolution can be sharpened through experiential factors (e.g., training or learning) has not yet been established. Previous studies have demonstrated sharper psychophysical tuning curves in trained musicians compared to nonmusicians, implying superior peripheral tuning. However, these findings are based on perceptual masking paradigms, and reflect engagement of the entire auditory system rather than cochlear tuning, per se. Here, by directly mapping physiological tuning curves from stimulus frequency otoacoustic emissions (SFOAEs)-cochlear emitted sounds-we show that estimates of human cochlear tuning in a high-frequency cochlear region (4 kHz) is further sharpened (by a factor of 1.5×) in musicians and improves with the number of years of their auditory training. These findings were corroborated by measurements of psychophysical tuning curves (PTCs) derived via simultaneous masking, which similarly showed sharper tuning in musicians. Comparisons between SFOAE and PTCs revealed closer correspondence between physiological and behavioral curves in musicians, indicating that tuning is also more consistent between different levels of auditory processing in trained ears. Our findings demonstrate an experience-dependent enhancement in the resolving power of the cochlear sensory epithelium and the spectral resolution of human hearing and provide a peripheral account for the auditory perceptual benefits observed in musicians. Both local and feedback (e.g., medial olivocochlear efferent) mechanisms are discussed as potential mechanisms for experience-dependent tuning. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Music Therapy for Preschool Cochlear Implant Recipients

    PubMed Central

    Gfeller, Kate; Driscoll, Virginia; Kenworthy, Maura; Van Voorst, Tanya

    2010-01-01

    This paper provides research and clinical information relevant to music therapy for preschool children who use cochlear implants (CI). It consolidates information from various disciplinary sources regarding (a) cochlear implantation of young prelingually-deaf children (~age 2-5), (b) patterns of auditory and speech-language development, and (c) research regarding music perception of children with CIs. This information serves as a foundation for the final portion of the article, which describes typical music therapy goals and examples of interventions suitable for preschool children. PMID:23904691

  2. Cochlear transduction: an integrative model and review

    PubMed Central

    Brownell, William E.

    2009-01-01

    A model for cochlear transduction is presented that is based on considerations of the cell biology of its receptor cells, particularly the mechanisms of transmitter release at recepto-neural synapses. Two new interrelated hypotheses on the functional organization of the organ of Corti result from these considerations, one dealing with the possibility of electrotonic interaction between inner and outer hair cells and the other with a possible contributing source to acoustic emissions of cochlear origin that results from vesicular membrane turnover. PMID:6282796

  3. The impact of cochlear implants on young deaf children: new methods to assess cognitive and behavioral development.

    PubMed

    Quittner, Alexandra L; Leibach, Pamela; Marciel, Kristen

    2004-05-01

    Much evidence suggests that, early in life, auditory input and communication are essential for the normal development of language, cognition, and behavior. Thus, deaf children, who experience significant disruptions in auditory input, are likely to show delays not only in the production of oral language but in other important aspects of development such as visual attention and behavioral control. Cochlear implants have shown tremendous promise in restoring auditory information to deaf children and concomitant improvements in speech recognition and production. However, little is known about how cochlear implants affect psychological variables. In this multisite trial, we assess the effects of cochlear implants on a range of developmental outcomes, including visual attention, problem-solving skills, symbolic play, and social adjustment. Measuring these constructs in young children, primarily younger than 2 years, has presented a number of unique challenges. In this article, we describe the methods used to assess these variables in young children and present preliminary findings comparing joint attention and symbolic play skills in a small sample of age-matched deaf and hearing children. As expected, deaf children performed more poorly than hearing children on measures of attention and symbolic play. As auditory input is restored via a cochlear implant, we predict that significant improvements in these variables will be observed.

  4. The internal dimensions of the cochlear scalae with special reference to cochlear electrode insertion trauma.

    PubMed

    Biedron, Slavomir; Prescher, Andreas; Ilgner, Justus; Westhofen, Martin

    2010-07-01

    To investigate the intracochlear micromorphology with regard to frequent patterns of cochlear electrode insertion trauma. Cochlear implantation is a widely accepted treatment for deafness and high-grade sensorineural hearing loss. Although the device and the implantation methods are continuously optimized, damage of intracochlear structures due to electrode insertion is a frequent finding in temporal bone studies. Reduction of insertional trauma is important for the preservation of residual hearing and on the background of increasing numbers of cochlear implant recipients. This study was performed with histologic specimens from the "Wittmaack temporal bone collection" (Hamburg, Germany) to examine the diameters of intracochlear spaces and to correlate the micromorphology of cochlear ducts to frequent patterns of intracochlear insertion trauma. The diameter of the scala tympani decreases by approximately 300 microm during the ascending part of the basal turn. In this region, the intersegmental decrease exceeds the assumed linear diameter decrease significantly (p < or = 0.001). The regression of the cross-sectional diameter is accompanied by a shift of the spiral osseous lamina toward the scala tympani and by narrowing of the bony capsule of the cochlea. Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantation. Little attention was paid to the distinct narrowing of the scala tympani in the region of the ascending part of the cochlear duct, although from the literature, it is known that electrode insertion trauma frequently occurs here. Individual variations of the cochlear micromorphology may additionally contribute to the failure of preformed electrode arrays, but the challenge of guiding the electrode array around the first bend of the cochlear turn, that is, the pars ascendens, is obviously impaired by the interindividually constant narrowing in this area. Therefore, this finding may have implications on the

  5. Development of Pre-Word-Learning Skills in Infants with Cochlear Implants

    PubMed Central

    Houston, Derek M.; Ying, Elizabeth A.; Pisoni, David B.; Kirk, Karen Iler

    2011-01-01

    Families of infants who are congenitally deaf now have the option of cochlear implantation at a very young age. In order to assess the effectiveness of early cochlear implantation, however, new behavioral procedures are needed to measure speech perception and language skills during infancy. One important component of language development is word learning—a complex skill that involves learning arbitrary relations between words and their referents. A precursor to word learning is the ability to perceive and encode intersensory relations between co-occurring auditory and visual events. Recent studies in infants with normal hearing have shown that intersensory redundancies, such as temporal synchrony, can facilitate the ability to learn arbitrary pairings between speech sounds and objects (Gogate & Bahrick, 1998). To investigate the early stages of learning arbitrary pairings of sounds and objects after cochlear implantation, we used the Preferential Looking Paradigm (PLP) to assess infants’ ability to associate speech sounds to objects that moved in temporal synchrony with the onset and offsets of the signals. Children with normal hearing ranging in age from 6, 9, 18, and 30 months served as controls and demonstrated the ability to learn arbitrary pairings between temporally synchronous speech sounds and dynamic visual events. Infants who received their cochlear implants (CIs) at earlier ages (7–15 months of age) performed similarly to the infants with normal hearing after about 2–6 months of CI experience. In contrast, infants who received their implants at later ages (16–25 months of age) did not demonstrate learning of the associations within the context of this experiment. Possible implications of these findings are discussed. PMID:21643556

  6. Physical and mathematical cochlear models

    NASA Astrophysics Data System (ADS)

    Lim, Kian-Meng

    2000-10-01

    The cochlea is an intricate organ in the inner ear responsible for our hearing. Besides acting as a transducer to convert mechanical sound vibrations to electrical neural signals, the cochlea also amplifies and separates the sound signal into its spectral components for further processing in the brain. It operates over a broad-band of frequency and a huge dynamic range of input while maintaining a low power consumption. The present research takes the approach of building cochlear models to study and understand the underlying mechanics involved in the functioning of the cochlea. Both physical and mathematical models of the cochlea are constructed. The physical model is a first attempt to build a life- sized replica of the human cochlea using advanced micro- machining techniques. The model takes a modular design, with a removable silicon-wafer based partition membrane encapsulated in a plastic fluid chamber. Preliminary measurements in the model are obtained and they compare roughly with simulation results. Parametric studies on the design parameters of the model leads to an improved design of the model. The studies also revealed that the width and orthotropy of the basilar membrane in the cochlea have significant effects on the sharply tuned responses observed in the biological cochlea. The mathematical model is a physiologically based model that includes three-dimensional viscous fluid flow and a tapered partition with variable properties along its length. A hybrid asymptotic and numerical method provides a uniformly valid and efficient solution to the short and long wave regions in the model. Both linear and non- linear activity are included in the model to simulate the active cochlea. The mathematical model has successfully reproduced many features of the response in the biological cochlea, as observed in experiment measurements performed on animals. These features include sharply tuned frequency responses, significant amplification with inclusion of activity

  7. Progress in Cochlear Physiology after Békésy

    PubMed Central

    Guinan, John J.; Salt, Alec; Cheatham, Mary Ann

    2012-01-01

    In the fifty years since Békésy was awarded the Nobel Prize, cochlear physiology has blossomed. Many topics that are now current are things Békésy could not have imagined. In this review we start by describing progress in understanding the origin of cochlear gross potentials, particularly the cochlear microphonic, an area in which Békésy had extensive experience. We then review progress in areas of cochlear physiology that were mostly unknown to Békésy, including: (1) stereocilia mechano-electrical transduction, force production, and response amplification, (2) outer hair cell (OHC) somatic motility and its molecular basis in prestin, (3) cochlear amplification and related micromechanics, including the evidence that prestin is the main motor for cochlear amplification, (4) the influence of the tectorial membrane, (5) cochlear micromechanics and the mechanical drives to inner hair cell stereocilia, (6) otoacoustic emissions, and (7) olivocochlear efferents and their influence on cochlear physiology. We then return to a subject that Békésy knew well: cochlear fluids and standing currents, as well as our present understanding of energy dependence on the lateral wall of the cochlea. Finally, we touch on cochlear pathologies including noise damage and aging, with an emphasis on where the field might go in the future. PMID:22633944

  8. Digital speech processing for cochlear implants.

    PubMed

    Dillier, N; Bögli, H; Spillmann, T

    1992-01-01

    A rather general basic working hypothesis for cochlear implant research might be formulated as follows. Signal processing for cochlear implants should carefully select a subset of the total information contained in the sound signal and transform these elements into those physical stimulation parameters which can generate distinctive perceptions for the listener. Several new digital processing strategies have thus been implemented on a laboratory cochlear implant speech processor for the Nucleus 22-electrode system. One of the approaches (PES, pitch excited sampler) is based on the maximum peak channel vocoder concept whereby the spectral energy of a number of frequency bands is transformed into appropriate electrical stimulation parameters for up to 22 electrodes using a voice pitch synchronous pulse rate at any electrode. Another approach (CIS, continuous interleaved sampler) uses a maximally high pitch-independent stimulation pulse rate on a selected number of electrodes. As only one electrode can be stimulated at any instance of time, the rate of stimulation is limited by the required stimulus pulse widths (as determined individually for each subject) and some additional constraints and parameters which have to be optimized and fine tuned by psychophysical measurements. Evaluation experiments with 5 cochlear implant users resulted in significantly improved performance in consonant identification tests with the new processing strategies as compared with the subjects own wearable speech processors whereas improvements in vowel identification tasks were rarely observed. The pitch-synchronous coding (PES) resulted in worse performance compared to the coding without explicit pitch extraction (CIS).(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Listening Effort with Cochlear Implant Simulations

    ERIC Educational Resources Information Center

    Pals, Carina; Sarampalis, Anastasios; Baskent, Deniz

    2013-01-01

    Purpose: Fitting a cochlear implant (CI) for optimal speech perception does not necessarily optimize listening effort. This study aimed to show that listening effort may change between CI processing conditions for which speech intelligibility remains constant. Method: Nineteen normal-hearing participants listened to CI simulations with varying…

  10. Impairment of Caloric Function after Cochlear Implantation

    ERIC Educational Resources Information Center

    Kuang, Heide; Haversat, Heather H.; Michaelides, Elias M.

    2015-01-01

    Purpose: This article seeks to review current literature on caloric function following cochlear implantation while analyzing any correlations of caloric function changes with vestibular symptoms. Method: This article is a systematic review of evidence-based literature. English language articles published between 1980 and 2014 that presented some…

  11. Gender Categorization in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Massida, Zoe; Marx, Mathieu; Belin, Pascal; James, Christopher; Fraysse, Bernard; Barone, Pascal; Deguine, Olivier

    2013-01-01

    Purpose: In this study, the authors examined the ability of subjects with cochlear implants (CIs) to discriminate voice gender and how this ability evolved as a function of CI experience. Method: The authors presented a continuum of voice samples created by voice morphing, with 9 intermediate acoustic parameter steps between a typical male and a…

  12. Intra-cochlear trafficking of aminoglycosides

    PubMed Central

    Karasawa, Takatoshi

    2008-01-01

    Cochlear sensory hair cells are pharmacologically sensitive to aminoglycoside antibiotics that are used for treating life-threatening bacterial sepsis. Cochlear tissues are compartmentalized behind an impermeable paracellular barrier called the blood-labyrinth barrier (BLB). Most macromolecules cannot cross the blood-labyrinth barrier; however, aminoglycosides can cross this barrier into the cochlear fluids and enter hair cells, inducing hair cell death and consequent permanent hearing loss or deafness. The trafficking routes and cellular mechanisms required for aminoglycoside trafficking across the blood-labyrinth barrier remain unknown. Aminoglycosides enter cochlear hair cells across their apical membranes that are bathed in endolymph, a hitherto unexpected trafficking route. The stria vascularis, a component of the blood- labyrinth barrier, preferentially loads with aminoglycosides. Our recent work demonstrates that the stria vascularis exhibits high expression of the cation-selective ion channel TRPV4, and that this channel is permeable to aminoglycosides. However, aminoglycosides must employ more than one cellular mechanism to cross the blood-labyrinth barrier into endolymph against the electrical gradient. PMID:19704872

  13. Intra-cochlear trafficking of aminoglycosides.

    PubMed

    Steyger, Peter S; Karasawa, Takatoshi

    2008-01-01

    Cochlear sensory hair cells are pharmacologically sensitive to aminoglycoside antibiotics that are used for treating life-threatening bacterial sepsis. Cochlear tissues are compartmentalized behind an impermeable paracellular barrier called the blood-labyrinth barrier (BLB). Most macromolecules cannot cross the blood-labyrinth barrier; however, aminoglycosides can cross this barrier into the cochlear fluids and enter hair cells, inducing hair cell death and consequent permanent hearing loss or deafness. The trafficking routes and cellular mechanisms required for aminoglycoside trafficking across the blood-labyrinth barrier remain unknown.Aminoglycosides enter cochlear hair cells across their apical membranes that are bathed in endolymph, a hitherto unexpected trafficking route. The stria vascularis, a component of the blood- labyrinth barrier, preferentially loads with aminoglycosides. Our recent work demonstrates that the stria vascularis exhibits high expression of the cation-selective ion channel TRPV4, and that this channel is permeable to aminoglycosides. However, aminoglycosides must employ more than one cellular mechanism to cross the blood-labyrinth barrier into endolymph against the electrical gradient.

  14. [Cost Analysis of Cochlear Implantation in Adults].

    PubMed

    Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

    2016-04-01

    The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Pharmacokinetics of Drug Entry into Cochlear Fluids

    ERIC Educational Resources Information Center

    Salt, Alec N.

    2005-01-01

    The inner ear is exposed to aminoglycosides or other drugs either intentionally or as a side effect of clinical treatments directed at other regions of the body. An understanding of the effects of drugs on the inner ear requires knowledge of the pharmacokinetics of the drug once it reaches the cochlear fluids, specifically how much of it reaches…

  16. Deaf Education: The Impact of Cochlear Implantation?

    ERIC Educational Resources Information Center

    Archbold, Sue; Mayer, Connie

    2012-01-01

    This paper reviews the impact that cochlear implantation has had on the practice of deaf education in terms of educational placement, communication choices, and educational attainments. Although there is variation in outcome, more children with implants are going to mainstream schools, and using spoken language as their primary means of…

  17. Word Learning in Children following Cochlear Implantation

    ERIC Educational Resources Information Center

    Houston, Derek M.; Carter, Allyson K.; Pisoni, David B.; Kirk, Karen Iler; Ying, Elizabeth A.

    2005-01-01

    An experimental procedure was developed to investigate word-learning skills of children who use cochlear implants (CIs). Using interactive play scenarios, 2- to 5-year olds were presented with sets of objects (Beanie Baby stuffed animals) and words for their names that corresponded to salient perceptual attributes (e.g., "horns" for a goat). Their…

  18. Gender Categorization in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Massida, Zoe; Marx, Mathieu; Belin, Pascal; James, Christopher; Fraysse, Bernard; Barone, Pascal; Deguine, Olivier

    2013-01-01

    Purpose: In this study, the authors examined the ability of subjects with cochlear implants (CIs) to discriminate voice gender and how this ability evolved as a function of CI experience. Method: The authors presented a continuum of voice samples created by voice morphing, with 9 intermediate acoustic parameter steps between a typical male and a…

  19. Amplification, Technology, and Cochlear Implants for Infants.

    ERIC Educational Resources Information Center

    Adam, Arlie J.

    1993-01-01

    Early amplification is crucial to efficient habilitation and development of oral communication skills in hearing-impaired infants. Initial evaluation and fitting of amplification is a joint effort by the audiologist, therapist, and parents, whether the child uses traditional hearing aids or cochlear implants, and should be supplemented by a…

  20. Educational Management of Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Moog, Jean S.; Geers, Ann E.

    1991-01-01

    This article outlines procedures for maximizing the benefits that profoundly deaf children can achieve through cochlear implants. The history of such implants and practical aspects in their use are described. Factors in development of speech perception skills, auditory training objectives and activities, and spoken language acquisition are…

  1. Environmental Sound Training in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Shafiro, Valeriy; Sheft, Stanley; Kuvadia, Sejal; Gygi, Brian

    2015-01-01

    Purpose: The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method: Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart,…

  2. Cochlear implants: our experience and literature review

    PubMed Central

    Martins, Mariane Barreto Brandão; de Lima, Francis Vinicius Fontes; Santos, Ronaldo Carvalho; Santos, Arlete Cristina Granizo; Barreto, Valéria Maria Prado; de Jesus, Eduardo Passos Fiel

    2012-01-01

    Summary Introduction: Cochlear Implants are important for individuals with severe to profound bilateral sensorineural hearing loss. Objective: Evaluate the experience of cochlear implant center of Otorhinolaryngology through the analysis of records of 9 patients who underwent cochlear implant surgery. Methods: This is a retrospective study performed with the patients records. Number 0191.0.107.000-11 ethics committee approval. We evaluated gender, etiology, age at surgery, duration of deafness, classification of deafness, unilateral or bilateral surgery, intraoperative and postoperative neural response and impedance of the electrodes in intraoperative and preoperative tests and found those that counter-indicated surgery. Results: There were 6 pediatric and 3 adult patients. Four male and 5 female. Etiologies: maternal rubella, cytomegalovirus, ototoxicity, meningitis, and sudden deafness. The age at surgery and duration of deafness ranged from 2–46 years and 2–18 years, respectively. Seven patients were pre-lingual. All had profound bilateral PA. There were 7 bilateral implants. Intraoperative complications: hemorrhage. Complications after surgery: vertigo and internal device failure. In 7 patients the electrodes were implanted through. Telemetry showed satisfactory neural response and impedance. CT and MRI was performed in all patients. We found enlargement of the vestibular aqueduct in a patient and incudomalleolar malformation. Conclusion: The cochlear implant as a form of auditory rehabilitation is well established and spreading to different centers specialized in otoaudiology. Thus, the need for structured services and trained professionals in this type of procedure is clear. PMID:25991976

  3. Auditory Learning in Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Mishra, Srikanta K.; Boddupally, Shiva P.; Rayapati, Deeksha

    2015-01-01

    Purpose: The purpose of this study was to examine and characterize the training-induced changes in speech-in-noise perception in children with congenital deafness who have cochlear implants (CIs). Method: Twenty-seven children with congenital deafness who have CIs were studied. Eleven children with CIs were trained on a speech-in-noise task,…

  4. Environmental Sound Training in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Shafiro, Valeriy; Sheft, Stanley; Kuvadia, Sejal; Gygi, Brian

    2015-01-01

    Purpose: The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method: Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart,…

  5. Impairment of Caloric Function after Cochlear Implantation

    ERIC Educational Resources Information Center

    Kuang, Heide; Haversat, Heather H.; Michaelides, Elias M.

    2015-01-01

    Purpose: This article seeks to review current literature on caloric function following cochlear implantation while analyzing any correlations of caloric function changes with vestibular symptoms. Method: This article is a systematic review of evidence-based literature. English language articles published between 1980 and 2014 that presented some…

  6. Our Decision on a Cochlear Implant.

    ERIC Educational Resources Information Center

    Peters, Edward

    2000-01-01

    In this essay, the hearing parents of a child with deafness explain why they have chosen not to seek a cochlear implant for their daughter. The essay concludes that deafness inspires and sustains a language and a culture that offer fulfilling participation in every important aspect of life and society. (CR)

  7. Peer Relationships of Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Bat-Chava, Yael; Deignan, Elizabeth

    2001-01-01

    Qualitative and quantitative analysis of interviews with parents of children with cochlear implants found that, although implants have the potential to improve deaf children's relationships with hearing peers, these children still face communication obstacles which impede their social relationships. Results are discussed from the viewpoints of…

  8. Word Learning in Children following Cochlear Implantation

    ERIC Educational Resources Information Center

    Houston, Derek M.; Carter, Allyson K.; Pisoni, David B.; Kirk, Karen Iler; Ying, Elizabeth A.

    2005-01-01

    An experimental procedure was developed to investigate word-learning skills of children who use cochlear implants (CIs). Using interactive play scenarios, 2- to 5-year olds were presented with sets of objects (Beanie Baby stuffed animals) and words for their names that corresponded to salient perceptual attributes (e.g., "horns" for a goat). Their…

  9. Listening Effort with Cochlear Implant Simulations

    ERIC Educational Resources Information Center

    Pals, Carina; Sarampalis, Anastasios; Baskent, Deniz

    2013-01-01

    Purpose: Fitting a cochlear implant (CI) for optimal speech perception does not necessarily optimize listening effort. This study aimed to show that listening effort may change between CI processing conditions for which speech intelligibility remains constant. Method: Nineteen normal-hearing participants listened to CI simulations with varying…

  10. Auditory Learning in Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Mishra, Srikanta K.; Boddupally, Shiva P.; Rayapati, Deeksha

    2015-01-01

    Purpose: The purpose of this study was to examine and characterize the training-induced changes in speech-in-noise perception in children with congenital deafness who have cochlear implants (CIs). Method: Twenty-seven children with congenital deafness who have CIs were studied. Eleven children with CIs were trained on a speech-in-noise task,…

  11. Pharmacokinetics of Drug Entry into Cochlear Fluids

    ERIC Educational Resources Information Center

    Salt, Alec N.

    2005-01-01

    The inner ear is exposed to aminoglycosides or other drugs either intentionally or as a side effect of clinical treatments directed at other regions of the body. An understanding of the effects of drugs on the inner ear requires knowledge of the pharmacokinetics of the drug once it reaches the cochlear fluids, specifically how much of it reaches…

  12. Tyrosine Hydroxylase Expression in Type II Cochlear Afferents in Mice.

    PubMed

    Vyas, Pankhuri; Wu, Jingjing Sherry; Zimmerman, Amanda; Fuchs, Paul; Glowatzki, Elisabeth

    2017-02-01

    Acoustic information propagates from the ear to the brain via spiral ganglion neurons that innervate hair cells in the cochlea. These afferents include unmyelinated type II fibers that constitute 5 % of the total, the majority being myelinated type I neurons. Lack of specific genetic markers of type II afferents in the cochlea has been a roadblock in studying their functional role. Unexpectedly, type II afferents were visualized by reporter proteins induced by tyrosine hydroxylase (TH)-driven Cre recombinase. The present study was designed to determine whether TH-driven Cre recombinase (TH-2A-CreER) provides a selective and reliable tool for identification and genetic manipulation of type II rather than type I cochlear afferents. The "TH-2A-CreER neurons" radiated from the spiral lamina, crossed the tunnel of Corti, turned towards the base of the cochlea, and traveled beneath the rows of outer hair cells. Neither the processes nor the somata of TH-2A-CreER neurons were labeled by antibodies that specifically labeled type I afferents and medial efferents. TH-2A-CreER-positive processes partially co-labeled with antibodies to peripherin, a known marker of type II afferents. Individual TH-2A-CreER neurons gave off short branches contacting 7-25 outer hair cells (OHCs). Only a fraction of TH-2A-CreER boutons were associated with CtBP2-immunopositive ribbons. These results show that TH-2A-CreER provides a selective marker for type II versus type I afferents and can be used to describe the morphology and arborization pattern of type II cochlear afferents in the mouse cochlea.

  13. Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult

    PubMed Central

    Heeringa, Amarins N.; Stefanescu, Roxana A.; Raphael, Yehoash; Shore, Susan E.

    2015-01-01

    Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to the sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e. in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration. PMID:26705736

  14. Auditory distraction transmitted by a cochlear implant alters allocation of attentional resources

    PubMed Central

    Finke, Mareike; Sandmann, Pascale; Kopp, Bruno; Lenarz, Thomas; Büchner, Andreas

    2015-01-01

    Cochlear implants (CIs) are auditory prostheses which restore hearing via electrical stimulation of the auditory nerve. The successful adaptation of auditory cognition to the CI input depends to a substantial degree on individual factors. We pursued an electrophysiological approach toward an analysis of cortical responses that reflect perceptual processing stages and higher-level responses to CI input. Performance and event-related potentials on two cross-modal discrimination-following-distraction (DFD) tasks from CI users and normal-hearing (NH) individuals were compared. The visual-auditory distraction task combined visual distraction with following auditory discrimination performance. Here, we observed similar cortical responses to visual distractors (Novelty-N2) and slowed, less accurate auditory discrimination performance in CI users when compared to NH individuals. Conversely, the auditory-visual distraction task was used to combine auditory distraction with visual discrimination performance. In this task we found attenuated cortical responses to auditory distractors (Novelty-P3), slowed visual discrimination performance, and attenuated cortical P3-responses to visual targets in CI users compared to NH individuals. These results suggest that CI users process auditory distractors differently than NH individuals and that the presence of auditory CI input has an adverse effect on the processing of visual targets and the visual discrimination ability in implanted individuals. We propose that this attenuation of the visual modality occurs through the allocation of neural resources to the CI input. PMID:25798083

  15. Shape Optimization of Cochlear Implant Electrode Array Using Genetic Algorithms

    DTIC Science & Technology

    2007-11-02

    Shape Optimization of Cochlear Implant Electrode Array using Genetic Algorithms Charles T.M. Choi, Ph.D., senior member, IEEE Department of...c.t.choi@ieee.org Abstract−Finite element analysis is used to compute the current distribution of the human cochlea during cochlear implant electrical...stimulation. Genetic algorithms are then applied in conjunction with the finite element analysis to optimize the shape of cochlear implant electrode array

  16. What Does Music Sound Like for a Cochlear Implant User?

    PubMed

    Jiam, Nicole T; Caldwell, Meredith T; Limb, Charles J

    2017-09-01

    Cochlear implant research and product development over the past 40 years have been heavily focused on speech comprehension with little emphasis on music listening and enjoyment. The relatively little understanding of how music sounds in a cochlear implant user stands in stark contrast to the overall degree of importance the public places on music and quality of life. The purpose of this article is to describe what music sounds like to cochlear implant users, using a combination of existing research studies and listener descriptions. We examined the published literature on music perception in cochlear implant users, particularly postlingual cochlear implant users, with an emphasis on the primary elements of music and recorded music. Additionally, we administered an informal survey to cochlear implant users to gather first-hand descriptions of music listening experience and satisfaction from the cochlear implant population. Limitations in cochlear implant technology lead to a music listening experience that is significantly distorted compared with that of normal hearing listeners. On the basis of many studies and sources, we describe how music is frequently perceived as out-of-tune, dissonant, indistinct, emotionless, and weak in bass frequencies, especially for postlingual cochlear implant users-which may in part explain why music enjoyment and participation levels are lower after implantation. Additionally, cochlear implant users report difficulty in specific musical contexts based on factors including but not limited to genre, presence of lyrics, timbres (woodwinds, brass, instrument families), and complexity of the perceived music. Future research and cochlear implant development should target these areas as parameters for improvement in cochlear implant-mediated music perception.

  17. Imaging living hair cells within the cochlear epithelium of mice using two-photon microscopy

    NASA Astrophysics Data System (ADS)

    Yuan, Tao; Gao, Simon S.; Saggau, Peter; Oghalai, John S.

    2009-02-01

    Mice are an excellent model for studying mammalian hearing and transgenic mouse models of human hearing loss are commonly available for research. However, the mouse cochlea is substantially smaller than other animal models routinely used to study cochlear physiology. This makes the study of their hair cells difficult. We developed a novel methodology to optically image calcium within living hair cells left undisturbed within the excised mouse cochlea. Fresh cochleae were harvested, left intact within their otic capsule bone, and glued upright in a recording chamber. The bone overlying the region of the cochlear epithelium to be studied was opened and Reissner's membrane was incised. A fluorescent indicator was applied to the preparation to image intracellular calcium. A custom-built upright two-photon microscope was used to image the preparation using three dimensional scanning. We were able to image about 1/3 of a cochlear turn simultaneously, in either the apical or basal regions. Within one hour of animal sacrifice, we found that outer hair cells demonstrated increased fluorescence compared with surrounding supporting cells. Thus, this methodology can be used to visualize hair cell calcium changes and mechanotransduction over a region of the epithelium. Because the epithelium is left within the cochlea, dissection trauma is minimized and artifactual changes in hair cell physiology are reduced.

  18. Solutions to electromagnetic interference problems between cochlear implants and GSM phones.

    PubMed

    Sorri, Martti J; Piiparinen, Peeta J; Huttunen, Kerttu H; Haho, Mikko J

    2006-03-01

    For persons using cochlear implants, electromagnetic compatibility (EMC) problems may sometimes be an obstacle to using digital cellular telephones. This study aimed at exploring the benefit of three new assistive listening device prototypes that eliminate or diminish EMC problems. Ten experienced cochlear implant users listened in quiet to running speech samples and a sentence test on a landline phone, a digital cellular phone with and without three prototypes. The subjects' performance was assessed using a sentence test, a subjective visual analog scale, and by ranking the best and the poorest listening condition. Compared to the other test conditions, listening to a digital cellular phone alone revealed, on average, the poorest sentence recognition scores (29%) and the poorest results in four different subjective judgments (the amount of disturbances, the clarity of the message, the quality of the sound, overall judgment) with all three implant systems tested. The prototypes generally helped the implantees to recognize speech better on the cellular telephone (by 10-21 percent units, on average). Use of assistive listening devices and further development of EMC of both cochlear implant systems and digital cellular phones needs to take place to enable smooth use of digital cellular phones for all implantees.

  19. Cognitive Evaluation of Cochlear Implanted Adults Using CODEX and MoCA Screening Tests.

    PubMed

    Ambert-Dahan, Emmanuèle; Routier, Shirley; Marot, Lucie; Bouccara, Didier; Sterkers, Olivier; Ferrary, Evelyne; Mosnier, Isabelle

    2017-09-01

    The relationship between hearing loss and cognitive function has already been established. The objective of our study was to determine whether the two short cognitive tests, COgnitive Disorders EXamination (CODEX) and Montreal Cognitive Assessment (MoCA), could be used in daily clinical practice to detect cognitive impairment, and its changes after cochlear implantation. Eighteen patients with severe to profound postlingual progressive hearing loss (mean age ± SEM: 64 ± 3.5 yr; range, 23-83 yr) were tested before, and 12 months after cochlear implantation, with adapted visual presentation of CODEX and MoCA tests. Auditory performance was tested under best-aided conditions in quiet and noise. Twelve months after cochlear implantation, hearing performance had clearly improved (paired t tests, p < 0.05). In addition, among the eight patients who had an abnormal cognitive score before implantation, four improved their cognitive performance, and were thus considered to be normal. No major alteration of cognitive performance was observed in the 10 patients who had normal cognitive performance before implantation. CODEX and MoCA are rapid tests that could be considered to be relevant cognitive performance screening tests. They could be used in daily clinical practice to improve the multidisciplinary sensory-cognitive monitoring of the elderly population.

  20. Anatomy of the murine and human cochlea visualized at the cellular level by synchrotron-radiation-based micro-computed tomography

    NASA Astrophysics Data System (ADS)

    Müller, B.; Lareida, A.; Beckmann, F.; Diakov, G. M.; Kral, F.; Schwarm, F.; Stoffner, R.; Gunkel, A. R.; Glueckert, R.; Schrott-Fischer, A.; Fischer, J.; Andronache, A.; Freysinger, W.

    2006-08-01

    Diseases of the hearing organ and impairment affect a significant fraction of population. Therefore, the hearing organ embedded as a helical structure in the cochlea within the hardest human osseous structure inside the petrous bone is intensively investigated. Currently, studies of the cochlea with true micrometer resolution or better are destructive. Membranes and three-dimensional vessel structures of post-mortem explanted human cochlea were only visualized with limited spatial resolution or deformed anatomical features resulting from preparation artifacts. We have applied a preparation and staining protocol developed for electron microscopy, which allows the visualization and quantification of a great variety of soft-tissue structures including the Reissner's membrane, the tectorial membrane, basilar membrane, modiolus, lamina radialis, and Nuel's space by the use of synchrotron-radiation-based micro computed tomography at the beamline BW 2 (HASYLAB at DESY). The level of detail can be even improved by the application of sophisticated computer vision tools, which enables the extraction of the vascular tree down to the capillaries and of the course of nerve fibers as well as the topology of the osseous lamina radialis, which assembles the nerve fibers from the hair-cells to the ganglia in the center of the cochlea, the modiolus. These non-destructively obtained three-dimensional data are principal for the refined understanding of the hearing process by membranes morphologies and further anatomical features at the cellular level and for teaching purposes in medical curricula.

  1. Sound-direction identification with bilateral cochlear implants.

    PubMed

    Neuman, Arlene C; Haravon, Anita; Sislian, Nicole; Waltzman, Susan B

    2007-02-01

    The purpose of this study was to compare the accuracy of sound-direction identification in the horizontal plane by bilateral cochlear implant users when localization was measured with pink noise and with speech stimuli. Eight adults who were bilateral users of Nucleus 24 Contour devices participated in the study. All had received implants in both ears in a single surgery. Sound-direction identification was measured in a large classroom by using a nine-loudspeaker array. Localization was tested in three listening conditions (bilateral cochlear implants, left cochlear implant, and right cochlear implant), using two different stimuli (a speech stimulus and pink noise bursts) in a repeated-measures design. Sound-direction identification accuracy was significantly better when using two implants than when using a single implant. The mean root-mean-square error was 29 degrees for the bilateral condition, 54 degrees for the left cochlear implant, and 46.5 degrees for the right cochlear implant condition. Unilateral accuracy was similar for right cochlear implant and left cochlear implant performance. Sound-direction identification performance was similar for speech and pink noise stimuli. The data obtained in this study add to the growing body of evidence that sound-direction identification with bilateral cochlear implants is better than with a single implant. The similarity in localization performance obtained with the speech and pink noise supports the use of either stimulus for measuring sound-direction identification.

  2. Forward masking in different cochlear implant systems

    NASA Astrophysics Data System (ADS)

    Boëx, Colette; Kós, Maria-Izabel; Pelizzone, Marco

    2003-10-01

    The goal of this study was to evaluate, from a psychophysical standpoint, the neural spread of excitation produced by the stimulation of different types of intracochlear electrode arrays: the Ineraid™, the Clarion™ S-Series on its own or with the Electrode Positioning System (EPS), and the Clarion™ HiFocus-I with the EPS. The EPS is an independent silicone part designed to bring the electrode array close to the modiolus. Forward masking was evaluated in 12 adult subjects (3 Ineraid™, 4 Clarion™ S-Series, 3 Clarion™ S-Series+EPS, 3 HiFocus-I+EPS) by psychophysical experiments conducted using trains of biphasic stimuli (813 pulses per second, 307.6 μs/phase). Masker signals (+8 dB re: threshold, 300 ms) were applied to the most apical electrode. Probe signals (30 ms, 10-ms postmasker) were delivered to more basal electrodes. Masked and unmasked detection thresholds of probe signals were measured. For both Clarion™ HiFocus-I subjects, measurements were conducted in both monopolar and bipolar stimulus configurations. No major differences were found in forward masking between the different intracochlear electrode arrays tested in the monopolar configuration at suprathreshold levels equivalent to those used in speech-coding strategies, but significant differences were found between subjects. A significant negative correlation also was found between the level of forward masking and the consonant identification performance. These measurements showed that the neural spread of excitation was more restricted in the bipolar configuration than in the monopolar configuration for HiFocus-I subjects. It was found that CIS strategies implemented without using apical electrodes, which showed high levels of masking, could improve consonant identification.

  3. Cochlear implantation: a personal and societal economic perspective examining the effects of cochlear implantation on personal income.

    PubMed

    Monteiro, Eric; Shipp, David; Chen, Joseph; Nedzelski, Julian; Lin, Vincent

    2012-04-01

    Although cochlear implantation has been shown to improve quality of life, the socioeconomic benefit to the individual and society has not been thoroughly investigated. Our objective was to determine the economic impact of profound deafness and subsequent effects of unilateral cochlear implantation. Retrospective analysis of a prospectively collected cochlear implantation database. An academic, tertiary care hospital. A prospectively collected cochlear implantation database of 702 patients was reviewed. Known Canadian economic surrogates were used to estimate the personal economic impact of both deafness and unilateral cochlear implantation. The main outcome measures included employment rates and personal income prior to and following cochlear implantation. A total of 637 patients had sufficient occupational data for inclusion in the study; 36.7% suffered a negative economic impact as a result of their deafness. Cochlear implantation was associated with a significant increase in median yearly income compared to preimplantation ($42 672 vs $30 432; p = .007). Cochlear implantation not only improves quality of life but also translates into significant economic benefits for patients and the Canadian economy. These benefits appear to exceed the overall costs of cochlear implantation.

  4. Adaptive benefit of cross-modal plasticity following cochlear implantation in deaf adults

    PubMed Central

    Wiggins, Ian M.; Hartley, Douglas E. H.

    2017-01-01

    It has been suggested that visual language is maladaptive for hearing restoration with a cochlear implant (CI) due to cross-modal recruitment of auditory brain regions. Rehabilitative guidelines therefore discourage the use of visual language. However, neuroscientific understanding of cross-modal plasticity following cochlear implantation has been restricted due to incompatibility between established neuroimaging techniques and the surgically implanted electronic and magnetic components of the CI. As a solution to this problem, here we used functional near-infrared spectroscopy (fNIRS), a noninvasive optical neuroimaging method that is fully compatible with a CI and safe for repeated testing. The aim of this study was to examine cross-modal activation of auditory brain regions by visual speech from before to after implantation and its relation to CI success. Using fNIRS, we examined activation of superior temporal cortex to visual speech in the same profoundly deaf adults both before and 6 mo after implantation. Patients’ ability to understand auditory speech with their CI was also measured following 6 mo of CI use. Contrary to existing theory, the results demonstrate that increased cross-modal activation of auditory brain regions by visual speech from before to after implantation is associated with better speech understanding with a CI. Furthermore, activation of auditory cortex by visual and auditory speech developed in synchrony after implantation. Together these findings suggest that cross-modal plasticity by visual speech does not exert previously assumed maladaptive effects on CI success, but instead provides adaptive benefits to the restoration of hearing after implantation through an audiovisual mechanism. PMID:28808014

  5. Working memory, short-term memory and reading proficiency in school-age children with cochlear implants.

    PubMed

    Bharadwaj, Sneha V; Maricle, Denise; Green, Laura; Allman, Tamby

    2015-10-01

    The objective of the study was to examine short-term memory and working memory through both visual and auditory tasks in school-age children with cochlear implants. The relationship between the performance on these cognitive skills and reading as well as language outcomes were examined in these children. Ten children between the ages of 7 and 11 years with early-onset bilateral severe-profound hearing loss participated in the study. Auditory and visual short-term memory, auditory and visual working memory subtests and verbal knowledge measures were assessed using the Woodcock Johnson III Tests of Cognitive Abilities, the Wechsler Intelligence Scale for Children-IV Integrated and the Kaufman Assessment Battery for Children II. Reading outcomes were assessed using the Woodcock Reading Mastery Test III. Performance on visual short-term memory and visual working memory measures in children with cochlear implants was within the average range when compared to the normative mean. However, auditory short-term memory and auditory working memory measures were below average when compared to the normative mean. Performance was also below average on all verbal knowledge measures. Regarding reading outcomes, children with cochlear implants scored below average for listening and passage comprehension tasks and these measures were positively correlated to visual short-term memory, visual working memory and auditory short-term memory. Performance on auditory working memory subtests was not related to reading or language outcomes. The children with cochlear implants in this study demonstrated better performance in visual (spatial) working memory and short-term memory skills than in auditory working memory and auditory short-term memory skills. Significant positive relationships were found between visual working memory and reading outcomes. The results of the study provide support for the idea that WM capacity is modality specific in children with hearing loss. Based on these

  6. Meningitis after cochlear implantation in Mondini malformation.

    PubMed

    Page, E L; Eby, T L

    1997-01-01

    Although the potential for CSF leakage and subsequent meningitis after cochlear implantation in the malformed cochlea has been recognized, this complication has not been previously reported. We report a case of CSF otorhinorrhea and meningitis after minor head trauma developing 2 years after cochlear implantation in a child with Mondini malformation. Leakage of CSF was identified from the cochleostomy around the electrode of the implant, and this leak was sealed with a temporalis fascia and muscle plug. Although this complication appears to be rare, care must be taken to seal the cochleostomy in children with inner ear malformations at the initial surgery, and any episode of meningitis after surgery must be thoroughly investigated to rule out CSF leakage from the labyrinth.

  7. Auditory neuroplasticity, hearing loss and cochlear implants.

    PubMed

    Ryugo, David

    2015-07-01

    Data from our laboratory show that the auditory brain is highly malleable by experience. We establish a base of knowledge that describes the normal structure and workings at the initial stages of the central auditory system. This research is expanded to include the associated pathology in the auditory brain stem created by hearing loss. Utilizing the congenitally deaf white cat, we demonstrate the way that cells, synapses, and circuits are pathologically affected by sound deprivation. We further show that the restoration of auditory nerve activity via electrical stimulation through cochlear implants serves to correct key features of brain pathology caused by hearing loss. The data suggest that rigorous training with cochlear implants and/or hearing aids offers the promise of heretofore unattained benefits.

  8. Changing expectations for children with cochlear implants.

    PubMed

    Moog, Jean Sachar

    2002-05-01

    Seventeen students with cochlear implants who were between 5 and 11 years of age and attended the Moog Center for Deaf Education school program were tested just before exiting the program. The Moog program is an intensive oral program that provides very focused instruction in spoken language and reading. Children leave the program when they are ready for a mainstream setting or when they are 11 years of age, whichever comes first. All of the children demonstrated open-set speech perception ranging from 36% to 100%. On a test of speech intelligibility, all students scored 90% or better. On language and reading tests, compared with the performance of normal-hearing children their age, more than 65% scored within the average range for language and more than 70% scored within the average range for reading. These data demonstrate what is possible for deaf children who benefit from a combination of a cochlear implant and a highly focused oral education program.

  9. Nonlinear Cochlear Signal Processing and Phoneme Perception

    NASA Astrophysics Data System (ADS)

    Allen, Jont B.; Régnier, Marion; Phatak, Sandeep; Li, Feipeng

    2009-02-01

    The most important communication signal is human speech. It is helpful to think of speech communication in terms of Claude Shannon's information theory channel model. When thus viewed, it immediately becomes clear that the most complex part of speech communication channel is in auditory system (the receiver). In my opinion, even after years of work, relatively little is know about how the human auditory system decodes speech. Given cochlear damaged, speech scores are greatly reduced, even with tiny amounts of noise. The exact reasons for this SNR-loss presently remain unclear, but I speculate that the source of this must be cochlear outer hair cell temporal processing, not central processing. Specifically, "temporal edge enhancement" of the speech signal and forward masking could easily be modified in such ears, leading to SNR-Loss. What ever the reason, SNR-Loss is the key problem that needs to be fully researched.

  10. Local Cochlear Correlations of Perceived Pitch

    NASA Astrophysics Data System (ADS)

    Martignoli, Stefan; Stoop, Ruedi

    2010-07-01

    Pitch is one of the most salient attributes of the human perception of sound, but is still not well understood. This difficulty originates in the entwined nature of the phenomenon, in which a physical stimulus as well as a psychophysiological signal receiver are involved. In an electronic realization of a biophysically detailed nonlinear model of the cochlea, we find local cochlear correlates of the perceived pitch that explain all essential pitch-shifting phenomena from physical grounds.

  11. Quantitative Changes in Calretinin Immunostaining in the Cochlear Nuclei after Unilateral Cochlear Removal in Young Ferrets

    PubMed Central

    Fuentes-Santamaria, Verónica; Alvarado, Juan Carlos; Taylor, Anna R.; Brunso-Bechtold, Judy K.; Henkel, Craig K.

    2007-01-01

    Neurons of the cochlear nuclei receive axosomatic endings from primary afferent fibers from the cochlea and have projections that diverge to form parallel ascending auditory pathways. These cells are characterized by neurochemical phenotypes such as levels of calretinin. To test whether or not early deafferentation results in changes in calretinin immunostaining in the cochlear nucleus, unilateral cochlear ablations were performed in ferrets soon after hearing onset (postnatal day [P]30–P40). Two months later, changes in calretinin immunostaining as well as cell size, volume, and synaptophysin immunostaining were assessed in the anteroventral (AVCN), posteroventral (PVCN), and dorsal cochlear nucleus (DCN). A decrease in calretinin immunostaining was evident ipsilaterally within the AVCN and PVCN but not in the DCN. Further analysis revealed a decrease both in the calretinin-immunostained neuropil and in the calretinin-immunostained area within AVCN and PVCN neurons. These declines were accompanied by significant ipsilateral decreases in volume as well as neuron area in the AVCN and PVCN compared with the contralateral cochlear nucleus and unoperated animals, but not compared with the DCN. In addition, there was a significant contralateral increase in calretinin-immunostained area within AVCN and PVCN neurons compared with control animals. Finally, a decrease in area of synaptophysin immunostaining in both the ipsilateral AVCN and PVCN without changes in the number of boutons was found. The present data demonstrate that unilateral cochlear ablation leads to 1) decreased immunostaining of the neuropil in the AVCN and PVCN ipsilaterally, 2) decreased calretinin immunostaining within AVCN and PVCN neurons ipsilaterally, 3) synaptogenesis in the AVCN and PVCN ipsilaterally, and 4) increased calretinin immunostaining within AVCN and PVCN neurons contralaterally. PMID:15700274

  12. Three-dimensional modeling and visualization of the cochlea on the Internet.

    PubMed

    Yoo, S K; Wang, G; Rubinstein, J T; Skinner, M W; Vannier, M W

    2000-06-01

    Three-dimensional (3-D) modeling and visualization of the cochlea using the World Wide Web (WWW) is an effective way of sharing anatomic information for cochlear implantation over the Internet, particularly for morphometry-based research and resident training in otolaryngology and neuroradiology. In this paper, 3-D modeling, visualization, and animation techniques are integrated in an interactive and platform-independent manner and implemented over the WWW. Cohen's template shape with mean cross-sectional areas of the human cochlea is extended into a 3-D geometrical model. Also, spiral computer tomography data of a patient's cochlea is digitally segmented and geometrically represented. The cochlear electrode array is synthesized according to its specification. Then, cochlear implantation is animated with both idealized and real cochlear models. Insertion length, angular position, and characteristic frequency of individual electrodes are estimated online during the virtual insertion. The optimization of the processing parameters is done to demonstrate the feasibility of this technology for clinical applications.

  13. Cochlear damages caused by vibration exposure.

    PubMed

    Moussavi Najarkola, Seyyed Ali; Khavanin, Ali; Mirzaei, Ramazan; Salehnia, Mojdeh; Muhammadnejad, Ahad

    2013-09-01

    Many industrial devices have an excessive vibration which can affect human body systems. The effect of vibration on cochlear histology has been as a debatable problem in occupational health and medicine. Due to limitation present in human studies, the research was conducted to survey the influence of vibration on cochlear histology in an animal model. TWELVE ALBINO RABBITS WERE EXPERIMENTED AS: Vibration group (n = 6; exposed to 1.0 m.s(-2) r.m.s vertical whole-body vibration at 4 - 8 Hz for 8 hours per day during 5 consecutive days) versus Control group (n = 6; the same rabbits without vibration exposure). After finishing the exposure scenario, all rabbits were killed by CO2 inhalation; their cochleae were extracted and fixed in 10% formaldehyde for 48 hours, decalcified by 10% nitric acid for 24 hours. Specimens were dehydrated, embedded, sectioned 5 µm thick and stained with Hematoxylin and Eosin for light microscopy observations. Severely hydropic degenerated and vacuolated inner hair cells (IHCs) were observed in vibration group compared to the control group. Inter and intracellular edema was appeared in supporting cells (SC). Nuclei of outer hair cells (OHCs) seemed to be pyknotic. Slightly thickened basilar membrane (BM) was probably implied to inter cellular edematous. Tectorial Membrane (TM) was not affected pathologically. Whole-body vibration could cause cochlear damages in male rabbits, though vibration-induced auditory functional effects might be resulted as subsequent outcome of prolonged high level vibration exposures.

  14. An Electromechanical Model for the Cochlear Microphonic

    NASA Astrophysics Data System (ADS)

    Teal, Paul D.; Lineton, Ben; Elliott, Stephen J.

    2011-11-01

    The first of the many electrical signals generated in the ear, nerves and brain as a response to a sound incident on the ear is the cochlear microphonic (CM). The CM is generated by the hair cells of the cochlea, primarily the outer hairs cells. The potentials of this signal are a nonlinear filtered version of the acoustic pressure at the tympanic membrane. The CM signal has been used very little in recent years for clinical audiology and audiological research. This is because of uncertainty in interpreting the CM signal as a diagnostic measure, and also because of the difficulty of obtaining the signal, which has usually required the use of a transtympanic electrode. There are however, several potential clinical and research applications for acquisition of the CM. To promote understanding of the CM, and potential clinical application, a model is presented which can account for the generation of the cochlear microphonic signal. The model incorporates micro-mechanical and macro-mechanical aspects of previously published models of the basilar membrane and reticular lamina, as well as cochlear fluid mechanics, piezoelectric activity and capacitance of the outer hair cells. It also models the electrical coupling of signals along the scalae.

  15. Surgical evaluation of candidates for cochlear implants

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Lilly, D. J.; Fowler, L. P.; Stypulkowski, P. H.

    1987-01-01

    The customary presentation of surgical procedures to patients in the United States consists of discussions on alternative treatment methods, risks of the procedure(s) under consideration, and potential benefits for the patient. Because the contents of the normal speech signal have not been defined in a way that permits a surgeon systematically to provide alternative auditory signals to a deaf patient, the burden is placed on the surgeon to make an arbitrary selection of candidates and available devices for cochlear prosthetic implantation. In an attempt to obtain some information regarding the ability of a deaf patient to use electrical signals to detect and understand speech, the Good Samaritan Hospital and Neurological Sciences Institute cochlear implant team has routinely performed tympanotomies using local anesthesia and has positioned temporary electrodes onto the round windows of implant candidates. The purpose of this paper is to review our experience with this procedure and to provide some observations that may be useful in a comprehensive preoperative evaluation for totally deaf patients who are being considered for cochlear implantation.

  16. Surgical evaluation of candidates for cochlear implants

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Lilly, D. J.; Fowler, L. P.; Stypulkowski, P. H.

    1987-01-01

    The customary presentation of surgical procedures to patients in the United States consists of discussions on alternative treatment methods, risks of the procedure(s) under consideration, and potential benefits for the patient. Because the contents of the normal speech signal have not been defined in a way that permits a surgeon systematically to provide alternative auditory signals to a deaf patient, the burden is placed on the surgeon to make an arbitrary selection of candidates and available devices for cochlear prosthetic implantation. In an attempt to obtain some information regarding the ability of a deaf patient to use electrical signals to detect and understand speech, the Good Samaritan Hospital and Neurological Sciences Institute cochlear implant team has routinely performed tympanotomies using local anesthesia and has positioned temporary electrodes onto the round windows of implant candidates. The purpose of this paper is to review our experience with this procedure and to provide some observations that may be useful in a comprehensive preoperative evaluation for totally deaf patients who are being considered for cochlear implantation.

  17. Cochlear implant speech recognition with speech maskers

    NASA Astrophysics Data System (ADS)

    Stickney, Ginger S.; Zeng, Fan-Gang; Litovsky, Ruth; Assmann, Peter

    2004-08-01

    Speech recognition performance was measured in normal-hearing and cochlear-implant listeners with maskers consisting of either steady-state speech-spectrum-shaped noise or a competing sentence. Target sentences from a male talker were presented in the presence of one of three competing talkers (same male, different male, or female) or speech-spectrum-shaped noise generated from this talker at several target-to-masker ratios. For the normal-hearing listeners, target-masker combinations were processed through a noise-excited vocoder designed to simulate a cochlear implant. With unprocessed stimuli, a normal-hearing control group maintained high levels of intelligibility down to target-to-masker ratios as low as 0 dB and showed a release from masking, producing better performance with single-talker maskers than with steady-state noise. In contrast, no masking release was observed in either implant or normal-hearing subjects listening through an implant simulation. The performance of the simulation and implant groups did not improve when the single-talker masker was a different talker compared to the same talker as the target speech, as was found in the normal-hearing control. These results are interpreted as evidence for a significant role of informational masking and modulation interference in cochlear implant speech recognition with fluctuating maskers. This informational masking may originate from increased target-masker similarity when spectral resolution is reduced.

  18. Cross-modal perception of rhythm in music and dance by cochlear implant users.

    PubMed

    Vongpaisal, Tara; Monaghan, Melanie

    2014-05-01

    Two studies examined adult cochlear implant (CI) users' ability to match auditory rhythms occurring in music to visual rhythms occurring in dance (Cha Cha, Slow Swing, Tango and Jive). In Experiment 1, adults CI users (n = 10) and hearing controls matched a music excerpt to choreographed dance sequences presented as silent videos. In Experiment 2, participants matched a silent video of a dance sequence to music excerpts. CI users were successful in detecting timing congruencies across music and dance at well above-chance levels suggesting that they were able to process distinctive auditory and visual rhythm patterns that characterized each style. However, they were better able to detect cross-modal timing congruencies when the reference was an auditory rhythm than when the reference was a visual rhythm. Learning strategies that encourage cross-modal learning of musical rhythms may have applications in developing novel rehabilitative strategies to enhance music perception and appreciation outcomes of child implant users.

  19. Turned On: Cochlear Implants for Deaf and Hard-of-Hearing Persons.

    ERIC Educational Resources Information Center

    Biderman, Beverly

    This first-person account discusses how a cochlear implant has allowed an individual with deafness to hear. It describes how cochlear implants function, the development of cochlear implants and who can benefit from the implants and to what extent. It also discusses how well people can hear with a cochlear implant. Factors strongly associated with…

  20. Exploring Perspectives on Cochlear Implants and Language Acquisition within the Deaf Community

    ERIC Educational Resources Information Center

    Gale, Elaine

    2011-01-01

    Cochlear implants generated intense debate almost immediately following their introduction in the 1980s. Today, with a vast number of deaf individuals with cochlear implants, the debate about the cochlear implant device and mode of communication continues. Q-methodology was used in this study to explore cochlear implants and language acquisition…

  1. Exploring Perspectives on Cochlear Implants and Language Acquisition within the Deaf Community

    ERIC Educational Resources Information Center

    Gale, Elaine

    2011-01-01

    Cochlear implants generated intense debate almost immediately following their introduction in the 1980s. Today, with a vast number of deaf individuals with cochlear implants, the debate about the cochlear implant device and mode of communication continues. Q-methodology was used in this study to explore cochlear implants and language acquisition…

  2. Taxonomic Knowledge of Children with and without Cochlear Implants

    ERIC Educational Resources Information Center

    Lund, Emily; Dinsmoor, Jessica

    2016-01-01

    Purpose: The purpose of this study was to compare the taxonomic vocabulary knowledge and organization of children with cochlear implants to (a) children with normal hearing matched for age, and (b) children matched for vocabulary development. Method: Ten children with cochlear implants, 10 age-matched children with normal hearing, and 10…

  3. Evaluation of Evoked Potentials to Dyadic Tones after Cochlear Implantation

    ERIC Educational Resources Information Center

    Sandmann, Pascale; Eichele, Tom; Buechler, Michael; Debener, Stefan; Jancke, Lutz; Dillier, Norbert; Hugdahl, Kenneth; Meyer, Martin

    2009-01-01

    Auditory evoked potentials are tools widely used to assess auditory cortex functions in clinical context. However, in cochlear implant users, electrophysiological measures are challenging due to implant-created artefacts in the EEG. Here, we used independent component analysis to reduce cochlear implant-related artefacts in event-related EEGs of…

  4. Evaluation of Evoked Potentials to Dyadic Tones after Cochlear Implantation

    ERIC Educational Resources Information Center

    Sandmann, Pascale; Eichele, Tom; Buechler, Michael; Debener, Stefan; Jancke, Lutz; Dillier, Norbert; Hugdahl, Kenneth; Meyer, Martin

    2009-01-01

    Auditory evoked potentials are tools widely used to assess auditory cortex functions in clinical context. However, in cochlear implant users, electrophysiological measures are challenging due to implant-created artefacts in the EEG. Here, we used independent component analysis to reduce cochlear implant-related artefacts in event-related EEGs of…

  5. Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

    ERIC Educational Resources Information Center

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

    2012-01-01

    The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests…

  6. Acoustic Trauma Increases Cochlear and Hair Cell Uptake of Gentamicin

    PubMed Central

    Li, Hongzhe; Wang, Qi; Steyger, Peter S.

    2011-01-01

    Background Exposure to intense sound or high doses of aminoglycoside antibiotics can increase hearing thresholds, induce cochlear dysfunction, disrupt hair cell morphology and promote hair cell death, leading to permanent hearing loss. When the two insults are combined, synergistic ototoxicity occurs, exacerbating cochlear vulnerability to sound exposure. The underlying mechanism of this synergism remains unknown. In this study, we tested the hypothesis that sound exposure enhances the intra-cochlear trafficking of aminoglycosides, such as gentamicin, leading to increased hair cell uptake of aminoglycosides and subsequent ototoxicity. Methods Juvenile C57Bl/6 mice were exposed to moderate or intense sound levels, while fluorescently-conjugated or native gentamicin was administered concurrently or following sound exposure. Drug uptake was then examined in cochlear tissues by confocal microscopy. Results Prolonged sound exposure that induced temporary threshold shifts increased gentamicin uptake by cochlear hair cells, and increased gentamicin permeation across the strial blood-labyrinth barrier. Enhanced intra-cochlear trafficking and hair cell uptake of gentamicin also occurred when prolonged sound, and subsequent aminoglycoside exposure were temporally separated, confirming previous observations. Acute, concurrent sound exposure did not increase cochlear uptake of aminoglycosides. Conclusions Prolonged, moderate sound exposures enhanced intra-cochlear aminoglycoside trafficking into the stria vascularis and hair cells. Changes in strial and/or hair cell physiology and integrity due to acoustic overstimulation could increase hair cell uptake of gentamicin, and may represent one mechanism of synergistic ototoxicity. PMID:21552569

  7. Realization of Complex Onsets by Pediatric Users of Cochlear Implants

    ERIC Educational Resources Information Center

    Chin, Steven B.

    2006-01-01

    This study examined variations in English complex onset realizations by children who use cochlear implants. Data consisted of 227 productions of two-segment onset clusters from 12 children. In general, onset cluster realizations of children with cochlear implants did not differ markedly from those reported for children with normal hearing: null…

  8. The Needs of Parents of Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Most, Tova; Zaidman-Zait, Anat

    2001-01-01

    This study surveyed 35 mothers of cochlear implant (CI) candidates or current users on the relative importance of various topics in a parent-targeted intervention program preceding and/or following cochlear implantation. Suggestions for an optimal intervention include use of a multidisciplinary team, information on many topics and services, and…

  9. Relationships among Professionals' Knowledge, Experience, and Expectations Regarding Cochlear Implants

    ERIC Educational Resources Information Center

    Ben-Itzhak, D.; Most, T.; Weisel, A.

    2005-01-01

    The present study examined the relationships between teachers' and communication clinicians' self-reported knowledge on cochlear implants and their expectations of CIs. The authors also explored these professionals' views regarding the child's communication mode, educational setting, and social options following cochlear implantation. The…

  10. Relationships among Professionals' Knowledge, Experience, and Expectations Regarding Cochlear Implants

    ERIC Educational Resources Information Center

    Ben-Itzhak, D.; Most, T.; Weisel, A.

    2005-01-01

    The present study examined the relationships between teachers' and communication clinicians' self-reported knowledge on cochlear implants and their expectations of CIs. The authors also explored these professionals' views regarding the child's communication mode, educational setting, and social options following cochlear implantation. The…

  11. Multidisciplinary Training for Rural Outreach to Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Schery, Teris K.; Tharpe, Anne Marie

    The number of deaf children with surgically implanted cochlear devices has been increasing since the device was approved in 1989. In rural communities, there may be no one who is knowledgeable about the care of cochlear implants, what to expect of the child's communication abilities, and how to maximize the child's progress. A federally funded…

  12. Remote programming of cochlear implants: a telecommunications model.

    PubMed

    McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

    2010-09-01

    Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

  13. Cochlear Implants:System Design, Integration and Evaluation

    PubMed Central

    Rebscher, Stephen; Harrison, William V.; Sun, Xiaoan; Feng, Haihong

    2009-01-01

    As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120,000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues from design and specifications to integration and evaluation. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants. PMID:19946565

  14. Taxonomic Knowledge of Children with and without Cochlear Implants

    ERIC Educational Resources Information Center

    Lund, Emily; Dinsmoor, Jessica

    2016-01-01

    Purpose: The purpose of this study was to compare the taxonomic vocabulary knowledge and organization of children with cochlear implants to (a) children with normal hearing matched for age, and (b) children matched for vocabulary development. Method: Ten children with cochlear implants, 10 age-matched children with normal hearing, and 10…

  15. Surgical Management of the Pediatric Cochlear Implant Patient.

    ERIC Educational Resources Information Center

    Cohen, Seth M.; Haynes, David S.

    2003-01-01

    This article discusses the surgical management of children receiving cochlear implants. It identifies preoperative considerations to select patients likely to benefit, contraindications, some new surgical techniques, complications, special considerations (otitis media, meningitis, head growth, inner ear malformations, and cochlear obstruction).…

  16. Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

    ERIC Educational Resources Information Center

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

    2012-01-01

    The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests…

  17. Performance of Cochlear Implant Recipients With GJB2-Related Deafness

    PubMed Central

    Green, Glenn E.; Scott, Daryl A.; McDonald, Joshua M.; Teagle, Holly F.B.; Tomblin, Bruce J.; Spencer, Linda J.; Woodworth, George G.; Knutson, John F.; Gantz, Bruce J.; Sheffield, Val C.; Smith, Richard J.H.

    2011-01-01

    Congenital profound hearing loss affects 0.05–0.1% of children and has many causes, some of which are associated with cognitive delay. For prelingually-deafened cochlear implant recipients, the etiology of deafness is usually unknown. Mutations in GJB2 have been established as the most common cause of heritable deafness in the United States. In this report, we identify cochlear implant recipients with GJB2-related deafness and examine the performance of these individuals. Cochlear implant recipients received a battery of perceptive, cognitive, and reading tests. Neither subjects nor examiners knew the etiology of deafness in these individuals. The implant recipients were then examined for mutations in GJB2 using an allele-specific polymerase chain reaction assay, single-strand conformation polymorphism analysis, and direct sequencing. GJB2 mutations were the leading cause of congenital deafness among the cochlear implant recipients screened. Cochlear implant recipients with GJB2-related deafness read within one standard deviation of hearing controls better than other congenitally deaf cochlear implant recipients and non-cochlear implant recipients. Individuals with congenital deafness should be offered GJB2 screening. Positive results establish an etiologic diagnosis and provide prognostic, genetic, and therapeutic information. Effective rehabilitation for profoundly deaf individuals with GJB2-related deafness is possible through cochlear implantation. PMID:11977173

  18. Speech Intelligibility and Prosody Production in Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Chin, Steven B.; Bergeson, Tonya R.; Phan, Jennifer

    2012-01-01

    Objectives: The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods: The Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal…

  19. Emotion Understanding in Deaf Children with a Cochlear Implant

    ERIC Educational Resources Information Center

    Wiefferink, Carin H.; Rieffe, Carolien; Ketelaar, Lizet; De Raeve, Leo; Frijns, Johan H. M.

    2013-01-01

    It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We examined indices for emotion understanding and their associations with communication skills in children aged 2.5-5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion…

  20. Congenitally Deafblind Children and Cochlear Implants: Effects on Communication

    ERIC Educational Resources Information Center

    Dammeyer, Jesper

    2009-01-01

    There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2…

  1. Including Children with Cochlear Implants in General Education Elementary Classrooms

    ERIC Educational Resources Information Center

    Stith, Joanna L.; Drasgow, Erik

    2005-01-01

    Cochlear implants can provide partial hearing to individuals with substantial hearing loss. Because of improvements in early identification and intervention, more children with cochlear implants will be included in elementary school general education classrooms. Thus, general education teachers should be prepared for teaching children with…

  2. Interviews with Deaf Children about Their Experiences Using Cochlear Implants

    ERIC Educational Resources Information Center

    Preisler, G.; Tvingstedt, A. -L.

    2005-01-01

    Within the framework of a longitudinal study of deaf children with cochlear implants, 11 children with implants were interviewed. The objective was to shed light on what it is like for a child to use a cochlear implant, based on these children's own experience with implants, which ranged from 5.0 to 7.5 years. Six of the children were in schools…

  3. Serving Deaf Students Who Have Cochlear Implants. PEPNet Tipsheet

    ERIC Educational Resources Information Center

    Searls, J. Matt, Comp.

    2010-01-01

    Cochlear implants (CIs) are complex electronic devices surgically implanted under the skin behind the ear. These devices utilize electrodes placed in the inner ear (the cochlea) to stimulate the auditory nerve of individuals with significant permanent hearing loss. Cochlear implants may not be suitable for everyone. They are designed to provide…

  4. Congenitally Deafblind Children and Cochlear Implants: Effects on Communication

    ERIC Educational Resources Information Center

    Dammeyer, Jesper

    2009-01-01

    There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2…

  5. Interviews with Deaf Children about Their Experiences Using Cochlear Implants

    ERIC Educational Resources Information Center

    Preisler, G.; Tvingstedt, A. -L.

    2005-01-01

    Within the framework of a longitudinal study of deaf children with cochlear implants, 11 children with implants were interviewed. The objective was to shed light on what it is like for a child to use a cochlear implant, based on these children's own experience with implants, which ranged from 5.0 to 7.5 years. Six of the children were in schools…

  6. Speech Intelligibility and Prosody Production in Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Chin, Steven B.; Bergeson, Tonya R.; Phan, Jennifer

    2012-01-01

    Objectives: The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods: The Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal…

  7. Hearing: A Second Language for Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Jaussi, Kyle R.

    1994-01-01

    This article addresses training of hearing-impaired children who have received cochlear implants from a "hearing as a second language" point of view. It compares cochlear implants to hearing aids. A project involving 7 children, ages 5 to 12, is detailed, noting efforts to provide a rich auditory environment and encouraging both manual and oral…

  8. Surgical Management of the Pediatric Cochlear Implant Patient.

    ERIC Educational Resources Information Center

    Cohen, Seth M.; Haynes, David S.

    2003-01-01

    This article discusses the surgical management of children receiving cochlear implants. It identifies preoperative considerations to select patients likely to benefit, contraindications, some new surgical techniques, complications, special considerations (otitis media, meningitis, head growth, inner ear malformations, and cochlear obstruction).…

  9. Emotion Understanding in Deaf Children with a Cochlear Implant

    ERIC Educational Resources Information Center

    Wiefferink, Carin H.; Rieffe, Carolien; Ketelaar, Lizet; De Raeve, Leo; Frijns, Johan H. M.

    2013-01-01

    It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We examined indices for emotion understanding and their associations with communication skills in children aged 2.5-5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion…

  10. Serving Deaf Students Who Have Cochlear Implants. PEPNet Tipsheet

    ERIC Educational Resources Information Center

    Searls, J. Matt, Comp.

    2010-01-01

    Cochlear implants (CIs) are complex electronic devices surgically implanted under the skin behind the ear. These devices utilize electrodes placed in the inner ear (the cochlea) to stimulate the auditory nerve of individuals with significant permanent hearing loss. Cochlear implants may not be suitable for everyone. They are designed to provide…

  11. Cochlear Implantation in Children With Autism Spectrum Disorder.

    PubMed

    Eshraghi, Adrien A; Nazarian, Ronen; Telischi, Fred F; Martinez, Diane; Hodges, Annelle; Velandia, Sandra; Cejas-Cruz, Ivette; Balkany, Thomas J; Lo, Kaming; Lang, Dustin

    2015-09-01

    To assess the outcome of cochlear implantation in children with autism spectrum disorder (ASD). Retrospective case review and survey. Tertiary referral center. Children who meet criteria for cochlear implantation and diagnosis of ASD. Receptive and expressive language scores and parental survey data. Fifteen patients with history of ASD and cochlear implantation were analyzed and compared with 15 patients who received cochlear implant and have no other disability. Postoperatively, more than 67% of children with ASD significantly improved their speech perception skills, and 60% significantly improved their speech expression skills, whereas all patients in the control group showed significant improvement in both aspects. The top 3 reported improvements after cochlear implantation were name recognition, response to verbal requests, and enjoyment of music. Of all behavioral aspects, the use of eye contact was the least improved. Survey results in regard to improvements in patient interaction were more subtle when compared with those related to sound and speech perception. The most improved aspects in the ASD patients' lives after cochlear implantation seemed to be attending to other people's requests and conforming to family routines. Of note, awareness of the child's environment is the most highly ranked improvement attributed to the cochlear implant. Cochlear implants are effective and beneficial for hearing impaired members of the ASD population, although development of language may lag behind that of implanted children with no additional disabilities. Significant speech perception and overall behavior improvement are noted.

  12. Cochlear perfusion with a viscous fluid.

    PubMed

    Wang, Yi; Olson, Elizabeth S

    2016-07-01

    The flow of viscous fluid in the cochlea induces shear forces, which could provide benefit in clinical practice, for example to guide cochlear implant insertion or produce static pressure to the cochlear partition or wall. From a research standpoint, studying the effects of a viscous fluid in the cochlea provides data for better understanding cochlear fluid mechanics. However, cochlear perfusion with a viscous fluid may damage the cochlea. In this work we studied the physiological and anatomical effects of perfusing the cochlea with a viscous fluid. Gerbil cochleae were perfused at a rate of 2.4 μL/min with artificial perilymph (AP) and sodium hyaluronate (Healon, HA) in four different concentrations (0.0625%, 0.125%, 0.25%, 0.5%). The different HA concentrations were applied either sequentially in the same cochlea or individually in different cochleae. The perfusion fluid entered from the round window and was withdrawn from basal scala vestibuli, in order to perfuse the entire perilymphatic space. Compound action potentials (CAP) were measured after each perfusion. After perfusion with increasing concentrations of HA in the order of increasing viscosity, the CAP thresholds generally increased. The threshold elevation after AP and 0.0625% HA perfusion was small or almost zero, and the 0.125% HA was a borderline case, while the higher concentrations significantly elevated CAP thresholds. Histology of the cochleae perfused with the 0.0625% HA showed an intact Reissner's membrane (RM), while in cochleae perfused with 0.125% and 0.25% HA RM was torn. Thus, the CAP threshold elevation was likely due to the broken RM, likely caused by the shear stress produced by the flow of the viscous fluid. Our results and analysis indicate that the cochlea can sustain, without a significant CAP threshold shift, up to a 1.5 Pa shear stress. Beside these finding, in the 0.125% and 0.25% HA perfusion cases, a temporary CAP threshold shift was observed, perhaps due to the presence and

  13. Cochlear perfusion with a viscous fluid

    PubMed Central

    Wang, Yi; Olson, Elizabeth S.

    2016-01-01

    The flow of viscous fluid in the cochlea induces shear forces, which could provide benefit in clinical practice, for example to guide cochlear implant insertion or produce static pressure to the cochlear partition or wall. From a research standpoint, studying the effects of a viscous fluid in the cochlea provides data for better understanding cochlear fluid mechanics. However, cochlear perfusion with a viscous fluid may damage the cochlea. In this work we studied the physiological and anatomical effects of perfusing the cochlea with a viscous fluid. Gerbil cochleae were perfused at a rate of 2.4 μL/min with artificial perilymph (AP) and sodium hyaluronate (Healon, HA) in four different concentrations (0.0625%, 0.125%, 0.25%, 0.5%). The different HA concentrations were applied either sequentially in the same cochlea or individually in different cochleae. The perfusion fluid entered from the round window and was withdrawnfrom basal scala vestibuli, in order to perfuse the entire perilymphatic space. Compound action potentials (CAP) were measured after each perfusion. After perfusion with increasing concentrations of HA in the order of increasing viscosity, the CAP thresholds generally increased. The threshold elevation after AP and 0.0625% HA perfusion was small or almost zero, and the 0.125% HA was a borderline case, while the higher concentrations significantly elevated CAP thresholds. Histology of the cochleae perfused with the 0.0625% HA showed an intact Reissner’s membrane, while in cochleae perfused with 0.125% and 0.25% HA Reissner’s membrane (RM) was torn. Thus, the CAP threshold elevation was likely due to the broken of RM, which likely caused by the shear stress produced by the flow of the viscous fluid. Our results and analysis indicate that the cochlea can sustain, without a significant CAP threshold shift, up to a 1.5 Pa shear stress. Beside these finding, in the 0.125% and 0.25% HA perfusion cases, a temporary CAP threshold shift was observed

  14. What to do with the other ear after cochlear implantation.

    PubMed

    Tange, R A; Grolman, W; Dreschler, W A

    2009-03-01

    Unilateral cochlear implantation has become a widely accepted surgical intervention for both deaf children and adults. It is a reliable and effective method to rehabilitate profound deafness. Recently the benefits of the use of a contralateral hearing aid (bimodal stimulation) with a cochlear implant became clear. Bilateral cochlear implantation benefits bilateral input into the auditory system for adults and children. To provide the binaural advantages experienced by normal hearing subjects bilateral cochlear implantation or bimodal stimulation is probably indicated. Whether to choose between both possibilities depends on many factors. Cortical auditory evoked potential (CAEP) measurements can be an important tool to decide bilateral implantation in young children. Enough residual hearing in the non-implanted ear might benefit from bimodal stimulation. New protocols are needed for the audiological management for recipients of cochlear implants.

  15. Gain and frequency tuning within the mouse cochlear apex

    SciTech Connect

    Oghalai, John S.; Raphael, Patrick D.; Gao, Simon; Lee, Hee Yoon; Groves, Andrew K.; Zuo, Jian; Applegate, Brian E.

    2015-12-31

    Normal mammalian hearing requires cochlear outer hair cell active processes that amplify the traveling wave with high gain and sharp tuning, termed cochlear amplification. We have used optical coherence tomography to study cochlear amplification within the apical turn of the mouse cochlea. We measured not only classical basilar membrane vibratory tuning curves but also vibratory responses from the rest of the tissues that compose the organ of Corti. Basilar membrane tuning was sharp in live mice and broad in dead mice, whereas other regions of the organ of Corti demonstrated phase shifts consistent with additional filtering beyond that provided by basilar membrane mechanics. We use these experimental data to support a conceptual framework of how cochlear amplification is tuned within the mouse cochlear apex. We will also study transgenic mice with targeted mutations that affect different biomechanical aspects of the organ of Corti in an effort to localize the underlying processes that produce this additional filtering.

  16. Histopathology of the inner ear relevant to cochlear implantation.

    PubMed

    Nadol, Joseph B; Eddington, Donald K

    2006-01-01

    The most common forms of severe hearing loss and deafness are related to morphological changes in the cochlea. Many individuals with such forms of hearing disorders have received cochlear implants. It has been assumed that preservation of spiral ganglion cells is important for success of cochlear implants. Preservation of ganglion cells is negatively correlated with the duration of the hearing loss. It has, however, not been possible to reveal a relationship between the degree of survival of spiral ganglion cells and performance of cochlear implants. It is important to understand the histopathological changes that follow cochlear implantation. Insertion of cochlear implants may cause trauma to the basilar membrane, the spiral lamina, and the spiral ligament. Rupture of the basilar membrane may occur. Over time, new bone forms at the cochleostomy and along the implant track. Further investigation is necessary to evaluate the causes of variability of behavioral measures of performance.

  17. Unilateral musical hallucination after a hybrid cochlear implantation.

    PubMed

    Joe, Soohyun; Park, Jangho; Lim, Jongseok; Park, Choongman

    2015-01-01

    To provide a description of musical hallucination associated with hybrid cochlear implantation. Case report. We report a case of musical hallucination secondary to hybrid cochlear implantation. Activation of electrical stimulation was closely related to onset of musical hallucination and deactivation was associated with attenuation of hallucination. Persistent musical hallucination severely impaired speech discrimination in spite of 2 years of listening rehabilitation. The hybrid cochlear implant is a relatively new surgical method, and its side effects have not been well documented. This is the first report of musical hallucination after a hybrid cochlear implantation. Also we provide evidence of the peripheral origin of musical hallucination by reporting lateralization and intensity change of hallucination by activation status of cochlear implant. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Gain and frequency tuning within the mouse cochlear apex

    NASA Astrophysics Data System (ADS)

    Oghalai, John S.; Gao, Simon; Lee, Hee Yoon; Raphael, Patrick D.; Groves, Andrew K.; Zuo, Jian; Applegate, Brian E.

    2015-12-01

    Normal mammalian hearing requires cochlear outer hair cell active processes that amplify the traveling wave with high gain and sharp tuning, termed cochlear amplification. We have used optical coherence tomography to study cochlear amplification within the apical turn of the mouse cochlea. We measured not only classical basilar membrane vibratory tuning curves but also vibratory responses from the rest of the tissues that compose the organ of Corti. Basilar membrane tuning was sharp in live mice and broad in dead mice, whereas other regions of the organ of Corti demonstrated phase shifts consistent with additional filtering beyond that provided by basilar membrane mechanics. We use these experimental data to support a conceptual framework of how cochlear amplification is tuned within the mouse cochlear apex. We will also study transgenic mice with targeted mutations that affect different biomechanical aspects of the organ of Corti in an effort to localize the underlying processes that produce this additional filtering.

  19. The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome

    PubMed Central

    Koyama, Hajime; Kashio, Akinori; Sakata, Aki; Tsutsumiuchi, Katsuhiro; Matsumoto, Yu; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

    2016-01-01

    Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome. PMID:27376080

  20. Response Properties of Cochlear Nucleus Neurons in Monkeys

    PubMed Central

    Roth, G. Linn; Recio, A.

    2009-01-01

    Much of what is known about how the cochlear nuclei participate in mammalian hearing comes from studies of non-primate mammalian species. To determine to what extent the cochlear nuclei of primates resemble those of other mammalian orders, we have recorded responses to sound in three primate species: marmosets, Cynomolgus macaques, and squirrel monkeys. These recordings show that the same types of temporal firing patterns are found in primates that have been described in other mammals. Responses to tones of neurons in the ventral cochlear nucleus have similar tuning, latencies, post-stimulus time and interspike interval histograms as those recorded in non-primate cochlear nucleus neurons. In the dorsal cochlear nucleus, too, responses were similar. From these results it is evident that insights gained from non-primate studies can be applied to the peripheral auditory system of primates. PMID:19531377

  1. Cochlear implants in children implanted in Jordan: A parental overview.

    PubMed

    Alkhamra, Rana A

    2015-07-01

    Exploring the perspective of parents on the cochlear implant process in Jordan. Sixty parents of deaf children were surveyed on the information gathering process prior to cochlear implant surgery, and their implant outcome expectations post-surgery. Whether child or parent characteristics may impact parents' post-surgical expectations was explored. Although parents used a variety of information sources when considering a cochlear implant, the ear, nose and throat doctor comprised their major source of information (60%). Parents received a range of information prior to cochlear implant but agreed (93.3%) on the need for a multidisciplinary team approach. Post-surgically, parents' expected major developments in the areas of spoken language (97%), and auditory skills (100%). Receiving education in mainstream schools (92%) was expected too. Parents perceived the cochlear implant decision as the best decision they can make for their child (98.3%). A significant correlation was found between parents contentment with the cochlear implant decision and expecting developments in the area of reading and writing (r=0.7). Child's age at implantation and age at hearing loss diagnosis significantly affected parents' post-implant outcome expectations (p<0.05). Despite the general satisfaction from the information quantity and quality prior to cochlear implant, parents agree on the need for a comprehensive multidisciplinary team approach during the different stages of the cochlear implant process. Parents' education about cochlear implants prior to the surgery can affect their post-surgical outcome expectations. The parental perspective presented in this study can help professionals develop better understanding of parents' needs and expectations and henceforth improve their services and support during the different stages of the cochlear implant process. Copyright © 2015. Published by Elsevier Ireland Ltd.

  2. From hearing screening to cochlear implantation: cochlear implants in children under 3 years of age.

    PubMed

    Profant, Milan; Kabátová, Zuzana; Simková, Ludovika

    2008-04-01

    Universal hearing screening gives a deaf child earlier diagnosis and intervention with a better chance for successful management of hearing and speech development. Universal newborn hearing screening has a major impact on early identification of deafness in children. This study evaluated the outcome of cochlear implantation in screened and non-screened deaf children. Group 1 comprised 9 deaf children diagnosed by screening; group 2 comprised 21 children diagnosed by traditional methods. The following parameters were evaluated: age at the time of diagnosis, age at the time of the first hearing aid fitting, age at the time of cochlear implantation. In children who had been using a cochlear implant for more than 2 years the results of audiological tests, category of auditory performance (CAP), and development and quality of speech were also evaluated. Hearing screening significantly reduced the age at the time of diagnosis (6.9 months vs 15.4 months) as well as the age at the time of the first hearing aid fitting (9.3 months vs 17 months) and age at the time of cochlear implantation (26 months vs 32 months). Children from the screening program had better results in speech audiometry (95% discrimination vs 84%), monosyllabic tests (62% vs 34%), CAP (level 6 vs level 5), evaluation of spontaneous speech (level 6 vs level 5), and intelligibility of speech (level 5 vs level 3.5). According to the statistical evaluation (Fisher's test) the functional results did not show significant difference.

  3. Non-penetrating round window electrode stimulation for tinnitus therapy followed by cochlear implantation.

    PubMed

    Wenzel, Gentiana I; Sarnes, Petra; Warnecke, Athanasia; Stöver, Timo; Jäger, Burkard; Lesinski-Schiedat, Anke; Lenarz, Thomas

    2015-11-01

    One main theory behind the origin of tinnitus is based on the idea that alterations of the spontaneous electrical activity within the auditory system lead to abnormal firing patterns in the affected nervous structures [1]. A possible therapeutic option is the use of electrical stimulation of the auditory nerve for the recovery or at least limitation of the abnormal firing pattern to a level that can be easily tolerated by the patient. The Tinnelec Implant consists of a single non-penetrating stimulation electrode connected to a Neurelec cochlear implant system. As a first feasibility study, before starting implantations in hearing patients, we thought to assess the potential of the Tinnelec stimulation to treat tinnitus in unilateral deaf patients, analysing hereby its effectivity and risks. Three patients suffering from unilateral tinnitus resistant to pharmacological treatment and ipsilateral severe to profound sensorineural hearing loss/deafness were implanted with a Tinnelec system between September 2007 and July 2008, at the ENT Department of Hannover Medical School. The stimulation strategy was chosen to induce alleviation of the tinnitus through suppression, masking and/or habituation and the response of each patient on the treatment was monitored using a visual analogue scale (VAS) on loudness and annoyance of tinnitus, mood of the patient, as well as the tinnitus handicap inventory (THI). All patients had a benefit from the electrical stimulation for their tinnitus (THI-score improvement of 20-70), however, not all participants profited from the Tinnelec system in same way and degree. In one patient, despite good results, the device had to be replaced with a conventional cochlear implant because of Tinnelec-independent increase in hearing loss on the contralateral ear. Additionally, due to the extension of cochlear implant indications, the devices of the other two patients have been meanwhile replaced with a conventional cochlear implant to benefit

  4. Concept formation skills in long-term cochlear implant users.

    PubMed

    Castellanos, Irina; Kronenberger, William G; Beer, Jessica; Colson, Bethany G; Henning, Shirley C; Ditmars, Allison; Pisoni, David B

    2015-01-01

    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e., language, working memory, and executive control). Relative to normally hearing (NH) peers, CI users displayed significantly poorer performance in several specific areas of concept formation, especially when multiple comparisons and relational concepts were components of the task. Differences in concept formation between CI users and NH peers were fully explained by differences in language and inhibition-concentration skills. Language skills were also found to be more strongly related to concept formation in CI users than in NH peers. The present findings suggest that complex relational concepts may be adversely affected by a period of early prelingual deafness followed by access to underspecified and degraded sound patterns and spoken language transmitted by a CI. Investigating a unique clinical population such as early-implanted prelingually deaf children with CIs can provide new insights into foundational brain-behavior relations and developmental processes.

  5. A cochlear implant phantom for evaluating CT acquisition parameters

    NASA Astrophysics Data System (ADS)

    Chakravorti, Srijata; Bussey, Brian J.; Zhao, Yiyuan; Dawant, Benoit M.; Labadie, Robert F.; Noble, Jack H.

    2017-03-01

    Cochlear Implants (CIs) are surgically implantable neural prosthetic devices used to treat profound hearing loss. Recent literature indicates that there is a correlation between the positioning of the electrode array within the cochlea and the ultimate hearing outcome of the patient, indicating that further studies aimed at better understanding the relationship between electrode position and outcomes could have significant implications for future surgical techniques, array design, and processor programming methods. Post-implantation high resolution CT imaging is the best modality for localizing electrodes and provides the resolution necessary to visually identify electrode position, albeit with an unknown degree of accuracy depending on image acquisition parameters, like the HU range of reconstruction, radiation dose, and resolution of the image. In this paper, we report on the development of a phantom that will both permit studying which CT acquisition parameters are best for accurately identifying electrode position and serve as a ground truth for evaluating how different electrode localization methods perform when using different CT scanners and acquisition parameters. We conclude based on our tests that image resolution and HU range of reconstruction strongly affect how accurately the true position of the electrode array can be found by both experts and automatic analysis techniques. The results presented in this paper demonstrate that our phantom is a versatile tool for assessing how CT acquisition parameters affect the localization of CIs.

  6. Concept Formation Skills in Long-Term Cochlear Implant Users

    PubMed Central

    Castellanos, Irina; Kronenberger, William G.; Beer, Jessica; Colson, Bethany G.; Henning, Shirley C.; Ditmars, Allison; Pisoni, David B.

    2015-01-01

    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e., language, working memory, and executive control). Relative to normally hearing (NH) peers, CI users displayed significantly poorer performance in several specific areas of concept formation, especially when multiple comparisons and relational concepts were components of the task. Differences in concept formation between CI users and NH peers were fully explained by differences in language and inhibition–concentration skills. Language skills were also found to be more strongly related to concept formation in CI users than in NH peers. The present findings suggest that complex relational concepts may be adversely affected by a period of early prelingual deafness followed by access to underspecified and degraded sound patterns and spoken language transmitted by a CI. Investigating a unique clinical population such as early-implanted prelingually deaf children with CIs can provide new insights into foundational brain–behavior relations and developmental processes. PMID:25583706

  7. Perceptual Learning and Auditory Training in Cochlear Implant Recipients

    PubMed Central

    Fu, Qian-Jie; Galvin, John J.

    2007-01-01

    Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant (CI) recipients. Recent studies have shown that most implant recipients at least partially adapt to these new patterns via passive, daily-listening experiences. Gradually introducing a speech processor parameter (eg, the degree of spectral mismatch) may provide for more complete and less stressful adaptation. Although the implant device restores hearing sensation and the continued use of the implant provides some degree of adaptation, active auditory rehabilitation may be necessary to maximize the benefit of implantation for CI recipients. Currently, there are scant resources for auditory rehabilitation for adult, postlingually deafened CI recipients. We recently developed a computer-assisted speech-training program to provide the means to conduct auditory rehabilitation at home. The training software targets important acoustic contrasts among speech stimuli, provides auditory and visual feedback, and incorporates progressive training techniques, thereby maintaining recipients’ interest during the auditory training exercises. Our recent studies demonstrate the effectiveness of targeted auditory training in improving CI recipients’ speech and music perception. Provided with an inexpensive and effective auditory training program, CI recipients may find the motivation and momentum to get the most from the implant device. PMID:17709574

  8. Musical FAVORS: Reintroducing music to adult cochlear implant users.

    PubMed

    Plant, Geoff

    2015-09-01

    Music represents a considerable challenge for many adult users of cochlear implants (CIs). Around half of adult CI users report that they do not find music enjoyable, and, in some cases, despite enhanced speech perception skills, this leads to considerable frustration and disappointment for the CI user. This paper presents suggestions to improve the musical experiences of deafened adults with CIs. Interviews with a number of adult CI users revealed that there were a number of factors which could lead to enhanced music experiences. The acronym FAVORS (familiar music, auditory-visual access, open-mindedness, and simple arrangements) summarizes the factors that have been identified, which can help CI users in their early music listening experiences. Each of these factors is discussed in detail, along with suggestions for how they can be used in therapy sessions. The use of a group approach (music focus groups) is also discussed and an overview of the approach and exercises used is presented. The importance of live music experiences is also discussed.

  9. [The impact of cochlear implants on the quality of life of patients with single-sided deafness].

    PubMed

    Rösli, M; Hoth, S; Baumann, I; Praetorius, M; Plinkert, P K

    2015-03-01

    Unilaterally deaf patients are increasingly supplied with a cochlear implant (CI). In the present study the change in quality of life following implantation was investigated. The study comprised 20 postlingual CI recipients with single-sided deafness, who were divided into two groups: "normal hearing" (group 1) and "moderate impairment" (group 2) contralaterally. Their quality of life was determined using four standardized questionnaires (NCIQ, HPS, APHAB, HHIE) and a visual analogue scale. With the exception of the sensation of loud everyday sounds (APHAB AV scale) reported by patients from group 2, all study participants benefited significantly from the implantation. The problems caused by the aversiveness of loud everyday sounds can be explained by the enhanced transmission of high frequencies and the associated unfamiliar sensations by the CI system. The effects of deafness duration and response shift remain to be investigated. Cochlear implantation for unilaterally deaf patients was found to be a legitimate and meaningful rehabilitation measure.

  10. CSF gusher in cochlear implantation: The risk of missing CT evidence of a cochlear base defect in the presence of otherwise normal cochlear anatomy.

    PubMed

    Cabbarzade, Cavid; Sennaroglu, Levent; Süslü, Nilda

    2015-07-01

    Intraoperative cerebrospinal fluid (CSF) leakages from the cochleostomy site - known as gushers - are a serious complication of cochlear implantation surgery in cases of congenital deafness. They occur as the result of abnormal communication between CSF in the internal auditory canal and perilymph in the cochlea. Gushers are well recognized as occurring in a proportion of cases in which there is a clearly visible congenital malformation of the cochlea. In this report, we describe two cases in which pre-operative computed tomography (CT) scanning of the cochlea was initially reported as normal but gushers occurred during cochlear implant surgery. In both cases, more detailed review of the CT scans (peroperatively in the first case, pre-operatively in the second case) showed a defect at the cochlear base, in the absence of any other cochlear malformation. The aim of this paper is to draw attention to the risk of missing this abnormality and to encourage careful inspection of the cochlear base on CT scans in all cases, even when the rest of the cochlear appears normal.

  11. Cochlear Function Monitoring After Spinal Anesthesia

    PubMed Central

    Janecka-Placek, Agata; Lisowska, Grażyna; Paradysz, Andrzej; Misiołek, Hanna

    2015-01-01

    Background The aim of the study was to examine the effect of spinal anesthesia on the function of cochlear outer hair cells (OHCs), determined by means of objective distortion product otoacoustic emissions (DPOAE) testing. To the best of our knowledge, our study was the second OAE-based analysis of cochlear function during spinal anesthesia, and the only experiment including such a large group of patients. Material/Methods The study included 20 patients (18 men and 2 women) subjected to a scheduled uretherorenoscopic lithotripsy with routine spinal anesthesia with 10 mg (2 ml) of 0.5% hyperbaric bupivacaine and 50 μg (1 ml) of fentanyl. The levels of DPOAEs and background noise at 1000–6000 Hz were recorded prior to and immediately after the anesthesia, and on the postoperative day 2. Results We did not find significant differences between DPOAEs values recorded prior to and immediately after the anesthesia. The only exception pertained to 5652 Hz, at which a significantly higher level of DPOAEs was observed immediately after the anesthesia. The levels of DPOAEs at 2002 Hz and 2380 Hz collected on the postoperative day 2 were significantly higher than the respective baseline values. Irrespective of the frequency and time of testing, we did not find any significant differences between the recorded levels of background noise. Conclusions Our findings point to the lack of a detrimental effect of spinal anesthesia on objectively evaluated cochlear function, and thus suggest that this method is safe, even for OHCs, which are extremely susceptible to exogenous and endogenous injuries. PMID:26377393

  12. Faster phonological processing and right occipito-temporal coupling in deaf adults signal poor cochlear implant outcome

    PubMed Central

    Lazard, Diane S.; Giraud, Anne-Lise

    2017-01-01

    The outcome of adult cochlear implantation is predicted positively by the involvement of visual cortex in speech processing, and negatively by the cross-modal recruitment of the right temporal cortex during and after deafness. How these two neurofunctional predictors concur to modulate cochlear implant (CI) performance remains unclear. In this fMRI study, we explore the joint involvement of occipital and right hemisphere regions in a visual-based phonological task in post-lingual deafness. Intriguingly, we show that some deaf subjects perform faster than controls. This behavioural effect is associated with reorganized connectivity across bilateral visual, right temporal and left inferior frontal cortices, but with poor CI outcome. Conversely, preserved normal-range reaction times are associated with left-lateralized phonological processing and good CI outcome. These results suggest that following deafness, involvement of visual cortex in the context of reorganized right-lateralized phonological processing compromises its availability for audio-visual synergy during adaptation to CI. PMID:28348400

  13. Racemic alkaloids from the fungus Ganoderma cochlear.

    PubMed

    Wang, Xin-Long; Dou, Man; Luo, Qi; Cheng, Li-Zhi; Yan, Yong-Ming; Li, Rong-Tao; Cheng, Yong-Xian

    2017-01-01

    Seven pairs of new alkaloid enantiomers, ganocochlearines C-I (1, 3-8), and three pairs of known alkaloids were isolated from the fruiting bodies of Ganoderma cochlear. The chemical structures of new compounds were elucidated on the basis of 1D and 2D NMR data. The absolute configurations of compounds 1, 3-10 were assigned by ECD calculations. Biological activities of these isolates against renal fibrosis were accessed in rat normal or diseased renal interstitial fibroblast cells. Importantly, the plausible biosynthetic pathway for this class of alkaloids was originally proposed.

  14. Spatial channel interactions in cochlear implants

    NASA Astrophysics Data System (ADS)

    Tang, Qing; Benítez, Raul; Zeng, Fan-Gang

    2011-08-01

    The modern multi-channel cochlear implant is widely considered to be the most successful neural prosthesis owing to its ability to restore partial hearing to post-lingually deafened adults and to allow essentially normal language development in pre-lingually deafened children. However, the implant performance varies greatly in individuals and is still limited in background noise, tonal language understanding, and music perception. One main cause for the individual variability and the limited performance in cochlear implants is spatial channel interaction from the stimulating electrodes to the auditory nerve and brain. Here we systematically examined spatial channel interactions at the physical, physiological, and perceptual levels in the same five modern cochlear implant subjects. The physical interaction was examined using an electric field imaging technique, which measured the voltage distribution as a function of the electrode position in the cochlea in response to the stimulation of a single electrode. The physiological interaction was examined by recording electrically evoked compound action potentials as a function of the electrode position in response to the stimulation of the same single electrode position. The perceptual interactions were characterized by changes in detection threshold as well as loudness summation in response to in-phase or out-of-phase dual-electrode stimulation. To minimize potentially confounding effects of temporal factors on spatial channel interactions, stimulus rates were limited to 100 Hz or less in all measurements. Several quantitative channel interaction indexes were developed to define and compare the width, slope and symmetry of the spatial excitation patterns derived from these physical, physiological and perceptual measures. The electric field imaging data revealed a broad but uniformly asymmetrical intracochlear electric field pattern, with the apical side producing a wider half-width and shallower slope than the basal

  15. Spatial channel interactions in cochlear implants.

    PubMed

    Tang, Qing; Benítez, Raul; Zeng, Fan-Gang

    2011-08-01

    The modern multi-channel cochlear implant is widely considered to be the most successful neural prosthesis owing to its ability to restore partial hearing to post-lingually deafened adults and to allow essentially normal language development in pre-lingually deafened children. However, the implant performance varies greatly in individuals and is still limited in background noise, tonal language understanding, and music perception. One main cause for the individual variability and the limited performance in cochlear implants is spatial channel interaction from the stimulating electrodes to the auditory nerve and brain. Here we systematically examined spatial channel interactions at the physical, physiological, and perceptual levels in the same five modern cochlear implant subjects. The physical interaction was examined using an electric field imaging technique, which measured the voltage distribution as a function of the electrode position in the cochlea in response to the stimulation of a single electrode. The physiological interaction was examined by recording electrically evoked compound action potentials as a function of the electrode position in response to the stimulation of the same single electrode position. The perceptual interactions were characterized by changes in detection threshold as well as loudness summation in response to in-phase or out-of-phase dual-electrode stimulation. To minimize potentially confounding effects of temporal factors on spatial channel interactions, stimulus rates were limited to 100 Hz or less in all measurements. Several quantitative channel interaction indexes were developed to define and compare the width, slope and symmetry of the spatial excitation patterns derived from these physical, physiological and perceptual measures. The electric field imaging data revealed a broad but uniformly asymmetrical intracochlear electric field pattern, with the apical side producing a wider half-width and shallower slope than the basal

  16. [(Re)habilitation after cochlear implantation].

    PubMed

    Diller, G

    2009-07-01

    Over the last years, indications for cochlear implants (CIs) have changed dramatically. The benefits depend on the preconditions of the individual patient as well as on the subsequent (re)habilitation. Therefore, many variables influencing the hearing and speech perception of a CI user must be kept in mind. As an example, the special situation of children having Turkish as their mother tongue is described. The most convincing argument concerning (re)habilitation is its benefit. Indeed, this benefit represents the final standard of quality and serves as the yardstick for standard assessments of (re)habilitation quality. CI (re)habilitation includes medical, pedagogical, audiological, hearing and speech, and psychological therapeutic aspects.

  17. Cochlear Micromechanics (Part I): A moderated discussion

    NASA Astrophysics Data System (ADS)

    Neely, Stephen T.

    2015-12-01

    The following is an edited transcript of a recorded discussion session on the topic of "Cochlear Micromechanics". The discussion, moderated by the author, took place at the 12th International Workshop on the Mechanics of Hearing held at Cape Sounio, Greece, in June 2014. All participants knew that the session was being recorded. In view of both the spontaneous nature of the discussion and the editing, however, this transcript may not represent the considered or final views of the participants, and may not represent a consensus of experts in the field. The reader is advised to consult additional independent publications.

  18. Cochlear Micromechanics (Part II): A moderated discussion

    NASA Astrophysics Data System (ADS)

    Gummer, Anthony W.; Mountain, David C.

    2015-12-01

    The following is an edited transcript of a recorded discussion session on the topic of "Cochlear Micromechanics". The discussion, moderated by the authors, took place at the 12th International Workshop on the Mechanics of Hearing held at Cape Sounio, Greece, in June 2014. All participants knew that the session was being recorded. In view of both the spontaneous nature of the discussion and the editing, however, this transcript may not represent the considered or final views of the participants, and may not represent a consensus of experts in the field. The reader is advised to consult additional independent publications.

  19. Cochlear microphonics generated by microwave pulses.

    PubMed

    Chou, C; Galambos, R; Guy, A W; Lovely, R H

    1975-12-01

    Oscillations at 50 kHz have been recorded from the round window of guinea pigs during irradiation by 918-MHz pulsed microwaves. The oscillations promptly follow the stimulas, outlast it by about 200 musec and measure to 50 muV in amplitude. They precede the auditory nerve's response and disappear with death. They are interpreted to be a cochlear microphonic and hence to demonstrate that the microwave auditory effect, in the guinea pig at least, is accompanied by a mechanical disturbance of the hari cells of the cochlea.

  20. Access to cochlear implants: Time to reflect.

    PubMed

    Raine, Christopher; Atkinson, Helen; Strachan, David R; Martin, Jane M

    2016-04-01

    Cochlear implant (CI) intervention is expensive and accessed mainly by developed countries. The introduction of Universal Newborn Hearing Screening and funding via a public health service give children better access to CIs. However for adults large disparities exist between utilization and estimated prevalence. In the UK CI selection criteria are restrictive compared with many other countries. Improved audiological awareness and screening programmes for adults would improve access to hearing technologies that would improve health and quality of life. Hearing loss itself has significant medical and financial burdens on society and by investing in early intervention and using best technology this would mitigate some of the rising associated medical costs.

  1. Microflora of Retained Intracochlear Electrodes from Infected Cochlear Implants.

    PubMed

    Varadarajan, Varun V; Dirain, Carolyn O; Antonelli, Patrick J

    2017-07-01

    Objectives Cochlear implant infections may be refractory to medical management and require device removal with subsequent reimplantation. During device removal, the intracochlear electrode array is commonly left in place to prevent obliteration of the cochlear lumen. If the electrode is colonized with pathogens, this risks contaminating the replacement implant. In this study, we compare the microorganisms detected on infected cochlear implants against those on the retained electrode using culture and microbial gene-sequencing techniques. Study Design Prospective single-cohort study. Setting Tertiary medical center. Subjects and Methods Six patients with refractory cochlear implant infections had the receiver-stimulator and extracochlear electrode removed to facilitate treatment of the infection. The intracochlear electrode was removed at (delayed) reimplantation. Implant specimens were analyzed by microbial culture and 16S DNA gene sequencing. Results Staphylococcus aureus was the organism most commonly identified. None of the 6 patients' intracochlear electrodes yielded microbes by culture. Two intracochlear electrodes revealed bacterial species, and 1 revealed fungal species by gene sequencing. There was no correlation between the microbes on the infected extracochlear implants and the retained intracochlear electrodes. All subjects underwent reimplantation after resolution of their infections. One of 6 subjects developed a second infection after reimplantation, with S aureus in the primary and secondary infections. Conclusions The intracochlear electrodes of infected cochlear implants carry a low microbial burden. Preserving intracochlear electrodes upon removal of infected cochlear implants appears to carry a low risk of contaminating a replacement cochlear implant.

  2. Electrode migration after cochlear implant surgery: more common than expected?

    PubMed

    Dietz, Aarno; Wennström, Minna; Lehtimäki, Antti; Löppönen, Heikki; Valtonen, Hannu

    2016-06-01

    The overall complication rate of cochlear implant surgery is low and so-called electrode failures (electrode migration, misplacement, etc.,) account for only a minority of all complications. The aim of this study was to explore the prevalence of electrode migration as the cause for increased impedance values and non-auditory stimulation in the basal channels. Within the scope of a quality control process, the cochlear implant database of the Kuopio University Hospital (Finland) was reviewed. Patients with gradual elevation of impedance values and/or non-auditory stimulation of the basal electrode channels were re-examined and cone-beam computed tomography was administered. There were 162 cochlear implant recipients and 201 implanted devices registered in the database. A total of 18 patients (18 devices) were identified having significantly increased impedance values or non-auditory stimulation of the basal electrodes. Cone-beam computed tomography revealed extra-cochlear electrodes in 12 of these patients due to the migration of the electrode array. All extruded electrodes were lateral wall electrodes, i.e., straight electrode arrays (Cochlear CI422 and Med-El devices). The most common feature of electrode migration was the gradual increase of the impedance values in the basal electrodes, even though telemetry could also be unsuspicious. Electrode migration after cochlear implant surgery may be more common than previously reported. At surgery, special attention should be paid to the reliable fixation of the electrode array. This study underlines the importance of postoperative imaging after cochlear implant surgery.

  3. Efferent Feedback Minimizes Cochlear Neuropathy from Moderate Noise Exposure

    PubMed Central

    Maison, Stéphane F.; Usubuchi, Hajime; Liberman, M. Charles

    2013-01-01

    Although protective effects of the cochlea’s efferent feedback pathways have been well documented, prior work has focused on hair cell damage and cochlear threshold elevation and, correspondingly, on the high sound pressure levels (> 100 dB SPL) necessary to produce them. Here we explore the noise-induced loss of cochlear neurons that occurs with lower intensity exposures and in the absence of permanent threshold shifts. Using confocal microscopy to count synapses between hair cells and cochlear nerve fibers, and using measurement of auditory brainstem responses and otoacoustic emissions to assess cochlear pre- and post-synaptic function, we compare the damage from a weeklong exposure to moderate-level noise (84 dB SPL) in mice with varying degrees of cochlear de-efferentation induced by surgical lesion to the olivocochlear pathway. Such exposure causes minimal acute threshold shift and no chronic shifts in mice with normal efferent feedback. In de-efferented animals, there was up to 40% loss of cochlear nerve synapses and a corresponding decline in the amplitude of the auditory brainstem response. Quantitative analysis of the de-efferentation in inner vs. outer hair cell areas suggested that outer hair cell efferents are most important in minimizing this neuropathy, presumably by virtue of their sound-evoked feedback reduction of cochlear amplification. The moderate nature of this acoustic overexposure suggests that cochlear neurons are at risk even in everyday acoustic environments, and, thus, that the need for cochlear protection is plausible as a driving force in the design of this feedback pathway. PMID:23536069

  4. Galvanic disruption of vestibulospinal postural control by cochlear implant devices.

    PubMed

    Black, F O; Wall, C; O'Leary, D P; Bilger, R C; Wolf, R V

    1978-12-01

    All subjects with implanted cochlear stimulators demonstrated evidence of abnormal postural stability without their stimulators activated. Instability increased when they were tested with cochlear stimulation units turned on, and additional instability was demonstrated in four of these subjects when tested in noise. These findings suggest that the electrical stimulation delivered by the cochlear prosthesis is not limited to the auditory system. The precise characteristics of electrical stimulation devices designed for stimulations limited to the cochlea and their spurious effects upon motor performance should be investigated. The design of future intralabyrinthine auditory electrical prostheses must include hardware designs and stimulus paradigms that avoid undesirable vestibular system stimulation.

  5. Von Békésy and cochlear mechanics

    PubMed Central

    Duifhuis, Hendrikus; Steele, Charles R.

    2012-01-01

    Georg Békésy laid the foundation for cochlear mechanics, foremost by demonstrating the traveling wave that is the substrate for mammalian cochlear mechanical processing. He made mechanical measurements and physical models in order to understand that fundamental cochlear response. In this tribute to Békésy we make a bridge between modern traveling wave observations and those of Békésy, discuss the mechanical properties and measurements that he considered to be so important, and touch on the range of computational traveling wave models. PMID:22633943

  6. The spiral staircase: Tonotopic microstructure and cochlear tuning

    NASA Astrophysics Data System (ADS)

    Shera, Christopher A.

    2015-12-01

    Cochlear frequency-position maps are predicted to manifest a staircase-like structure comprising plateaus of nearly constant characteristic frequency separated by abrupt discontinuities. The height and width of the stair steps are determined by parameters of cochlear frequency tuning and vary with location in the cochlea. The step height is approximately equal to the critical band, and the step width matches that of the spatial excitation pattern produced by a low-level pure tone. Stepwise tonotopy is an emergent property arising from wave reflection and interference within the cochlea. Possible relationships between the microstructure of the cochlear map and the tiered tonotopy observed in the inferior colliculus are explored.

  7. Cochlear Nerve Action Potential Monitoring for Preserving Function of an Unseen Cochlear Nerve in Vestibular Schwannoma Surgery.

    PubMed

    Ishikawa, Mami; Kojima, Atsuhiro; Terao, Satoshi; Nagai, Mutsumi; Kusaka, Gen; Naritaka, Heiji

    2017-07-26

    Intraoperative monitoring of cochlear nerve action potential (CNAP) has been used in patients with small vestibular schwannoma (<15 mm) to preserve cochlear nerve function. We performed surgery for a larger vestibular schwannoma under CNAP monitoring with the aim of preserving cochlear nerve function, and compared the data with findings from 10 patients with hemifacial spasm who underwent microvascular decompression surgery. We report the case of a patient with a 26-mm vestibular schwannoma and normal hearing function who underwent neurosurgery under electrophysiological monitoring of the facial and cochlear nerves. Amplitudes of evoked facial muscle responses were maintained at approximately 70% during the operation. The latency of wave V on brainstem auditory evoked potential (BAEP) increased by 0.5 ms, and amplitude was maintained at approximately 70% of the value at the beginning of the operation. Latencies of P1, N1, and P2 on CNAP did not change intraoperatively. These latencies were comparable to those of 10 normal patients with hemifacial spasm. CNAP monitoring proved very useful in confirming the location of the cochlear nerve in the operative field and preserving cochlear nerve function. Both facial nerve function and hearing acuity were completely preserved after tumor removal, and wave V latency on BAEP returned to normal and was maintained in the normal range for at least 2 years. CNAP monitoring is extremely useful for preserving the function of the unseen cochlear nerve during vestibular schwannoma surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Cochlear Implants Special Issue Article: Vocal Emotion Recognition by Normal-Hearing Listeners and Cochlear Implant Users

    PubMed Central

    Luo, Xin; Fu, Qian-Jie; Galvin, John J.

    2007-01-01

    The present study investigated the ability of normal-hearing listeners and cochlear implant users to recognize vocal emotions. Sentences were produced by 1 male and 1 female talker according to 5 target emotions: angry, anxious, happy, sad, and neutral. Overall amplitude differences between the stimuli were either preserved or normalized. In experiment 1, vocal emotion recognition was measured in normal-hearing and cochlear implant listeners; cochlear implant subjects were tested using their clinically assigned processors. When overall amplitude cues were preserved, normal-hearing listeners achieved near-perfect performance, whereas listeners with cochlear implant recognized less than half of the target emotions. Removing the overall amplitude cues significantly worsened mean normal-hearing and cochlear implant performance. In experiment 2, vocal emotion recognition was measured in listeners with cochlear implant as a function of the number of channels (from 1 to 8) and envelope filter cutoff frequency (50 vs 400 Hz) in experimental speech processors. In experiment 3, vocal emotion recognition was measured in normal-hearing listeners as a function of the number of channels (from 1 to 16) and envelope filter cutoff frequency (50 vs 500 Hz) in acoustic cochlear implant simulations. Results from experiments 2 and 3 showed that both cochlear implant and normal-hearing performance significantly improved as the number of channels or the envelope filter cutoff frequency was increased. The results suggest that spectral, temporal, and overall amplitude cues each contribute to vocal emotion recognition. The poorer cochlear implant performance is most likely attributable to the lack of salient pitch cues and the limited functional spectral resolution. PMID:18003871

  9. Effects of cochlear ablation on amino acid concentrations in the chinchilla posteroventral cochlear nucleus, as compared to rat.

    PubMed

    Godfrey, D A; Chen, K; Godfrey, M A; Jin, Y-M; Robinson, K T; Hair, C

    2008-06-12

    Using a microchemical approach, we measured changes of amino acid concentrations in the chinchilla caudal posteroventral cochlear nucleus (PVCN) after cochlear ablation to determine to what extent slow decreases of glutamate and aspartate concentrations after carboplatin treatment resulted from slower effects of cochlear damage in chinchillas than in rats and guinea pigs, as opposed to effects of carboplatin treatment being slower than those of cochlear ablation. Our results indicate that both factors are involved: decreases of glutamate and aspartate concentrations after cochlear ablation are much slower in chinchillas than in rats and guinea pigs, but they are much faster than the decreases after carboplatin treatment. Further, aspartate and glutamate concentrations in the chinchilla caudal PVCN decreased by larger amounts after cochlear ablation than in rats or guinea pigs, and there was a transient increase of aspartate concentration at short survival times. Detailed mapping of amino acid concentrations in the PVCN of a chinchilla with 1 month survival after cochlear ablation and a rat with 7 days' survival indicated that the reductions of glutamate and aspartate occurred throughout the PVCN but were somewhat larger in ventral and caudal parts in chinchilla. Any decreases in the adjacent granular region were very small. There were also sustained bilateral decreases in concentrations of other amino acids, notably GABA and glycine, in the caudal PVCN of cochlea-ablated chinchillas but not rats. The effects of cochlear ablation on the concentrations of most of these other amino acids in chinchilla caudal PVCN differed from those of carboplatin treatment. Thus, although a major effect of auditory nerve damage on the cochlear nucleus-decreases of glutamate and aspartate concentrations-occurs across species and types of lesions, the details of timing and magnitude and the effects on other amino acids can vary greatly.

  10. [Discrimination of musical pitch with cochlear implants].

    PubMed

    Haumann, S; Mühler, R; Ziese, M; von Specht, H

    2007-08-01

    Numerous people with cochlear implants (CI) report difficulties in listening to music even though they understand speech quite well. One reason for this is a limited perception of pitch and timbre. In this study ability of adult CI subjects to discriminate musical pitch is investigated. In two psychoacoustic experiments, each conducted in 10 adult CI subjects provided with MED-EL Combi 40+ cochlear implant devices and a control group of subjects with normal hearing, individual discrimination abilities for musical pitch perception were determined. To investigate the influence of the group of instruments on discrimination ability, stimuli representing four different groups of instruments were used: woodwind (clarinet), brass (trumpet), strings (violin) and keyboard instruments (piano). The discrimination thresholds determined varied between individual CI subjects, and on average they were significantly higher for the piano than for the other three instruments. The results show that in subjects with CI pitch perception differs from instrument to instrument and is in general worse than in persons with normal hearing.

  11. Stochastic beamforming for cochlear implant coding

    NASA Astrophysics Data System (ADS)

    Morse, Robert P.; Holmes, Stephen D.; Shulgin, Boris; Nikitin, Alexander; Stocks, Nigel G.

    2007-06-01

    Cochlear implants are prosthetic devices used to provide hearing to people who would otherwise be profoundly deaf. The deliberate addition of noise to the electrode signals could increase the amount of information transmitted, but standard cochlear implants do not replicate the noise characteristic of normal hearing because if noise is added in an uncontrolled manner with a limited number of electrodes then it will almost certainly lead to worse performance. Only if partially independent stochastic activity can be achieved in each nerve fibre can mechanisms like suprathreshold stochastic resonance be effective. We are investigating the use of stochastic beamforming to achieve greater independence. The strategy involves presenting each electrode with a linear combination of independent Gaussian noise sources. Because the cochlea is filled with conductive salt solutions, the noise currents from the electrodes interact and the effective stimulus for each nerve fibre will therefore be a different weighted sum of the noise sources. To some extent therefore, the effective stimulus for a nerve fibre will be independent of the effective stimulus of neighbouring fibres. For a particular patient, the electrode position and the amount of current spread are fixed. The objective is therefore to find the linear combination of noise sources that leads to the greatest independence between nerve discharges. In this theoretical study we show that it is possible to get one independent point of excitation (one null) for each electrode and that stochastic beamforming can greatly decrease the correlation between the noise exciting different regions of the cochlea.

  12. Musical pitch discrimination by cochlear implant users.

    PubMed

    Ping, Lichuan; Yuan, Meng; Feng, Haihong

    2012-05-01

    The main goal of this study was to investigate the effects of acoustic characteristics, including timbre and fundamental frequency (F0), on the musical pitch discrimination of cochlear implant users. Eight postlingually deafened cochlear implant users were recruited, along with 8 control subjects with normal hearing. Pitch discrimination tests were carried out using test stimuli from 4 musical instruments plus synthetic complex stimuli. Three reference tones with different F0s were used. The mean difference limens were 1.8 to 10.7 semitones in the just-noticeable difference task and 2.1 to 13.6 semitones in the pitch-direction discrimination task for different timbre and F0 combinations. Three-way analysis of variance showed that the acoustic characteristics of the musical stimuli, such as timbre and F0, significantly influenced pitch discrimination performance. Acoustic characteristics determine the complexity of the electrical stimulation pattern, which directly affects performance in pitch discrimination. A place pattern with a clear and regular low-order harmonic structure is most important for good pitch discrimination. A clear F0-related temporal pattern is also useful when the F0 is low. Pitch perception performance will worsen when there is interference in the high-frequency channels.

  13. Frequency modulation detection in cochlear implant subjects

    NASA Astrophysics Data System (ADS)

    Chen, Hongbin; Zeng, Fan-Gang

    2004-10-01

    Frequency modulation (FM) detection was investigated in acoustic and electric hearing to characterize cochlear-implant subjects' ability to detect dynamic frequency changes and to assess the relative contributions of temporal and spectral cues to frequency processing. Difference limens were measured for frequency upward sweeps, downward sweeps, and sinusoidal FM as a function of standard frequency and modulation rate. In electric hearing, factors including electrode position and stimulation level were also studied. Electric hearing data showed that the difference limen increased monotonically as a function of standard frequency regardless of the modulation type, the modulation rate, the electrode position, and the stimulation level. In contrast, acoustic hearing data showed that the difference limen was nearly a constant as a function of standard frequency. This difference was interpreted to mean that temporal cues are used only at low standard frequencies and at low modulation rates. At higher standard frequencies and modulation rates, the reliance on the place cue is increased, accounting for the better performance in acoustic hearing than for electric hearing with single-electrode stimulation. The present data suggest a speech processing strategy that encodes slow frequency changes using lower stimulation rates than those typically employed by contemporary cochlear-implant speech processors. .

  14. Profile of patients assessed for cochlear implants.

    PubMed

    Barbosa, Maria Helena de Magalhães; Felix, Felippe; Ribeiro, Marcia Gonçalves; Tomita, Shiro; Pinheiro, Cintia; Baptista, Monica Machado

    2014-01-01

    Knowledge of the characteristics related to profound hearing loss is a matter of great importance, as it allows for the etiological and prognostic identification and strategic planning for public health interventions. To assess the different etiologies of hearing loss, age at diagnosis of the hearing loss, its relation to language acquisition, and the age at the first consultation in this service for cochlear implant assessment. This was a historical cohort, cross-sectional study, using retrospective analysis of the records of 115 patients with confirmed sensorineural hearing loss, who were followed in a university hospital, based on gender, age of hearing loss, age at the first consultation, language, and hearing loss etiology. The majority of patients assessed for cochlear implants attend the first consultation when they are older than one year (an alarming mean of 3.8 years in the prelingual group) in spite of the early diagnosis of hearing loss. This reflects an already deficient health care system, in terms of referral. The idiopathic cause remains the most frequently identified. Among the known causes, the most prevalent are perinatal causes and meningitis. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. Use of FM System in cochlear implant.

    PubMed

    Silva, Joice de Moura; Pizarro, Luzia Maria Pozzobom Ventura; Tanamati, Liège Franzini

    2017-03-09

    To verify the use of the Frequency Modulation System (FM) and its benefit for cochlear implant users. Analysis of medical records of 113 users of Cochlear Implants (CI) adapted with FM System kits between September 2013 and September 2015 after publication of the Administrative Rule 1.274 of 6/25/2013, regarding the results of the speech perception tests (SPT) and the Listening Inventory For Education - Revised (LIFE-R) and Classroom Participation Questionnaire (CPQ). The use of the FM System in the classroom was effective for 47.15% of the patients, while 21.42% did not use it. There was no correlation between the use of the FM System and the age group of patients. The results of the SPT regarding noise were statistically better with the use of FM System. Regarding the questionnaires, the score obtained in the LIFE-R in the situation "after use of the FM System" was statistically better for the item "listening situations in the classroom" and in the CPQ, for the items "teacher understanding" and "positive aspects", when compared to the situation "without using the FM System". Patients benefitting from the concession of the FM System made use of the device in the classroom and improvement in both speech perception in noisy environments and subjective impression of the understanding of teachers' speech in the classroom was observed after the use of the FM System.

  16. Better speech recognition with cochlear implants

    NASA Astrophysics Data System (ADS)

    Wilson, Blake S.; Finley, Charles C.; Lawson, Dewey T.; Wolford, Robert D.; Eddington, Donald K.; Rabinowitz, William M.

    1991-07-01

    HIGH levels of speech recognition have been achieved with a new sound processing strategy for multielectrode cochlear implants. A cochlear implant system consists of one or more implanted elec-trodes for direct electrical activation of the auditory nerve, an external speech processor that transforms a microphone input into stimuli for each electrode, and a transcutaneous (rf-link) or per-cutaneous (direct) connection between the processor and the elec-trodes. We report here the comparison of the new strategy and a standard clinical processor. The standard compressed analogue (CA) processor1,2 presented analogue waveforms simultaneously to all electrodes, whereas the new continuous interleaved sampling (CIS) strategy presented brief pulses to each electrode in a nonover-lapping sequence. Seven experienced implant users, selected for their excellent performance with the CA processor, participated as subjects. The new strategy produced large improvements in the scores of speech reception tests for all subjects. These results have important implications for the treatment of deafness and for minimal representations of speech at the auditory periphery.

  17. Methods of Hearing Preservation during Cochlear Implantation.

    PubMed

    Khater, Ahmed; El-Anwar, Mohammad Waheed

    2017-07-01

    Introduction  Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives  The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis  We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in "study selection". The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion  Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.

  18. Music Perception of Cochlear Implant Recipients with Implications for Music Instruction: A Review of Literature.

    PubMed

    Hsiao, Feilin; Gfeller, Kate

    2012-03-23

    This review of literature presents a systematic analysis of the capabilities and limitations of cochlear implant recipients regarding music perception. Specifically, it a) analyzes individual components of music (e.g., rhythm, timbre, and pitch) as they interface with the technical characteristics of cochlear implants and the perceptual abilities of cochlear implant recipients; and b) describes accommodations for music instruction that support successful participation of children with cochlear implants. This article consolidates research studies from various disciplines (audiology, hearing science, speech-language pathology, cochlear implants, and music therapy) to provide practical recommendations for educators in fostering the musical growth of children with cochlear implants.

  19. Reduction in spread of excitation from current focusing at multiple cochlear locations in cochlear implant users.

    PubMed

    Padilla, Monica; Landsberger, David M

    2016-03-01

    Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.

  20. Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

    PubMed Central

    Padilla, Monica; Landsberger, David M.

    2016-01-01

    Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy. PMID:26778546

  1. Cochlear Implants Keep Twin Sisters Learning, Discovering Together

    MedlinePlus

    ... Current Issue Past Issues Special Section: Focus on Communication Cochlear Implants Past Issues / Fall 2008 Table of ... from the National Institute on Deafness and Other Communication Disorders (NIDCD), he studies how the language skills ...

  2. Programming, Care, and Troubleshooting of Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hedley-Williams, Andrea J.; Sladen, Douglas P.; Tharpe, Anne Marie

    2003-01-01

    This article provides an overview of current cochlear implant technology, programming strategies, troubleshooting, and care techniques. It considers: device components, initial stimulation, speech coding strategies, use and care, troubleshooting, and the classroom environment. (Contains references.) (DB)

  3. Auditory Mechanics of the Tectorial Membrane and the Cochlear Spiral

    PubMed Central

    Gavara, Núria; Manoussaki, Daphne; Chadwick, Richard S.

    2012-01-01

    Purpose of review This review is timely and relevant since new experimental and theoretical findings suggest that cochlear mechanics from the nanoscale to the macroscale are affected by mechanical properties of the tectorial membrane and the spiral shape. Recent findings Main tectorial membrane themes covered are i) composition and morphology, ii) nanoscale mechanical interactions with the outer hair cell bundle, iii) macroscale longitudinal coupling, iv) fluid interaction with inner hair cell bundles, v) macroscale dynamics and waves. Main cochlear spiral themes are macroscale low-frequency energy focusing and microscale organ of Corti shear gain. Implications Findings from new experimental and theoretical models reveal exquisite sensitivity of cochlear mechanical performance to tectorial membrane structural organization, mechanics, and its positioning with respect to hair bundles. The cochlear spiral geometry is a major determinant of low frequency hearing. Suggestions are made for future research directions. PMID:21785353

  4. The mathematical abilities of children with cochlear implants.

    PubMed

    Edwards, Alexandra; Edwards, Lindsey; Langdon, Dawn

    2013-01-01

    Research has shown that cochlear implants give rise to improvements in speech recognition and production in children with profound hearing loss but very few studies have explored mathematical abilities in these children. The current study compared the mathematical abilities of 24 children with cochlear implants (mean age 10 years 1 month) to a control group of 22 hearing children (mean age 9 years 8 months). The math questions were categorized into questions that tapped into arithmetic or geometrical reasoning. It was predicted that the cochlear implant group would perform below the hearing group on the arithmetic questions but not the geometrical reasoning questions. Unexpectedly, the results showed that the cochlear implant group performed significantly below the hearing group on both types of math questions, but that this difference was mediated by language skill as assessed by vocabulary knowledge. The clinical implications of these results and possible future research results are considered.

  5. Vibrational modes and damping in the cochlear partition

    NASA Astrophysics Data System (ADS)

    O'Maoiléidigh, Dáibhid; Hudspeth, A. J.

    2015-12-01

    It has been assumed in models of cochlear mechanics that the primary role of the cochlear active process is to counteract the damping of the basilar membrane, the vibration of which is much larger in a living animal than post mortem. Recent measurements of the relative motion between the reticular lamina and basilar membrane imply that this assumption is incorrect. We propose that damping is distributed throughout the cochlear partition rather than being concentrated in the basilar membrane. In the absence of significant damping, the cochlear partition possesses three modes of vibration, each associated with its own locus of Hopf bifurcations. Hair-cell activity can amplify any of these modes if the system's operating point lies near the corresponding bifurcation. The distribution of damping determines which mode of vibration predominates. For physiological levels of damping, only one mode produces a vibration pattern consistent with experimental measurements of relative motion and basilar-membrane motion.

  6. Audiological findings from an adult with thin cochlear nerves

    PubMed Central

    Prabhu, Prashanth; Shivaswamy, Jyothi

    2017-01-01

    Summary Reported here are audiological findings from an adult with thin cochlear nerves. Magnetic resonance imaging (MRI) revealed that he had a thinner cochlear nerve in the left ear than in the right ear. He had a higher degree of hearing loss in the left ear and poor speech recognition scores for both ears. He had normal middle ear and cochlear functioning. The auditory brainstem response and acoustic reflexes were absent, indicating a retrocochlear pathology. Long latency responses (LLR) revealed normal cortical functioning. Hence, implantation of an auditory brainstem implant might be an option, but the patient would need to be aware of its limitations. This case highlights the importance of MRI in evaluating congenital malformations of the cochlear nerve when audiological findings indicate a retrocochlear pathology. PMID:28357188

  7. A UK experience of daycase cochlear implant surgery.

    PubMed

    Mawby, T A R; Kaleva, A I; Ramsden, J D

    2014-03-01

    This study aims to assess the safety of daycase cochlear implant surgery. A retrospective review was conducted on all patients who underwent cochlear implant surgery at a teaching hospital in Oxford, UK between September 2008 and February 2012. One hundred and sixteen patients underwent cochlear implant surgery. This included 73 adults and 43 children. Twenty-six patients underwent the procedure as a daycase procedure. There were no readmissions. The demand 'to do more with less' has led to increasing drives for efficiency and cost-effectiveness. Therefore, the role of daycase surgery is becoming increasingly widespread. Daycase surgery has been shown to be advantageous for both patients and hospitals. Daycase cochlear implant surgery is feasible and can be safely conducted in a select group of patients.

  8. Developing Quality Measures for Adult Cochlear Implant Centers: Preliminary Findings.

    PubMed

    Vila, Peter M; Lieu, Judith E C; Hullar, Timothy E; Buchman, Craig A

    2016-11-01

    The study objective was to develop quality measures for adult cochlear implant centers. A modified Delphi design beginning with focus groups of surgeons and audiologists was used, as adapted from the American College of Cardiology / American Heart Association method for creating quality measures. Two academic cochlear implant programs and 1 private program participated. Qualitative focus group analysis yielded 58 candidate measures. An additional 5 candidate measures were added from a systematic review of the literature. After exclusion of pediatric measures, structure measures, and process measures and discussion of details and implications of each measure, 8 measures remained as the preliminary Adult Cochlear Implant Outcome (CI-OUTCOME) Measure Set. This study provides a preliminary set of measures for evaluating the quality of adult cochlear implant centers, based on input from implant surgeons and audiologists. The next step will be to gather feedback from implant patients. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  9. Cochlear Macro- and Micromechanics—A Moderated Discussion

    NASA Astrophysics Data System (ADS)

    Dong, Wei; Ruggero, Mario A.

    2011-11-01

    A discussion moderated by the authors on the topic "Cochlear Macro- and Micromechanics" was held on 19 July 2011 at the 11th International Mechanics of Hearing Workshop in Williamstown, Massachusetts. The paper provides an edited transcript of the session.

  10. Surgical considerations and safety of cochlear implantation in otitis media with effusion.

    PubMed

    Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

    2017-07-26

    To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Phase of shear vibrations within cochlear partition leads to activation of the cochlear amplifier.

    PubMed

    Lamb, Jessica S; Chadwick, Richard S

    2014-01-01

    Since Georg von Bekesy laid out the place theory of the hearing, researchers have been working to understand the remarkable properties of mammalian hearing. Because access to the cochlea is restricted in live animals, and important aspects of hearing are destroyed in dead ones, models play a key role in interpreting local measurements. Wentzel-Kramers-Brillouin (WKB) models are attractive because they are analytically tractable, appropriate to the oblong geometry of the cochlea, and can predict wave behavior over a large span of the cochlea. Interest in the role the tectorial membrane (TM) plays in cochlear tuning led us to develop models that directly interface the TM with the cochlear fluid. In this work we add an angled shear between the TM and reticular lamina (RL), which serves as an input to a nonlinear active force. This feature plus a novel combination of previous work gives us a model with TM-fluid interaction, TM-RL shear, a nonlinear active force and a second wave mode. The behavior we get leads to the conclusion the phase between the shear and basilar membrane (BM) vibration is critical for amplification. We show there is a transition in this phase that occurs at a frequency below the cutoff, which is strongly influenced by TM stiffness. We describe this mechanism of sharpened BM velocity profile, which demonstrates the importance of the TM in overall cochlear tuning and offers an explanation for the response characteristics of the Tectb mutant mouse.

  12. Changes in gene expression and hearing thresholds after cochlear implantation

    PubMed Central

    Zhang, Hongzheng; Stark, Gemaine; Reiss, Lina

    2016-01-01

    Hypothesis Gene expression changes occur in conjunction with hearing threshold changes after cochlear implantation. Background Between 30–50% of individuals who receive electro-acoustic stimulation (EAS) cochlear implants lose residual hearing after cochlear implantation, reducing the benefits of EAS. The mechanism underlying this hearing loss is unknown; potential pathways include mechanical damage, inflammation, or tissue remodeling changes. Methods Guinea pigs were implanted in one ear with cochlear implant electrode arrays, with non-implanted ears serving as controls, and allowed to recover for 1, 3, 7, or 14 days. Hearing threshold changes were measured over time. Cochlear ribonucleic acid was analyzed using real-time quantitative reverse transcription-polymerase chain reaction from the following gene families: cytokines, tight junction claudins, ion and water (aquaporin) transport channels, gap junction connexins, and tissue remodeling genes. Results Significant increases in expression were observed for cochlear inflammatory genes (Cxcl1, IL-1b, TNFα and Tnfrsf1a/b) and ion homeostasis genes (Scnn1γ, Aqp3 and Gjb3). Upregulation of tissue remodeling genes (TGF-β, MMP2, MMP9) as well as a paracrine gene (CTGF) was also observed. Hearing loss occurred rapidly, peaking at 3 days with some recovery at 7 and 14 days after implantation. MM9 exhibited extreme upregulation of expression and was qualitatively associated with changes in hearing thresholds. Conclusion Cochlear implantation induces similar changes as middle ear inflammation for genes involved in inflammation and ion and water transport function, whereas tissue remodeling changes differ markedly. The upregulation of MMP9 with hearing loss is consistent with previous findings linking stria vascularis vessel changes with cochlear implant-induced hearing loss. PMID:25970030

  13. Abnormal Pitch Perception Produced by Cochlear Implant Stimulation

    PubMed Central

    Zeng, Fan-Gang; Tang, Qing; Lu, Thomas

    2014-01-01

    Contemporary cochlear implants with multiple electrode stimulation can produce good speech perception but poor music perception. Hindered by the lack of a gold standard to quantify electric pitch, relatively little is known about the nature and extent of the electric pitch abnormalities and their impact on cochlear implant performance. Here we overcame this obstacle by comparing acoustic and electric pitch perception in 3 unilateral cochlear-implant subjects who had functionally usable acoustic hearing throughout the audiometric frequency range in the non-implant ear. First, to establish a baseline, we measured and found slightly impaired pure tone frequency discrimination and nearly perfect melody recognition in all 3 subjects’ acoustic ear. Second, using pure tones in the acoustic ear to match electric pitch induced by an intra-cochlear electrode, we found that the frequency-electrode function was not only 1–2 octaves lower, but also 2 times more compressed in frequency range than the normal cochlear frequency-place function. Third, we derived frequency difference limens in electric pitch and found that the equivalent electric frequency discrimination was 24 times worse than normal-hearing controls. These 3 abnormalities are likely a result of a combination of broad electric field, distant intra-cochlear electrode placement, and non-uniform spiral ganglion cell distribution and survival, all of which are inherent to the electrode-nerve interface in contemporary cochlear implants. Previous studies emphasized on the “mean” shape of the frequency-electrode function, but the present study indicates that the large “variance” of this function, reflecting poor electric pitch discriminability, is the main factor limiting contemporary cochlear implant performance. PMID:24551131

  14. Cochlear implantation in the Mondini inner ear malformation.

    PubMed

    Miyamoto, R T; Robbins, A J; Myres, W A; Pope, M L

    1986-07-01

    We report the case of a profoundly deaf 4-year-old boy with congenital deafness as a result of Mondini's dysplasia. The Mondini inner ear malformation is the result of arrested labyrinthine development during embryogenesis and is characterized by both bony and membranous anomalies of the inner ear. The dysplastic cochlear anatomy does not preclude successful cochlear implantation, and electrical threshold measurements are similar to those recorded in pediatric subjects deafened as a result of other causes.

  15. On the controversy about the sharpness of human cochlear tuning.

    PubMed

    Lopez-Poveda, Enrique A; Eustaquio-Martin, Almudena

    2013-10-01

    In signal processing terms, the operation of the mammalian cochlea in the inner ear may be likened to a bank of filters. Based on otoacoustic emission evidence, it has been recently claimed that cochlear tuning is sharper for human than for other mammals. The claim was corroborated with a behavioral method that involves the masking of pure tones with forward notched noises (NN). Using this method, it has been further claimed that human cochlear tuning is sharper than suggested by earlier behavioral studies. These claims are controversial. Here, we contribute to the controversy by theoretically assessing the accuracy of the NN method at inferring the bandwidth (BW) of nonlinear cochlear filters. Behavioral forward masking was mimicked using a computer model of the squared basilar membrane response followed by a temporal integrator. Isoresponse and isolevel versions of the forward masking NN method were applied to infer the already known BW of the cochlear filter used in the model. We show that isolevel methods were overall more accurate than isoresponse methods. We also show that BWs for NNs and sinusoids equate only for isolevel methods and when the levels of the two stimuli are appropriately scaled. Lastly, we show that the inferred BW depends on the method version (isolevel BW was twice as broad as isoresponse BW at 40 dB SPL) and on the stimulus level (isoresponse and isolevel BW decreased and increased, respectively, with increasing level over the level range where cochlear responses went from linear to compressive). We suggest that the latter may contribute to explaining the reported differences in cochlear tuning across behavioral studies and species. We further suggest that given the well-established nonlinear nature of cochlear responses, even greater care must be exercised when using a single BW value to describe and compare cochlear tuning.

  16. Parallel mechanisms suppress cochlear bone remodeling to protect hearing.

    PubMed

    Jáuregui, Emmanuel J; Akil, Omar; Acevedo, Claire; Hall-Glenn, Faith; Tsai, Betty S; Bale, Hrishikesh A; Liebenberg, Ellen; Humphrey, Mary Beth; Ritchie, Robert O; Lustig, Lawrence R; Alliston, Tamara

    2016-08-01

    Bone remodeling, a combination of bone resorption and formation, requires precise regulation of cellular and molecular signaling to maintain proper bone quality. Whereas osteoblasts deposit and osteoclasts resorb bone matrix, osteocytes both dynamically resorb and replace perilacunar bone matrix. Osteocytes secrete proteases like matrix metalloproteinase-13 (MMP13) to maintain the material quality of bone matrix through perilacunar remodeling (PLR). Deregulated bone remodeling impairs bone quality and can compromise hearing since the auditory transduction mechanism is within bone. Understanding the mechanisms regulating cochlear bone provides unique ways to assess bone quality independent of other aspects that contribute to bone mechanical behavior. Cochlear bone is singular in its regulation of remodeling by expressing high levels of osteoprotegerin. Since cochlear bone expresses a key PLR enzyme, MMP13, we examined whether cochlear bone relies on, or is protected from, osteocyte-mediated PLR to maintain hearing and bone quality using a mouse model lacking MMP13 (MMP13(-/-)). We investigated the canalicular network, collagen organization, lacunar volume via micro-computed tomography, and dynamic histomorphometry. Despite finding defects in these hallmarks of PLR in MMP13(-/-) long bones, cochlear bone revealed no differences in these markers, nor hearing loss as measured by auditory brainstem response (ABR) or distortion product oto-acoustic emissions (DPOAEs), between wild type and MMP13(-/-) mice. Dynamic histomorphometry revealed abundant PLR by tibial osteocytes, but near absence in cochlear bone. Cochlear suppression of PLR corresponds to repression of several key PLR genes in the cochlea relative to long bones. These data suggest that cochlear bone uniquely maintains bone quality and hearing independent of MMP13-mediated osteocytic PLR. Furthermore, the cochlea employs parallel mechanisms to inhibit remodeling by osteoclasts and osteoblasts, and by

  17. Otoacoustic Estimation of Cochlear Tuning: Validation in the Chinchilla

    PubMed Central

    Guinan, John J.; Oxenham, Andrew J.

    2010-01-01

    We analyze published auditory-nerve and otoacoustic measurements in chinchilla to test a network of hypothesized relationships between cochlear tuning, cochlear traveling-wave delay, and stimulus-frequency otoacoustic emissions (SFOAEs). We find that the physiological data generally corroborate the network of relationships, including predictions from filter theory and the coherent-reflection model of OAE generation, at locations throughout the cochlea. The results support the use of otoacoustic emissions as noninvasive probes of cochlear tuning. Developing this application, we find that tuning ratios—defined as the ratio of tuning sharpness to SFOAE phase-gradient delay in periods—have a nearly species-invariant form in cat, guinea pig, and chinchilla. Analysis of the tuning ratios identifies a species-dependent parameter that locates a transition between “apical-like” and “basal-like” behavior involving multiple aspects of cochlear physiology. Approximate invariance of the tuning ratio allows determination of cochlear tuning from SFOAE delays. We quantify the procedure and show that otoacoustic estimates of chinchilla cochlear tuning match direct measures obtained from the auditory nerve. By assuming that invariance of the tuning ratio extends to humans, we derive new otoacoustic estimates of human cochlear tuning that remain mutually consistent with independent behavioral measurements obtained using different rationales, methodologies, and analysis procedures. The results confirm that at any given characteristic frequency (CF) human cochlear tuning appears sharper than that in the other animals studied, but varies similarly with CF. We show, however, that the exceptionality of human tuning can be exaggerated by the ways in which species are conventionally compared, which take no account of evident differences between the base and apex of the cochlea. Finally, our estimates of human tuning suggest that the spatial spread of excitation of a pure tone

  18. Cochlear abnormality in a case of Pallister-Hall syndrome.

    PubMed

    Avula, Shivaram; Alam, Nusrat; Roberts, Elaine

    2012-12-01

    Pallister-Hall syndrome (PHS) is a rare condition characterised by anomalies including hypothalamic hamartoma, bifid epiglottis and postaxial polydactyly. Hearing loss has been recognised in this condition. Cochlear abnormalities have been described in mouse models of PHS, but there are no reports of similar findings in humans to date. This report describes a case of PHS with bilateral cochlear hypoplasia as seen on MRI.

  19. Cochlear Implantation in Children with Autism Spectrum Disorder

    PubMed Central

    Eshraghi, Adrien A.; Nazarian, Ronen; Telischi, Fred F.; Martinez, Diane; Hodges, Annelle; Velandia, Sandra; Cejas-Cruz, Ivette; Balkany, Thomas J.; Lo, Kaming; Lang, Dustin

    2015-01-01

    Objective To assess the outcome of cochlear implantation in children with Autism Spectrum Disorder Study Design Retrospective case review and survey Setting Tertiary referral center Patients Children who meet criteria for cochlear implantation and diagnosis of Autism Spectrum Disorder Main Outcome Measures Receptive and expressive language scores and parental survey data. Results 15 patients with history of ASD and cochlear implantation were analyzed and compared to 15 patients who received cochlear implant and have no other disability. Post-operatively, more than 67% of children with ASD significantly improved their speech perception skills and 60% significantly improved their speech expression skills while all patients in the control group showed significant improvement in both aspects. The top three reported improvements after cochlear implantation were name recognition, response to verbal requests, and enjoyment of music. Of all behavioral aspects, the use of eye contact was the least improved. Survey results in regards to improvements in patient interaction were more subtle when compared to those related to sound and speech perception. The most improved aspects in the ASD patients’ lives after cochlear implantation appeared to be attending to other people’s requests and conforming to family routines. Of note, awareness of the child’s environment is the most highly ranked improvement attributed to the cochlear implant. Conclusions Cochlear implants are effective and beneficial for hearing impaired members of the ASD population even though development of language may lag behind that of implanted children with no additional disabilities. Significant speech perception and overall behavior improvement are noted. PMID:25899551

  20. The effect of implantation age on visual attention skills.

    PubMed

    Yucel, Esra; Derim, Deray

    2008-06-01

    The aim of this study is to evaluate the visual attention skills of deaf children with cochlear implants and to determine whether age at implantation had any impact on visual attention skills. Thirty children with cochlear implants aged 6 and 11 years were evaluated and were compared with age matched 36 normal hearing children. The children with cochlear implants were analyzed in to two groups according to their age at implantation; under and at/over 4 years old. The Gordon Diagnostic System (GDS) was used in order to evaluate visual attention skills of cochlear implanted (Group 1 and Group 2) and children with normal hearing. The number of correct responses, extraneous button presses (commission errors) and the number of omission errors or the failure to respond to target stimuli which were recorded by GDS was used to evaluate the visual attention skills of the subjects. Also six different types of commission errors (19X, XX9, XX1, X1X, X9X, XXX) were analyzed and compared both for normal and cochlear implant user children. Concerning the total number of correct response, omission and commission errors no statistical difference was found between two implanted groups. Besides, both groups with cochlear implantation differed from normal hearing peers on the total number of correct responses, omission errors (p<0.017). According to these findings cochlear implanted children had less correct responses and had more omission errors compared with control group. These findings clearly show that children with cochlear implants performed poorly on visual attention task which requires constant attention together with the ability to exert impulse control despite they hear enhanced sensory information by cochlear implants. Concerning the types of commission errors Group 1 and 2 performed similarly in all types of errors (p>0.017). Besides, Group 1 and 2 made more errors in types 19X, XX9 and XXX, XX9 compared with the control group (p<0.017). Group 2 who had their implants

  1. Cochlear length determination using Cone Beam Computed Tomography in a clinical setting.

    PubMed

    Würfel, Waldemar; Lanfermann, Heinrich; Lenarz, Thomas; Majdani, Omid

    2014-10-01

    Indications for cochlear implants are determined by audiological and medical considerations. Clinical imaging is therefore an integral element for anatomical evaluation in terms of medical considerations. Several authors have discussed the variability of cochlear shape, especially cochlear length. Cochlear length is, however, an increasingly recognized parameter in terms of preoperative evaluation. This study introduces a methodology to determine individual cochlear length in clinical setting by using Cone Beam Computed Tomography. Cochlear length determination was performed retrospectively with an OsiriX curved 3D Multiplanar Reconstruction tool on subjects who underwent temporal bone imaging from January 2011 to February 2013. Cochlear length was defined as the spiral route from the center-distal point of the bony round window along the lateral wall towards the helicotrema, which is the endpoint of the measurement. Cochlear length was measured in 436 temporal bones (218 left ears, 218 right ears, 218 subjects). The mean cochlear length was 37.6 mm (SD: ± 1.93 mm), median was 37.6 mm, range 32-43.5 mm. The cochlear length had a normal distribution. A significant difference was found between cochlear length by gender (p < .0001), but not between the left and right cochlea (p = .301) or according to age. Consideration of the cochlear length in clinical data may be an insufficiently represented parameter in cochlear implant treatment. Literature shows the impact of electrode insertion depth on residual hearing preservation and speech performance. Individual evaluation of the cochlear implant electrode choice may be the next step in personalized cochlear implant treatment as a valuable addition to existing audiological and surgical evaluation. The cochlear length determination methodology presented herein is a reproducible and clinically available parameter. Indeed, revealing a significant cochlear length span width, especially according to gender differences, may be

  2. Quantitative polarized light microscopy of unstained mammalian cochlear sections

    PubMed Central

    Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.

    2013-01-01

    Abstract. Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo. PMID:23407909

  3. Optimal electrode length to match patient specific cochlear anatomy.

    PubMed

    Mistrík, P; Jolly, C

    2016-06-01

    Cochlear implantation (CI) has reached over years of practicing high standards of surgical outcomes. Even patients with significant residual hearing are nowadays benefiting from a cochlear implant. However, the speech perception still depends to great extent on the adequate pitch match between the frequency components delivered by an electrode array and individual cochlear tonotopic map. Compression, deletion or shift of frequency components can be tolerated by patients only to some extent. Furthermore, low frequency information delivered to the cochlear apex is particularly important for spatial hearing. It is therefore important to use the electrode array of an appropriate length for each individual cochlea. The large variability in the anatomy makes this task difficult as a single design does not fit all cochlear shapes. Fortunately, preoperative CT imaging, routinely taken in most of ENT clinics, can be exploited also for the prediction of the cochlear duct length (CDL). It turns out that a single radiological measurement, the diameter of the basal turn, is highly correlated with CDL and its measurement can be used for the informed selection of the most suitable electrode array length from the available array portfolio for each CI patient. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Quantitative polarized light microscopy of unstained mammalian cochlear sections

    NASA Astrophysics Data System (ADS)

    Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.; Stankovic, Konstantina M.

    2013-02-01

    Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo.

  5. Solving cochlear mechanics problems with higher-order differential equations.

    PubMed

    de Boer, E; van Bienema, E

    1982-11-01

    Since most "exact" solution methods for cochlear models are rather unwieldy, they do not lend themselves to easy and multi-purpose application. In this paper a new solution method is described that is more flexible in this respect. A three-dimensional cochlear model is considered. It can be described by an integral equation in terms of the wavenumber k. The kernel Q (k) of that equation is approximated by a rational function of k and this makes it possible to reformulate the problem as a differential equation. The latter can be solved by a straightforward and well-known method. Results of computations with this technique are presented in two forms: an overview of the entire cochlear wave pattern and a detailed representation of the response peak. The method is also used to determine whether a discernible reflected wave is produced in the cochlea or not. For this purpose the wavenumber spectrum of the cochlear wave is studied: it is found to be a one-sided function of k. With surprisingly simple means it is thus shown that no appreciable reflection occurs from the inhomogeneity that is characteristic in cochlear wave propagation. This holds true for values of damping constant delta as low as 0.01, a factor of 5 smaller than is commonly used in cochlear modeling.

  6. Musical ear syndrome in adult cochlear implant patients.

    PubMed

    Low, W-K; Tham, C A; D'Souza, V-D; Teng, S-W

    2013-09-01

    Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being. STUDY DESIGN, PATIENTS AND INTERVENTION: A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010. Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’. In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients’ emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.

  7. The development of the Nucleus Freedom Cochlear implant system.

    PubMed

    Patrick, James F; Busby, Peter A; Gibson, Peter J

    2006-12-01

    Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.

  8. Calcium imaging of inner ear hair cells within the cochlear epithelium of mice using two-photon microscopy.

    PubMed

    Yuan, Tao; Gao, Simon S; Saggau, Peter; Oghalai, John S

    2010-01-01

    Mice are an excellent model for studying mammalian hearing and transgenic mouse models of human hearing, loss are commonly available. However, the mouse cochlea is substantially smaller than other animal models routinely used to study cochlear physiology. This makes study of their hair cells difficult. We develop a novel methodology to optically image calcium within living hair cells left undisturbed within the excised mouse cochlea. Fresh cochleae are harvested, left intact within their otic capsule bone, and fixed in a recording chamber. The bone overlying the cochlear epithelium is opened and Reissner's membrane is incised. A fluorescent calcium indicator is applied to the preparation. A custom-built upright two-photon microscope was used to image the preparation using 3-D scanning. We are able to image about one third of a cochlear turn simultaneously, in either the apical or basal regions. Within one hour of animal sacrifice, we find that outer hair cells demonstrate increased fluorescence compared with surrounding supporting cells. This methodology is then used to visualize hair cell calcium changes during mechanotransduction over a region of the epithelium. Because the epithelium is left within the cochlea, dissection trauma is minimized and artifactual changes in hair cell physiology are expected to be reduced.

  9. Calcium imaging of inner ear hair cells within the cochlear epithelium of mice using two-photon microscopy

    NASA Astrophysics Data System (ADS)

    Yuan, Tao; Gao, Simon S.; Saggau, Peter; Oghalai, John S.

    2010-01-01

    Mice are an excellent model for studying mammalian hearing and transgenic mouse models of human hearing, loss are commonly available. However, the mouse cochlea is substantially smaller than other animal models routinely used to study cochlear physiology. This makes study of their hair cells difficult. We develop a novel methodology to optically image calcium within living hair cells left undisturbed within the excised mouse cochlea. Fresh cochleae are harvested, left intact within their otic capsule bone, and fixed in a recording chamber. The bone overlying the cochlear epithelium is opened and Reissner's membrane is incised. A fluorescent calcium indicator is applied to the preparation. A custom-built upright two-photon microscope was used to image the preparation using 3-D scanning. We are able to image about one third of a cochlear turn simultaneously, in either the apical or basal regions. Within one hour of animal sacrifice, we find that outer hair cells demonstrate increased fluorescence compared with surrounding supporting cells. This methodology is then used to visualize hair cell calcium changes during mechanotransduction over a region of the epithelium. Because the epithelium is left within the cochlea, dissection trauma is minimized and artifactual changes in hair cell physiology are expected to be reduced.

  10. Feasibility of multichannel human cochlear nucleus stimulation.

    PubMed

    Luetje, C M; Whittaker, C K; Geier, L; Mediavilla, S J; Shallop, J K

    1992-01-01

    Bipolar electrical stimulation of the brainstem cochlear nucleus (CN) following acoustic tumor removal in an only-hearing ear can provide beneficial hearing. However, the benefits of multichannel stimulation have yet to be defined. Following removal of a second acoustic tumor in a patient with neurofibromatosis 2, a Nucleus mini-22 channel implant device was inserted with the electrode array tip from the foramen of Luschka cephalad along the root entry zone of the eighth nerve, secured by a single suture superficially in the brain stem. Initial stimulation on the sixth postoperative day indicated that electrodes 18 to 22 were capable of CN stimulation without seventh nerve stimulation. Presumed electrode migration precluded further CN stimulation 1 month later. This report illustrates the feasibility of brainstem CN stimulation with an existing multichannel system.

  11. Cortical reorganization in children with cochlear implants.

    PubMed

    Gilley, Phillip M; Sharma, Anu; Dorman, Michael F

    2008-11-06

    Congenital deafness leads to atypical organization of the auditory nervous system. However, the extent to which auditory pathways reorganize during deafness is not well understood. We recorded cortical auditory evoked potentials in normal hearing children and in congenitally deaf children fitted with cochlear implants. High-density EEG and source modeling revealed principal activity from auditory cortex in normal hearing and early implanted children. However, children implanted after a critical period of seven years revealed activity from parietotemporal cortex in response to auditory stimulation, demonstrating reorganized cortical pathways. Reorganization of central auditory pathways is limited by the age at which implantation occurs, and may help explain the benefits and limitations of implantation in congenitally deaf children.

  12. Evoked cochlear potentials in the barn owl.

    PubMed

    Köppl, Christine; Gleich, Otto

    2007-06-01

    Gross electrical responses to tone bursts were measured in adult barn owls, using a single-ended wire electrode placed onto the round window. Cochlear microphonic (CM) and compound action potential (CAP) responses were evaluated separately. Both potentials were physiologically vulnerable. Selective abolishment of neural responses at high frequencies confirmed that the CAP was of neural origin, while the CM remained unaffected. CAP latencies decreased with increasing stimulus frequency and CAP amplitudes were correlated with known variations in afferent fibre numbers from the different papillar regions. This suggests a local origin of the CAP along the tonotopic gradient within the basilar papilla. The audiograms derived from CAP and CM threshold responses both showed a broad frequency region of optimal sensitivity, very similar to behavioural and single-unit data, but shifted upward in absolute sensitivity. CAP thresholds rose above 8 kHz, while CM responses showed unchanged sensitivity up to 10 kHz.

  13. Fluid Coupling in a Discrete Cochlear Model

    NASA Astrophysics Data System (ADS)

    Elliott, S. J.; Lineton, B.; Ni, G.

    2011-11-01

    The interaction between the basilar membrane, BM, dynamics and the fluid coupling in the cochlea can be formulated using a discrete model by assuming that the BM is divided into a number of longitudinal elements. The form of the fluid coupling can then be understood by dividing it into a far field component, due to plane wave acoustic coupling, and a near field component, due to higher order evanescent acoustic modes. The effects of non-uniformity and asymmetry in the cross-sectional areas of the fluid chambers can also be accounted for within this formulation. The discrete model is used to calculate the effect on the coupled BM response of a short cochlear implant, which reduces the volume of one of the fluid chambers over about half its length. The passive response of the coupled cochlea at lower frequencies is shown to be almost unaffected by this change in volume.

  14. Accurate guitar tuning by cochlear implant musicians.

    PubMed

    Lu, Thomas; Huang, Juan; Zeng, Fan-Gang

    2014-01-01

    Modern cochlear implant (CI) users understand speech but find difficulty in music appreciation due to poor pitch perception. Still, some deaf musicians continue to perform with their CI. Here we show unexpected results that CI musicians can reliably tune a guitar by CI alone and, under controlled conditions, match simultaneously presented tones to <0.5 Hz. One subject had normal contralateral hearing and produced more accurate tuning with CI than his normal ear. To understand these counterintuitive findings, we presented tones sequentially and found that tuning error was larger at ∼ 30 Hz for both subjects. A third subject, a non-musician CI user with normal contralateral hearing, showed similar trends in performance between CI and normal hearing ears but with less precision. This difference, along with electric analysis, showed that accurate tuning was achieved by listening to beats rather than discriminating pitch, effectively turning a spectral task into a temporal discrimination task.

  15. Accurate Guitar Tuning by Cochlear Implant Musicians

    PubMed Central

    Lu, Thomas; Huang, Juan; Zeng, Fan-Gang

    2014-01-01

    Modern cochlear implant (CI) users understand speech but find difficulty in music appreciation due to poor pitch perception. Still, some deaf musicians continue to perform with their CI. Here we show unexpected results that CI musicians can reliably tune a guitar by CI alone and, under controlled conditions, match simultaneously presented tones to <0.5 Hz. One subject had normal contralateral hearing and produced more accurate tuning with CI than his normal ear. To understand these counterintuitive findings, we presented tones sequentially and found that tuning error was larger at ∼30 Hz for both subjects. A third subject, a non-musician CI user with normal contralateral hearing, showed similar trends in performance between CI and normal hearing ears but with less precision. This difference, along with electric analysis, showed that accurate tuning was achieved by listening to beats rather than discriminating pitch, effectively turning a spectral task into a temporal discrimination task. PMID:24651081

  16. Dynamic Aspects of Cochlear Microphonic Potentials

    NASA Astrophysics Data System (ADS)

    Meenderink, Sebastiaan W. F.; van der Heijden, Marcel

    2011-11-01

    Cochlear microphonic potentials were recorded from the Mongolian gerbil in response to low-frequency auditory stimuli. Provided that contamination of the potentials by the phase-locked neurophonic is avoided, these recordings can be interpreted "as if recorded from a single outer hair cell". It is found that the instantaneous I/O-curves resemble the well-known Boltzmann activation curve. The dynamic aspect of the I/O-curves does reveal hysteresis and a level-dependent gain that is not observed in static measures of these curves. We explore a model that simulates CM generation from hair cell populations, but find it inadequate to reproduce the data. Rather, there seem to be fast, adaptive mechanisms probably at the level of the transduction channels themselves.

  17. Phase contrast imaging of cochlear soft tissue

    NASA Astrophysics Data System (ADS)

    Shintani Smith, Stephanie; Hwang, Margaret; Rau, Christoph; Fishman, Andrew J.; Lee, Wah-Keat; Richter, Claus-Peter

    2011-03-01

    A noninvasive technique to image soft tissue could expedite diagnosis and disease management in the auditory system. We propose inline phase contrast imaging with hard X-rays as a novel method that overcomes the limitations of conventional absorption radiography for imaging soft tissue. In this study, phase contrast imaging of mouse cochleae was performed at the Argonne National Laboratory Advanced Photon Source. The phase contrast tomographic reconstructions show soft tissue structures of the cochlea, including the inner pillar cells, the inner spiral sulcus, the tectorial membrane, the basilar membrane, and the Reissner's membrane. The results suggest that phase contrast X-ray imaging and tomographic techniques hold promise to noninvasively image cochlear structures at an unprecedented cellular level.

  18. The cochlear CRF signaling systems and their mechanisms of action in modulating cochlear sensitivity and protection against trauma

    PubMed Central

    Graham, Christine E.; Basappa, Johnvesly; Turcan, Sevin; Vetter, Douglas E.

    2011-01-01

    A key requirement for encoding the auditory environment is the ability to dynamically alter cochlear sensitivity. However, merely attaining a steady state of maximal sensitivity is not a viable solution since the sensory cells and ganglion cells of the cochlea are prone to damage following exposure to loud sound. Most often, such damage is via initial metabolic insult that can lead to cellular death. Thus, establishing the highest sensitivity must be balanced with protection against cellular metabolic damage that can lead to loss of hair cells and ganglion cells, resulting in loss of frequency representation. While feedback mechanisms are known to exist in the cochlea that alter sensitivity, they respond only after stimulus encoding, allowing potentially damaging sounds to impact the inner ear at times coincident with increased sensitivity. Thus, questions remain concerning the endogenous signaling systems involved in dynamic modulation of cochlear sensitivity and protection against metabolic stress. Understanding endogenous signaling systems involved in cochlear protection may lead to new strategies and therapies for prevention of cochlear damage and consequent hearing loss. We have recently discovered a novel cochlear signaling system that is molecularly equivalent to the classic hypothalamic-pituitary-adrenal (HPA) axis. This cochlear HPA-equivalent system functions to balance auditory sensitivity and susceptibility to noise-induced hearing loss, and also protects against cellular metabolic insults resulting from exposures to ototoxic drugs. We review the anatomy, physiology, and cellular signaling of this system, and compare it to similar signaling in other organs/tissues of the body. PMID:21909974

  19. A resonance approach to cochlear mechanics.

    PubMed

    Bell, Andrew

    2012-01-01

    How does the cochlea analyse sound into its component frequencies? In the 1850s Helmholtz thought it occurred by resonance, whereas a century later Békésy's work indicated a travelling wave. The latter answer seemed to settle the question, but with the discovery in 1978 that the cochlea emits sound, the mechanics of the cochlea was back on the drawing board. Recent studies have raised questions about whether the travelling wave, as currently understood, is adequate to explain observations. Applying basic resonance principles, this paper revisits the question. A graded bank of harmonic oscillators with cochlear-like frequencies and quality factors is simultaneously excited, and it is found that resonance gives rise to similar frequency responses, group delays, and travelling wave velocities as observed by experiment. The overall effect of the group delay gradient is to produce a decelerating wave of peak displacement moving from base to apex at characteristic travelling wave speeds. The extensive literature on chains of coupled oscillators is considered, and the occurrence of travelling waves, pseudowaves, phase plateaus, and forced resonance in such systems is noted. This alternative approach to cochlear mechanics shows that a travelling wave can simply arise as an apparently moving amplitude peak which passes along a bank of resonators without carrying energy. This highlights the possible role of the fast pressure wave and indicates how phase delays and group delays of a set of driven harmonic oscillators can generate an apparent travelling wave. It is possible to view the cochlea as a chain of globally forced coupled oscillators, and this model incorporates fundamental aspects of both the resonance and travelling wave theories.

  20. A Resonance Approach to Cochlear Mechanics

    PubMed Central

    Bell, Andrew

    2012-01-01

    Background How does the cochlea analyse sound into its component frequencies? In the 1850s Helmholtz thought it occurred by resonance, whereas a century later Békésy's work indicated a travelling wave. The latter answer seemed to settle the question, but with the discovery in 1978 that the cochlea emits sound, the mechanics of the cochlea was back on the drawing board. Recent studies have raised questions about whether the travelling wave, as currently understood, is adequate to explain observations. Approach Applying basic resonance principles, this paper revisits the question. A graded bank of harmonic oscillators with cochlear-like frequencies and quality factors is simultaneously excited, and it is found that resonance gives rise to similar frequency responses, group delays, and travelling wave velocities as observed by experiment. The overall effect of the group delay gradient is to produce a decelerating wave of peak displacement moving from base to apex at characteristic travelling wave speeds. The extensive literature on chains of coupled oscillators is considered, and the occurrence of travelling waves, pseudowaves, phase plateaus, and forced resonance in such systems is noted. Conclusion and significance This alternative approach to cochlear mechanics shows that a travelling wave can simply arise as an apparently moving amplitude peak which passes along a bank of resonators without carrying energy. This highlights the possible role of the fast pressure wave and indicates how phase delays and group delays of a set of driven harmonic oscillators can generate an apparent travelling wave. It is possible to view the cochlea as a chain of globally forced coupled oscillators, and this model incorporates fundamental aspects of both the resonance and travelling wave theories. PMID:23144835

  1. Parental perspectives of children using cochlear implant.

    PubMed

    Stefanini, Marcela Roselin; Morettin, Marina; Zabeu, Julia Speranza; Bevilacqua, Maria Cecília; Moret, Adriane Lima Mortari

    2014-01-01

    To evaluate the parents' perspective with regard to evolution of their child with cochlear implant (CI). This was a cross-sectional prospective study conducted at the Centro de Pesquisas Audiológicas of Hospital de Reabilitação de Anomalias Craniofaciais of Universidade de São Paulo. The selection of the sample was performed from the spontaneous demand, among the months from July to December 2011. The final sample comprised 50 parents or guardians of children using CI, with minimum 1 year and maximum of 3 years of device use. The translated and adapted to Brazilian Portuguese version of the questionnaire "Perspectives of parents of children with cochlear implants" was applied. This instrument consists of 74 questions and allows quantification of the parents' perspective on subscales that illustrate the situation of the child and family. Each question has five options scored from one to five responses. The Spearman test for comparison of results between the subscales was applied. The social relationships, self-sufficiency, and communication subscales showed the highest mean score, whereas the worst score was for child support subscale, reflecting the independence and autonomy of the patients. The correlation between the child subscales was realized, and the results showed themselves significant and positive for communication subscale of communication with all others subscales. The family subscales also had a positive correlation with the communication, education, and self-sufficiency. These results demonstrate that parents have good expectations regarding communication, independence, and social participation of children after CI surgery, and this questionnaire is a useful tool for use in clinical practice.

  2. Emergent literacy in kindergartners with cochlear implants

    PubMed Central

    Nittrouer, Susan; Caldwell, Amanda; Lowenstein, Joanna H; Tarr, Eric; Holloman, Christopher

    2012-01-01

    Problem A key ingredient to academic success is being able to read. Deaf individuals have historically failed to develop literacy skills comparable to those of their normal-hearing peers, but early identification and cochlear implants have improved prospects that these children can learn to read at the levels of their peers. The goal of this study was to examine early, or emergent, literacy in these children. Method 27 deaf children with cochlear implants (CIs) who had just completed kindergarten were tested on emergent literacy, as well as on cognitive and linguistic skills that support emergent literacy, specifically ones involving phonological awareness, executive functioning, and oral language. 17 kindergartners with normal hearing (NH) and 8 with hearing loss, but who used hearing aids (HAs) served as controls. Outcomes were compared for these three groups of children, regression analyses were performed to see if predictor variables for emergent literacy differed for children with NH and those with CIs, and factors related to the early treatment of hearing loss and prosthesis configuration were examined for children with CIs. Results Performance of children with CIs was roughly one or more standard deviations below the mean performance of children with NH on all tasks, except for syllable counting, reading fluency, and rapid serial naming. Oral language skills explained more variance in emergent literacy for children with CIs than for children with NH. Age of first implant explained moderate amounts of variance for several measures. Having one or two CIs had no effect, but children who had some amount of bimodal experience outperformed children who had none on several measures. Conclusions Even deaf children who have benefitted from early identification, intervention, and implantation are still at risk for problems with emergent literacy that could affect their academic success. This finding means that intensive language support needs to continue through at

  3. Extraocular Surgical Approach for Placement of Subretinal Implants in Blind Patients: Lessons from Cochlear-Implants

    PubMed Central

    Koitschev, Assen; Stingl, Katarina; Bartz-Schmidt, Karl Ulrich; Braun, Angelika; Gekeler, Florian; Greppmaier, Udo; Sachs, Helmut; Peters, Tobias; Wilhelm, Barbara; Zrenner, Eberhart; Besch, Dorothea

    2015-01-01

    In hereditary retinal diseases photoreceptors progressively degenerate, often causing blindness without therapy being available. Newly developed subretinal implants can substitute functions of photoreceptors. Retina implant extraocular surgical technique relies strongly on cochlear-implant know-how. However, a completely new surgical approach providing safe handling of the photosensor array had to be developed. The Retina Implant Alpha IMS consisting of a subretinal microphotodiode array and cable linked to a cochlear-implant-like ceramic housing was introduced via a retroauricular incision through a subperiosteal tunnel above the zygoma into the orbit using a specially designed trocar. Implant housing was fixed in a bony bed within a tight subperiosteal pocket in all patients. Primary outcomes were patient short term safety as well as effectiveness. Nine patients participated in the first part of the multicenter trial and received the subretinal visual implant in one eye. In all cases microphotodiode array pull-through procedure and stable positioning were possible without affecting the device function. No intraoperative complications were encountered. The minimally invasive suprazygomatic tunneling technique for the sensor unit as well as a subperiosteal pocket fixation of the implant housing provides a safe extraocular implantation approach of a subretinal device with a transcutaneous extracorporeal power supply. PMID:26783453

  4. Cognitive Compensation of Speech Perception With Hearing Impairment, Cochlear Implants, and Aging

    PubMed Central

    Clarke, Jeanne; Pals, Carina; Benard, Michel R.; Bhargava, Pranesh; Saija, Jefta; Sarampalis, Anastasios; Wagner, Anita; Gaudrain, Etienne

    2016-01-01

    External degradations in incoming speech reduce understanding, and hearing impairment further compounds the problem. While cognitive mechanisms alleviate some of the difficulties, their effectiveness may change with age. In our research, reviewed here, we investigated cognitive compensation with hearing impairment, cochlear implants, and aging, via (a) phonemic restoration as a measure of top-down filling of missing speech, (b) listening effort and response times as a measure of increased cognitive processing, and (c) visual world paradigm and eye gazing as a measure of the use of context and its time course. Our results indicate that between speech degradations and their cognitive compensation, there is a fine balance that seems to vary greatly across individuals. Hearing impairment or inadequate hearing device settings may limit compensation benefits. Cochlear implants seem to allow the effective use of sentential context, but likely at the cost of delayed processing. Linguistic and lexical knowledge, which play an important role in compensation, may be successfully employed in advanced age, as some compensatory mechanisms seem to be preserved. These findings indicate that cognitive compensation in hearing impairment can be highly complicated—not always absent, but also not easily predicted by speech intelligibility tests only.

  5. Imaging of cochlear tissue with a grating interferometer and hard X-rays

    SciTech Connect

    Richter, Claus-Peter; Shintani-Smith, Stephanie; Fishman, Andrew; David, Christian; Robinson, Ian; Rau, Christoph

    2010-01-28

    This article addresses an important current development in medical and biological imaging: the possibility of imaging soft tissue at resolutions in the micron range using hard X-rays. Challenging environments, including the cochlea, require the imaging of soft tissue structure surrounded by bone. We demonstrate that cochlear soft tissue structures can be imaged with hard X-ray phase contrast. Furthermore, we show that only a thin slice of the tissue is required to introduce a large phase shift. It is likely that the phase contrast image of the soft tissue structures is sufficient to image the structures even if surrounded by bone. For the present set of experiments, structures with low-absorption contrast have been visualized using in-line phase contrast imaging and a grating interferometer. The experiments have been performed at the Advanced Photon Source at Argonne National Laboratories, a third generation source of synchrotron radiation. The source provides highly coherent X-ray radiation with high-photon flux (>10{sup 12} photons/s) at high-photon energies (5-70 keV). Radiographic and light microscopy images of the gerbil cochlear slice samples were compared. It has been determined that a 20-{micro}m thick tissue slice induces a phase shift between 1/3{pi} and 2/3{pi}.

  6. Extraocular Surgical Approach for Placement of Subretinal Implants in Blind Patients: Lessons from Cochlear-Implants.

    PubMed

    Koitschev, Assen; Stingl, Katarina; Bartz-Schmidt, Karl Ulrich; Braun, Angelika; Gekeler, Florian; Greppmaier, Udo; Sachs, Helmut; Peters, Tobias; Wilhelm, Barbara; Zrenner, Eberhart; Besch, Dorothea

    2015-01-01

    In hereditary retinal diseases photoreceptors progressively degenerate, often causing blindness without therapy being available. Newly developed subretinal implants can substitute functions of photoreceptors. Retina implant extraocular surgical technique relies strongly on cochlear-implant know-how. However, a completely new surgical approach providing safe handling of the photosensor array had to be developed. The Retina Implant Alpha IMS consisting of a subretinal microphotodiode array and cable linked to a cochlear-implant-like ceramic housing was introduced via a retroauricular incision through a subperiosteal tunnel above the zygoma into the orbit using a specially designed trocar. Implant housing was fixed in a bony bed within a tight subperiosteal pocket in all patients. Primary outcomes were patient short term safety as well as effectiveness. Nine patients participated in the first part of the multicenter trial and received the subretinal visual implant in one eye. In all cases microphotodiode array pull-through procedure and stable positioning were possible without affecting the device function. No intraoperative complications were encountered. The minimally invasive suprazygomatic tunneling technique for the sensor unit as well as a subperiosteal pocket fixation of the implant housing provides a safe extraocular implantation approach of a subretinal device with a transcutaneous extracorporeal power supply.

  7. Deep round window insertion versus standard approach in cochlear implant surgery.

    PubMed

    Nordfalk, Karl Fredrik; Rasmussen, Kjell; Bunne, Marie; Jablonski, Greg Eigner

    2016-01-01

    The aim of this study was to compare the outcomes of vestibular tests and the residual hearing of patients who have undergone full insertion cochlear implant surgery using the round window approach with a hearing preservation protocol (RW-HP) or the standard cochleostomy approach (SCA) without hearing preservation. A prospective study of 34 adults who underwent unilateral cochlear implantation was carried out. One group was operated using the RW-HP (n = 17) approach with Med-El +Flex(SOFT) electrode array with full insertion, while the control group underwent a more conventional SCA surgery (n = 17) with shorter perimodiolar electrodes. Assessments of residual hearing, cervical vestibular-evoked myogenic potentials (cVEMP), videonystagmography, subjective visual vertical/horizontal (SVH/SVV) were performed before and after surgery. There was a significantly (p < 0.05) greater number of subjects who exhibited complete or partial hearing preservation in the deep insertion RW-HP group (9/17) compared to the SCA group (2/15). A higher degree of vestibular loss but a lower degree of vertigo symptoms could be seen in the RW-HP group, but the differences were not statistically significant. It is possible to preserve residual hearing to a certain extent also with deep insertion. Full insertion with hearing preservation was less harmful to residual hearing particularly at 125 Hz (p < 0.05), than was the standard cochleostomy approach.

  8. Vestibular function following unilateral cochlear implantation for profound sensorineural hearing loss.

    PubMed

    le Nobel, Gavin J; Hwang, Euna; Wu, Adrian; Cushing, Sharon; Lin, Vincent Y

    2016-06-14

    Many Canadians are affected by sensorineural hearing loss (SNHL) and those with severe or profound hearing loss may have poor hearing function despite optimized hearing aids. Cochlear implants (CI) offer effective hearing rehabilitation for these patients, however, concern continues to exist regarding possible effects of CI on the vestibular system and balance. The objective of this study was to conduct a pilot study assessing the effects of unilateral cochlear implantation (CI) on balance and the vestibular system in post-lingually deafened adults. Twelve patients were included in this pilot study and were assessed pre-operatively and at immediate, 1 week, and 1 month post-operative intervals. Assessments consisted of the dizziness handicap inventory (DHI), subjective visual vertical (SVV), and timed up-and-go testing (TUG). When applicable, testing was repeated with the CI on and off. Many patients were found to have deviated SVV at pre-operative and post-operative assessments. However, statistically significant changes were not seen when comparing pre-operative and post-operative SVV or when comparing SVV with the CI on and with the CI off. DHI was found to improve in five patients and worsen in two patients, however, no statistically significant change was found in DHI scores or with TUG testing. This current pilot study does not indicate that CI surgery or implant activity influence vestibular or balance function, however, this pilot study is underpowered and greater numbers of patients would need be assessed to confirm these findings.

  9. Multisensory Training Improves Auditory Spatial Processing following Bilateral Cochlear Implantation

    PubMed Central

    Isaiah, Amal; Vongpaisal, Tara; King, Andrew J.

    2014-01-01

    Cochlear implants (CIs) partially restore hearing to the deaf by directly stimulating the inner ear. In individuals fitted with CIs, lack of auditory experience due to loss of hearing before language acquisition can adversely impact outcomes. For example, adults with early-onset hearing loss generally do not integrate inputs from both ears effectively when fitted with bilateral CIs (BiCIs). Here, we used an animal model to investigate the effects of long-term deafness on auditory localization with BiCIs and approaches for promoting the use of binaural spatial cues. Ferrets were deafened either at the age of hearing onset or as adults. All animals were implanted in adulthood, either unilaterally or bilaterally, and were subsequently assessed for their ability to localize sound in the horizontal plane. The unilaterally implanted animals were unable to perform this task, regardless of the duration of deafness. Among animals with BiCIs, early-onset hearing loss was associated with poor auditory localization performance, compared with late-onset hearing loss. However, performance in the early-deafened group with BiCIs improved significantly after multisensory training with interleaved auditory and visual stimuli. We demonstrate a possible neural substrate for this by showing a training-induced improvement in the responsiveness of auditory cortical neurons and in their sensitivity to interaural level differences, the principal localization cue available to BiCI users. Importantly, our behavioral and physiological evidence demonstrates a facilitative role for vision in restoring auditory spatial processing following potential cross-modal reorganization. These findings support investigation of a similar training paradigm in human CI users. PMID:25122908

  10. Pediatric cochlear implantation: candidacy evaluation, medical and surgical considerations, and expanding criteria.

    PubMed

    Heman-Ackah, Selena E; Roland, J Thomas; Haynes, David S; Waltzman, Susan B

    2012-02-01

    Since the first cochlear implant approved by the US Food and Drug Administration in the early 1980s, great advances have occurred in cochlear implant technology. With these advances, patient selection, preoperative evaluation, and rehabilitation consideration continue to evolve. This article describes the current practice in pediatric candidacy evaluation, reviews the medical and surgical considerations in pediatric cochlear implantation, and explores the expanding criteria for cochlear implantation within the pediatric population.

  11. Language Processing in Children with Cochlear Implants: A Preliminary Report on Lexical Access for Production and Comprehension

    PubMed Central

    Schwartz, Richard G.; Steinman, Susan; Ying, Elizabeth; Mystal, Elana Ying; Houston, Derek M.

    2013-01-01

    In this plenary paper we present a review of language research in children with cochlear implants along with at outline of a five-year project designed to examine lexical access for production and recognition. The project will use auditory priming, picture naming with auditory or visual interfering stimuli (Picture-Word Interference and Picture-Picture Interference, respectively) and eye tracking paradigms to examine the role of semantic and various phonological factors. Preliminary data are presented from auditory priming, the picture-word interference, and picture-picture interference tasks. The emergence of group difference is briefly discussed. PMID:23489339

  12. Physiological basis for cochlear and auditory brainstem implants.

    PubMed

    Møller, Aage R

    2006-01-01

    Cochlear implants bypass functions of the cochlea that have been regarded to be fundamental for discrimination of the frequency (or spectrum). Frequency discrimination is essential for discrimination of sounds, including speech sounds, and the normal auditory system is assumed to make use of both (power) spectral and temporal information for frequency discrimination. Spectral information is represented by the place on the basilar membrane that generates the largest amplitude of vibration on the basilar membrane. Evidence has been presented that the temporal representation of frequency is more robust than the place representation and thus regarded more important for speech discrimination. The fact that some cochlear implants provide good speech discrimination using only information about the energy in a few spectral bands seems to contradict these studies. In that way, frequency discrimination may be similar to trichromatic color vision, which is based on the energy in only three different spectral bands of light, accomplished by different color-sensitive pigments in the cones of the retina. Cochlear nucleus implants (ABIs) also bypass the auditory nerve, which does not perform any processing. Therefore, it may be expected that ABIs are equally efficient as cochlear implants. However, experience from the use of ABIs in patients with bilateral vestibular schwannoma has not been encouraging, but recent studies of the use of ABIs in patients with other causes of injuries to the auditory nerve have shown similar speech discrimination as achieved with modern cochlear implants. Cochlear implants and ABIs are successful in providing speech discrimination because of redundancy in the processing in the ear, redundancy of the speech signal and because the auditory nervous system has a high degree of plasticity. Expression of neural plasticity makes the auditory nervous system adapt to the change in demands of processing of the information provided by cochlear implants.

  13. Cochlear implantation in autistic children with profound sensorineural hearing loss.

    PubMed

    Lachowska, Magdalena; Pastuszka, Agnieszka; Łukaszewicz-Moszyńska, Zuzanna; Mikołajewska, Lidia; Niemczyk, Kazimierz

    2016-11-19

    Cochlear implants have become the method of choice for the treatment of severe-to-profound hearing loss in both children and adults. Its benefits are well documented in the pediatric and adult population. Also deaf children with additional needs, including autism, have been covered by this treatment. The aim of this study was to assess the benefits from cochlear implantation in deafened children with autism as the only additional disability. This study analyzes data of six children. The follow-up time was at least 43 months. The following data were analyzed: medical history, reaction to music and sound, Ling's six sounds test, onomatopoeic word test, reaction to spoken child's name, response to requests, questionnaire given to parents, sound processor fitting sessions and data. After cochlear implantation each child presented other communication skills. In some children, the symptoms of speech understanding were observed. No increased hyperactivity associated with daily use cochlear implant was observed. The study showed that in autistic children the perception is very important for a child's sense of security and makes contact with parents easier. Our study showed that oral communication is not likely to be a realistic goal in children with cochlear implants and autism. The implantation results showed benefits that varied among those children. The traditional methods of evaluating the results of cochlear implantation in children with autism are usually insufficient to fully assess the functional benefits. These benefits should be assessed in a more comprehensive manner taking into account the limitations of communication resulting from the essence of autism. It is important that we share knowledge about these complex children with cochlear implants. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  14. Central auditory development after long-term cochlear implant use.

    PubMed

    Jiwani, Salima; Papsin, Blake C; Gordon, Karen A

    2013-09-01

    We aimed to determine whether long-term cortical auditory development is altered or delayed in children using cochlear implants relative to their normal hearing peers. We hypothesized that cortical development in children using unilateral cochlear implants follows a normal trajectory with long-term auditory input when the duration of bilateral auditory deprivation in childhood is limited. Electrically-evoked cortical responses were recorded in 79 children who received one cochlear implant within 2.03 ± 1.36 years of bilateral deafness and had up to ∼16 years of time-in-sound experience, and in 58 peers with normal hearing. Amplitude differences between the responses from children using cochlear implants and with normal hearing were calculated between 0 and 300 ms. Responses from cochlear implant users remain different from those of their normal hearing peers. These differences decreased over time, but were not eliminated even after 10 years of time-in-sound. Specifically, the P(1)-N(1)-P(2)-N(2) complex, typical of a normally mature response, began to emerge by 10 years of time-in-sound experience, but the amplitudes of peaks P(2) and N(2) became abnormally large. Mature-like cortical responses emerge in children after long-term unilateral cochlear implant use, however, differences from normal persist. Maturation of cortical responses with long-term cochlear implant use potentially underlies functional improvements in hearing. Persistent differences from normal could reflect an increase in attention or multi-sensory processing during listening. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. New Criteria of Indication and Selection of Patients to Cochlear Implant

    PubMed Central

    Sampaio, André L. L.; Araújo, Mercêdes F. S.; Oliveira, Carlos A. C. P.

    2011-01-01

    Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant. PMID:22013448

  16. Hearing Experience and Receptive Vocabulary Development in Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Fagan, Mary K.; Pisoni, David B.

    2010-01-01

    This study investigated receptive vocabulary delay in deaf children with cochlear implants. Participants were 23 children with profound hearing loss, ages 6-14 years, who received a cochlear implant between ages 1.4 and 6 years. Duration of cochlear implant use ranged from 3.7 to 11.8 years. "Peabody Picture Vocabulary Test, Third…

  17. Hearing Experience and Receptive Vocabulary Development in Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Fagan, Mary K.; Pisoni, David B.

    2010-01-01

    This study investigated receptive vocabulary delay in deaf children with cochlear implants. Participants were 23 children with profound hearing loss, ages 6-14 years, who received a cochlear implant between ages 1.4 and 6 years. Duration of cochlear implant use ranged from 3.7 to 11.8 years. "Peabody Picture Vocabulary Test, Third…

  18. Responsiveness of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency.

    PubMed

    He, Shuman; Shahsavarani, Bahar S; McFayden, Tyler C; Wang, Haibo; Gill, Katherine E; Xu, Lei; Chao, Xiuhua; Luo, Jianfen; Wang, Ruijie; He, Nancy

    2017-07-01

    This study aimed to (1) investigate the responsiveness of the cochlear nerve (CN) to a single biphasic-electrical pulse in implanted children with cochlear nerve deficiency (CND) and (2) compare their results with those measured in implanted children with normal-size CNs. Participants included 23 children with CND (CND1 to CND23) and 18 children with normal-size CNs (S1 to S18). All subjects except for CND1 used Cochlear Nucleus cochlear implants with contour electrode arrays in their test ears. CND1 was implanted with a Cochlear Nucleus Freedom cochlear implant with a straight electrode array in the test ear. For each subject, the CN input/output (I/O) function and the refractory recovery function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at multiple electrode sites across the electrode array. Dependent variables included eCAP threshold, the maximum eCAP amplitude, slope of the I/O function, and time-constants of the refractory recovery function. Slopes of I/O functions were estimated using statistical modeling with a sigmoidal function. Recovery time-constants, including measures of the absolute refractory period and the relative refractory period, were estimated using statistical modeling with an exponential decay function. Generalized linear mixed-effect models were used to evaluate the effects of electrode site on the dependent variables measured in children with CND and to compare results of these dependent variables between subject groups. The eCAP was recorded at all test electrodes in children with normal-size CNs. In contrast, the eCAP could not be recorded at any electrode site in 4 children with CND. For all other children with CND, the percentage of electrodes with measurable eCAPs decreased as the stimulating site moved in a basal-to-apical direction. For children with CND, the stimulating site had a significant effect on the slope of the I/O functions and the relative refractory

  19. Cochlear nucleus whole mount explants promote the differentiation of neuronal stem cells from the cochlear nucleus in co-culture experiments.

    PubMed

    Rak, Kristen; Völker, Johannes; Jürgens, Lukas; Völker, Christine; Frenz, Silke; Scherzad, Agmal; Schendzielorz, Philipp; Jablonka, Sibylle; Mlynski, Robert; Radeloff, Andreas; Hagen, Rudolf

    2015-08-07

    The cochlear nucleus is the first brainstem nucleus to receive sensory input from the cochlea. Depriving this nucleus of auditory input leads to cellular and molecular disorganization which may potentially be counteracted by the activation or application of stem cells. Neuronal stem cells (NSCs) have recently been identified in the neonatal cochlear nucleus and a persistent neurogenic niche was demonstrated in this brainstem nucleus until adulthood. The present work investigates whether the neurogenic environment of the cochlear nucleus can promote the survival of engrafted NSCs and whether cochlear nucleus-derived NSCs can differentiate into neurons and glia in brain tissue. Therefore, cochlear nucleus whole-mount explants were co-cultured with NSCs extracted from either the cochlear nucleus or the hippocampus and compared to a second environment using whole-mount explants from the hippocampus. Factors that are known to induce neuronal differentiation were also investigated in these NSC-explant experiments. NSCs derived from the cochlear nucleus engrafted in the brain tissue and differentiated into all cells of the neuronal lineage. Hippocampal NSCs also immigrated in cochlear nucleus explants and differentiated into neurons, astrocytes and oligodendrocytes. Laminin expression was up-regulated in the cochlear nucleus whole-mounts and regulated the in vitro differentiation of NSCs from the cochlear nucleus. These experiments confirm a neurogenic environment in the cochlear nucleus and the capacity of cochlear nucleus-derived NSCs to differentiate into neurons and glia. Consequently, the presented results provide a first step for the possible application of stem cells to repair the disorganization of the cochlear nucleus, which occurs after hearing loss. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. IL-10/HMOX1 signaling modulates cochlear inflammation via negative regulation of MCP-1/CCL2 expression in cochlear fibrocytes

    PubMed Central

    Woo, Jeong-Im; Kil, Sung-Hee; Oh, Sejo; Lee, Yoo-Jin; Park, Raekil; Lim, David J.; Moon, Sung K.

    2015-01-01

    Cochlear inflammatory diseases such as tympanogenic labyrinthitis are associated with acquired sensorineural hearing loss. Although otitis media is extremely frequent in children, tympanogenic labyrinthitis is not commonly observed, which suggests the existence of a potent anti-inflammatory mechanism modulating cochlear inflammation. In this study, we aim to determine the molecular mechanism involved in cochlear protection from inflammation-mediated tissue damage, focusing on interleukin-10 (IL-10) and hemoxygenase-1 (HMOX1) signaling. We demonstrated that IL-10 receptors (IL-10Rs) are expressed in the cochlear lateral wall of mice and rats, particularly in the spiral ligament fibrocytes (SLFs). The rat SLF cell line (RSL) was found to inhibit nontypeable H. influenzae (NTHi)-induced up-regulation of monocyte chemotactic protein-1 (MCP-1/CCL2) in response to IL-10. This inhibition was suppressed by silencing IL-10R1 and was mimicked by cobalt protoporphyrin IX (CoPP) and carbon monoxide-releasing molecule-2 (CORM-2). In addition, IL-10 appeared to suppress monocyte recruitment through reduction of NTHi-induced RSL-derived chemoattractants. Silencing of HMOX1 was found to attenuate the inhibitory effect of IL-10 on NTHi-induced MCP-1/CCL2 up-regulation. Chromatin immunoprecipitation (ChIP) assays showed that IL-10 inhibits NTHi-induced binding of p65 NF-κB to the distal motif in the promoter region of MCP-1/CCL2, resulting in suppression of NTHi-induced NF-κB activation. Furthermore, IL-10 deficiency appeared to significantly affect cochlear inflammation induced by intratympanic injections of NTHi. Taken together, our results suggest that IL-10/HMOX1 signaling is involved in modulation of cochlear inflammation through inhibition of MCP-1/CCL2 regulation in SLFs, implying therapeutic potential of a carbon monoxide (CO)-based approach for inflammation-associated cochlear diseases. PMID:25780042

  1. Cochlear implants in forty-eight children with cochlear and/or vestibular abnormality.

    PubMed

    Dettman, Shani; Sadeghi-Barzalighi, Ana; Ambett, Ranjeeta; Dowell, Richard; Trotter, Matthew; Briggs, Robert

    2011-01-01

    CT and MRI scans for 48 children with cochlear and/or vestibular abnormality were classified in decreasing severity; common cavity, Mondini plus enlarged vestibular aqueduct, Mondini dysplasia alone and enlarged vestibular aqueduct alone. No significant relationship between degree of cochlea abnormality and surgical issues (cerebrospinal fluid gusher, depth of insertion, number of electrodes) or speech perception/language outcomes was found. A significant relationship was observed between cerebrospinal fluid gusher and partial electrode insertion, fewer active electrodes and poorer sentence understanding. Optimum language outcomes were associated with younger age at implant.

  2. Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions.

    PubMed

    Lee, Joseph

    2016-02-01

    Biomedical engineering technologies such as brain-machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be "human" if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism's reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation's unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation-and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.

  3. Prevalence of inner ear anomalies among cochlear implant candidates

    PubMed Central

    Aldhafeeri, Ahmad M.; Alsanosi, Abdulrahman A.

    2016-01-01

    Objectives: To determine the prevalence of inner ear anomalies and the frequency of different anomaly types among cochlear implant recipients. Methods: This study included a retrospective chart review of all patients who received cochlear implants between January 2009 and January 2013 in King Abdulaziz University Hospital cochlear implant program in Riyadh, Saudi Arabia. All subjects underwent thin-cut CT of the temporal bone and MRI. The collected data included age, gender, and CT and MRI findings regarding temporal bone anomalies. Patients with any identified congenital inner ear anomalies were included in the study. Results: In total, 316 patients’ cases were reviewed. Inner ear malformations were identified in 24 patients, which represented a prevalence of 7.5%. Among these 24 patients, 8 (33.3%) presented with a large vestibular aqueduct (LVA), 8 (33.3%) semicircular canal (SCC) dysplasia, 7 (29.1%) classical Mondini deformity, and one (4.1%) cochlear hypoplasia. Conclusion: The prevalence of inner ear anomalies among cochlear implant recipients was 7.5%. This result is consistent with findings worldwide. The most common anomalies were LVA and SCC hypoplasia; by contrast, in other regions, the most common anomaly is either the Mondini deformity, or LVA. PMID:27652360

  4. Curcumin Reduces the Noise-Exposed Cochlear Fibroblasts Apoptosis

    PubMed Central

    Haryuna, Tengku Siti Hajar; Riawan, Wibi; Nasution, Ardyansyah; Ma'at, Suprapto; Harahap, Juliandi; Adriztina, Indri

    2016-01-01

    Introduction The structural changes underlying permanent noise-induced hearing loss (NIHL) include loss of the sensory hair cells, damage to their stereocilia, and supporting tissues within the cochlear lateral wall. Objective The objective of this study is to demonstrate curcumin as a safe and effective therapeutic agent in the prevention and treatment for fibroblasts damage within the cochlear supporting tissues and lateral wall through cell death pathway. Methods We divided 24 Rattus norvegicus into 4 groups, Group 1: control; Group 2: noise (+); Group 3: noise (+), 50 mg/day curcumin (+); Group 4: noise (+), 100 mg/day curcumin (+). We provided the noise exposure dose at 100 dB SPL for two hours over two weeks and administered the curcumin orally over two weeks. We examined all samples for the expressions of calcineurin, nuclear factor of activated T-cells cytoplasmic 1 (NFATc1), and apoptotic index of cochlear fibroblasts. Results We found significant differences for the expressions of calcineurin (p < 0.05) in all groups, significant differences for the expressions of NFATc1 (p < 0.05) in all groups, except in Groups 1 and 4, and significant differences for the apoptotic index (p < 0.05) in all groups. Conclusion Curcumin proved to be potentially effective in the prevention and treatment for fibroblasts damage within the cochlear supporting tissues and lateral wall regarding the decreased expression of calcineurin, NFATc1, and apoptotic index of cochlear fibroblasts. PMID:27746842

  5. Single and Multiple Microphone Noise Reduction Strategies in Cochlear Implants

    PubMed Central

    Azimi, Behnam; Hu, Yi; Friedland, David R.

    2012-01-01

    To restore hearing sensation, cochlear implants deliver electrical pulses to the auditory nerve by relying on sophisticated signal processing algorithms that convert acoustic inputs to electrical stimuli. Although individuals fitted with cochlear implants perform well in quiet, in the presence of background noise, the speech intelligibility of cochlear implant listeners is more susceptible to background noise than that of normal hearing listeners. Traditionally, to increase performance in noise, single-microphone noise reduction strategies have been used. More recently, a number of approaches have suggested that speech intelligibility in noise can be improved further by making use of two or more microphones, instead. Processing strategies based on multiple microphones can better exploit the spatial diversity of speech and noise because such strategies rely mostly on spatial information about the relative position of competing sound sources. In this article, we identify and elucidate the most significant theoretical aspects that underpin single- and multi-microphone noise reduction strategies for cochlear implants. More analytically, we focus on strategies of both types that have been shown to be promising for use in current-generation implant devices. We present data from past and more recent studies, and furthermore we outline the direction that future research in the area of noise reduction for cochlear implants could follow. PMID:22923425

  6. [Establishment of a mathematical model for calculating cochlear length].

    PubMed

    Zhong, L L; Hao, Q Q; Ren, L L; Guo, W W; Yang, S M

    2016-06-07

    To compare the cochlear length of the miniature pig calculated by 3-dimensional reconstruction technique and an Archimedean spiral model, and to evaluate the feasibility of determining the length of the cochlea using a mathematical model. The temporal bones of three miniature pigs with normal hearing were selected and scanned by micro-CT. The pictures were input into Mimics software, the 3D structure of the inner ear was reconstructed, and the following parameters were determined through Mimics: cochlear length, diameter of each turn, cochlear height, and apical turn angle. The cochlear length was calculated using the Archimedean spiral model. The length of the cochlea was (35.30±0.88)mm based on the three-dimensional reconstruction technique compared to (34.85±0.64)mm based on the Archimedean spiral model. The differences between the two values were not statistically significant. The height of the cochlea is (2.64±0.24)mm. The capsule of the cochlea had 3.67 turns. The three-dimensional reconstruction technique provides accurate and reliable results, but the reconstruction process is time-consuming and is unsuitable for clinical application. The Archimedean spiral model method is simple, feasible, reliable, and therefore suitable for clinical applications, in particular to provide references for cochlear implantation surgeries.

  7. A cochlear implant user with exceptional musical hearing ability.

    PubMed

    Maarefvand, Mohammad; Marozeau, Jeremy; Blamey, Peter J

    2013-06-01

    Although the perception of music is generally poor in cochlear implant users, there are a few excellent performers. The aim of this study was the assessment of different aspects of music perception in one exceptional cochlear implant user. The assessments included pitch direction discrimination, melody and timbre recognition, relative and absolute pitch judgment, and consonance rating of musical notes presented through the sound processor(s). An adult cochlear implant user with musical background who lost her hearing postlingually, and five normally-hearing listeners with musical training participated in the study. The CI user discriminated pitch direction for sounds differing by one semitone and recognized melody with nearly 100% accuracy. Her results in timbre recognition were better than average published data for cochlear implant users. Her consonance rating, and relative and absolute pitch perception were comparable to normally-hearing listeners with musical training. The results in this study showed that excellent performance is possible on musical perception tasks including pitch perception using present day cochlear implant technologies. Factors that may explain this user's exceptional performance are short duration of deafness, pre- and post-deafness musical training, and perfect pitch abilities before the onset of deafness.

  8. Speech development after cochlear implantation in children from bilingual homes.

    PubMed

    Teschendorf, Melanie; Janeschik, Sandra; Bagus, Heike; Lang, Stephan; Arweiler-Harbeck, Diana

    2011-02-01

    The aim of this study was to investigate whether exposure to a second language in bilingual families influences the spoken German skills after cochlear implantation. A further question was how many children with migration background are bilingual. Retrospective case review. Tertiary referral center; cochlear implant program. Ninety-three profoundly hearing-impaired children; 52 of these children reside in bilingual and 41 in monolingual homes. Cochlear implantation before the age of 6 years, speech and language skills assessments. Standard speech perception and receptive and expressive language measures. Data on used primary and secondary languages were obtained by questionnaire. Children growing up in bilingual homes performed worse than children from monolingual homes in all performed speech tests. Almost all children with bilingual parents indicated German as their main language. In some cases, the second language is used actively, but in most children, the use is limited to single words and expressions. However, some children from bilingual homes achieve high skill level in German language and, furthermore, develop competency in second spoken language. Advanced language skills including the learning of a second spoken language are possible for children with cochlear implant living in bilingual homes, but that is the exception rather than the rule. It seems that other factors, such as spoken German language skills of the parents, integration of the family, and compliance with the rehabilitation program, play an important role. Therefore, a special support for children with cochlear implants from bilingual homes is needed.

  9. Maximizing Cochlear Implant Patients’ Performance with Advanced Speech Training Procedures

    PubMed Central

    Fu, Qian-Jie; Galvin, John J.

    2008-01-01

    Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years’ experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted auditory training can significantly improve cochlear implant patients’ speech recognition performance. Such benefits are not only observed in poorly performing patients, but also in good performers under difficult listening conditions (e.g., speech noise, telephone speech, music, etc.). Targeted auditory training has also been shown to enhance performance gains provided by new implant devices and/or speech processing strategies. These studies suggest that cochlear implantation alone may not fully meet the needs of many patients, and that additional auditory rehabilitation may be needed to maximize the benefits of the implant device. Continuing research will aid in the development of efficient and effective training protocols and materials, thereby minimizing the costs (in terms of time, effort and resources) associated with auditory rehabilitation while maximizing the benefits of cochlear implantation for all recipients. PMID:18295992

  10. Predicting cochlear implant outcome from brain organisation in the deaf.

    PubMed

    Giraud, Anne-Lise; Lee, Hyo-Jeong

    2007-01-01

    Cochlear implantation is an effective technique for restoring hearing in the profoundly deaf. Although cochlear implants are a therapeutical success, huge performance variability in speech comprehension is observed after implantation. The reason for this remains incompletely understood after 20 years of clinical practice and basic research. Which patients are going to respond well and why is an unresolved question. The duration of auditory deprivation plays an important role, and currently is the main predictor of implantation success in children; basically, the earlier the better. However, among patients with identical duration of deafness, performance remains highly variable, suggesting there are other more fundamental factors that determine clinical outcome. To delineate the cognitive factors that could influence the clinical outcome of cochlear implantation, we correlated resting metabolism PET images acquired before implantation in congenitally deaf children with speech perception behavioural scores measured three years after implantation. Using this paradigm, we showed distinct brain organisation patterns in the deaf brain, which predict good and bad speech perception outcome after cochlear implantation. These data show that brain organisation assessed immediately before cochlear implantation can efficiently predict subsequent speech outcome.

  11. Evaluating the Feasibility of Using Remote Technology for Cochlear Implants.

    PubMed

    Goehring, Jenny L; Hughes, Michelle L; Baudhuin, Jacquelyn L

    2012-01-01

    The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests (electrode impedance and electrically evoked compound action potentials) are equivalent to those obtained in the face-to-face condition. Despite these promising findings, speech perception using remote technology has proven to be more challenging. Previous investigations have evaluated speech perception with recipients of cochlear implants using videoconference (Polycom) equipment in nonsound-treated rooms (due to lack of access to audiological sound booths in rural areas). Results have revealed poorer speech perception scores using remote technology compared to face-to-face results. Additionally, it has been shown that Polycom transmission of a speech stimulus does not cause significant compression for adequate evaluation; rather, poorer results are due to testing performed in nonsound-treated environments. Based on the literature, telepractice is a feasible option for cochlear implant service delivery. Barriers to the wide-spread use of remote services for recipients of cochlear implants include a uniform system for the evaluation of speech perception, validation of services for pediatric recipients and initial activations, license reciprocity, and reimbursement for services.

  12. Detection of bacteria in healthy middle ears during cochlear implantation.

    PubMed

    Tonnaer, Edith L; Mylanus, Emmanuel A; Mulder, Jef J; Curfs, Jo H

    2009-03-01

    To assess whether free-living and/or biofilm bacteria are present in the putative sterile middle ear cavity before insertion of the electrode array during cochlear implantation. Prospective study. Tertiary academic hospital. The study included 45 healthy children (with or without a history of otitis media) undergoing cochlear implantation. Transmission electron microscopy or scanning electron microscopy was used to detect the presence of bacteria. Presence of both free-living bacteria and biofilm bacteria on the epithelial surface of biopsy specimens of middle ear mucosa. A majority of all mucosal specimens from clinically healthy tympanic cavities displayed inflammatory areas as well as dispersed, nonmatrix-enclosed bacteria. Also, rarely, fragments of biofilms were found. The presence of bacteria in the tympanic cavity, which is generally assumed to be sterile in healthy individuals, may provide an explanation for infectious complications after cochlear implantation. However, the possibility that the electrode array of a cochlear implant will actually become contaminated during insertion is unlikely because of the small amounts and dispersed presence of bacteria, which may account for the relatively low incidence of infectious complications after cochlear implantation.

  13. Current Research with Cochlear Implants at Arizona State University

    PubMed Central

    Dorman, Michael F.; Spahr, Anthony; Gifford, Rene H.; Cook, Sarah; Zhang, Ting; Loiselle, Louise; Yost, William; Cardy, Lara; Whittingham, JoAnne; Schramm, David

    2013-01-01

    In this article we review, and discuss the clinical implications of, five projects currently underway in the Cochlear Implant Laboratory at Arizona State University. The projects are (1) norming the AzBio sentence test, (2) comparing the performance of bilateral and bimodal cochlear implant (CI) patients in realistic listening environments, (3) accounting for the benefit provided to bimodal patients by low-frequency acoustic stimulation, (4) assessing localization by bilateral hearing aid patients and the implications of that work for hearing preservation patients, and (5) studying heart rate variability as a possible measure for quantifying the stress of listening via an implant. The long-term goals of the laboratory are to improve the performance of patients fit with cochlear implants and to understand the mechanisms, physiological or electronic, that underlie changes in performance. We began our work with cochlear implant patients in the mid-1980s and received our first grant from the National Institutes of Health (NIH) for work with implanted patients in 1989. Since that date our work with cochlear implant patients has been funded continuously by the NIH. In this report we describe some of the research currently being conducted in our laboratory. PMID:22668760

  14. Hyperbaric oxygen upregulates cochlear constitutive nitric oxide synthase

    PubMed Central

    2011-01-01

    Background Hyperbaric oxygen therapy (HBOT) is a known adjuvant for treating ischemia-related inner ear diseases. Controversies still exist in the role of HBOT in cochlear diseases. Few studies to date have investigated the cellular changes that occur in inner ears after HBOT. Nitric oxide, which is synthesized by nitric oxide synthase (NOS), is an important signaling molecule in cochlear physiology and pathology. Here we investigated the effects of hyperbaric oxygen on eardrum morphology, cochlear function and expression of NOS isoforms in cochlear substructures after repetitive HBOT in guinea pigs. Results Minor changes in the eardrum were observed after repetitive HBOT, which did not result in a significant hearing threshold shift by tone burst auditory brainstem responses. A differential effect of HBOT on the expression of NOS isoforms was identified. Upregulation of constitutive NOS (nNOS and eNOS) was found in the substructures of the cochlea after HBOT, but inducible NOS was not found in normal or HBOT animals, as shown by immunohistochemistry. There was no obvious DNA fragmentation present in this HBOT animal model. Conclusions The present evidence indicates that the customary HBOT protocol may increase constitutive NOS expression but such upregulation did not cause cell death in the treated cochlea. The cochlear morphology and auditory function are consequently not changed through the protocol. PMID:21342510

  15. Single and multiple microphone noise reduction strategies in cochlear implants.

    PubMed

    Kokkinakis, Kostas; Azimi, Behnam; Hu, Yi; Friedland, David R

    2012-06-01

    To restore hearing sensation, cochlear implants deliver electrical pulses to the auditory nerve by relying on sophisticated signal processing algorithms that convert acoustic inputs to electrical stimuli. Although individuals fitted with cochlear implants perform well in quiet, in the presence of background noise, the speech intelligibility of cochlear implant listeners is more susceptible to background noise than that of normal hearing listeners. Traditionally, to increase performance in noise, single-microphone noise reduction strategies have been used. More recently, a number of approaches have suggested that speech intelligibility in noise can be improved further by making use of two or more microphones, instead. Processing strategies based on multiple microphones can better exploit the spatial diversity of speech and noise because such strategies rely mostly on spatial information about the relative position of competing sound sources. In this article, we identify and elucidate the most significant theoretical aspects that underpin single- and multi-microphone noise reduction strategies for cochlear implants. More analytically, we focus on strategies of both types that have been shown to be promising for use in current-generation implant devices. We present data from past and more recent studies, and furthermore we outline the direction that future research in the area of noise reduction for cochlear implants could follow.

  16. Growth behavior of cochlear nucleus neuronal cells on semiconductor substrates.

    PubMed

    Rak, Kristen; Wasielewski, Natalia; Radeloff, Andreas; Scherzed, Agmal; Jablonka, Sibylle; Hagen, Rudolf; Mlynski, Robert

    2011-05-01

    Auditory brainstem implants provide sound information by direct stimulation of the cochlear nucleus to patients with dysfunctional or absent cranial nerve VIII. In contrast to patients with cochlear implants, the use of the auditory brainstem implants is less successful. This cannot be fully explained by the difference location of stimulation but a rather unspecific neuronal stimulation. The aim of this study was to further examine neuronal cells of the cochlear nucleus and to test their interactions with semiconductor substrates as a potential electrode material for improved auditory brainstem implants. The cochlear nuclei of postnatal day 7 rats were microsurgically dissected. The tissue was dissociated enzymatically and plated on coverslips as control and on the semiconductor substrates silicon or silicon nitride. After 4 days in culture the morphology and growth of dissociated cells was determined by fluorescence and scanning electron microscopy. Dissociated cells of the cochlear nucleus showed reduced cell growth on semiconductor substrates compared with controls. SEM analysis demonstrated close contact of neurons with supporting cells in culture and good adherence of neuronal growth cones on the used materials. These findings present basic knowledge for the development of neuron-electrode interfaces for future auditory brainstem implants. Copyright © 2011 Wiley Periodicals, Inc.

  17. An acoustic analysis of the vowel space in young and old cochlear-implant speakers.

    PubMed

    Neumeyer, Veronika; Harrington, Jonathan; Draxler, Christoph

    2010-09-01

    The main purpose of this study was to compare acoustically the vowel spaces of two groups of cochlear implantees (CI) with two age-matched normal hearing groups. Five young test persons (15-25 years) and five older test persons (55-70 years) with CI and two control groups of the same age with normal hearing were recorded. The speech material consisted of five German vowels V = /a, e, i, o, u/ in bilabial and alveolar contexts. The results showed no differences between the two groups on Euclidean distances for the first formant frequency. In contrast, Euclidean distances for F2 of the CI group were shorter than those of the control group, causing their overall vowel space to be compressed. The main differences between the groups are interpreted in terms of the extent to which the formants are associated with visual cues to the vowels. Further results were partially longer vowel durations for the CI speakers.

  18. Deaf parents of cochlear-implanted children: beliefs on bimodal bilingualism.

    PubMed

    Mitchiner, Julie Cantrell

    2015-01-01

    This study investigated 17 Deaf (1) families in North America with cochlear-implanted children about their attitudes, beliefs, and practices on bimodal bilingualism (defined as using both a visual/manual language and an aural/oral language) in American Sign Language (ASL) and English. A survey and follow-up interviews with 8 families were conducted. The majority of the Deaf families exhibited positive beliefs toward bimodal bilingualism, where they set high expectations for their children to become equally fluent in both languages. However, their perspectives about the purpose for each language differed; they viewed English as a "survival language" and ASL as a "cultural language" but supported the use of both languages at home as part of their children's lives. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Impaired Vestibular Function After Cochlear Implantation in Children: Role of Static Posturography.

    PubMed

    Nair, Satish; Gupta, Atul; Nilakantan, Ajith; Mittal, Ruchika; Dahiya, Ruchi; Saini, Sachin; Prasad, Rachana; Vajpayee, Deepika

    2017-06-01

    To identify vestibular dysfunction in children after cochlear implant surgery and to study the utility of static posturography in evaluating vestibular function in children. A prospective study was carried out on 25 children between 2 and 7 years of age with sensorineural hearing loss with no overt vestibular dysfunction. All children underwent static posturography using Synapsis Posturographic System (SPS) software (Version 3.0, REV C) using a static platform with foam. The centre of pressure (COP) shift was recorded as statokinesiogram on the software and the mean vestibular, visual and somesthetic scores were obtained. Cochlear implantation (CI) surgery was done with insertion of Med-El Pulsar standard cochlear implant with 12 twin electrodes. Children were evaluated again after 4 weeks of CI surgery (2 weeks after switch on) with static posturography on the same SPS software. The scores obtained were compared with pre op value and data analyzed statistically by paired t tests on SPSS 18 software. The mean age was 4.6 years with range 2-7 years. All the children in the study were able to complete the test with no difficulty and the mean time required for each child was 10.2 min. The mean pre op somesthetic score was 95.16 (SD 1.52) and post op score was 94.06 (SD 1.79). The mean pre op visual score was 86.64 (SD 2.24) and post op score was 82.55 (2.89). The mean pre op vestibular score was 84.11 (SD 2.20) and post op score was 73.66 (SD 4.25). Correlation and statistical analysis of the pre and post values of each score revealed statistically significant reduction in vestibular scores post CI. The vestibular system is at high risk of injury leading to vestibular dysfunction in children during CI. Our study found the static posturography as a simple, fast and efficient tool to screen children for vestibular dysfunction post CI. Identifying the dysfunction early can help in initiating early rehabilitation measures.

  20. Preoperative differences of cerebral metabolism relate to the outcome of cochlear implants in congenitally deaf children.

    PubMed

    Lee, Hyo Jeong; Kang, Eunjoo; Oh, Seung-Ha; Kang, Hyejin; Lee, Dong Soo; Lee, Myung Chul; Kim, Chong-Sun

    2005-05-01

    In congenitally deaf children, chronological age is generally accepted as a critical factor that affects successful rehabilitation following cochlear implantation (CI). However, a wide variance among patients is known to exist regardless of the age at CI [Sarant, J.Z., Blamey, P.J., Dowell, R.C., Clark, G.M., Gibson, W.P., 2001. Variation in speech perception scores among children with cochlear implants. Ear Hear. 22, 18-28]. In a previous study, we reported that prelingually deaf children in the age range 5-7 years at implantation showed greatest outcome variability [Oh S.H., Kim C.S., Kang E.J., Lee D.S., Lee H.J., Chang S.O., Ahn S.H., Hwang C.H., Park H.J., Koo J.W., 2003. Speech perception after cochlear implantation over a 4-year time period. Acta Otolaryngol. 123, 148-153]. Eleven children who underwent CI between the age of 5 and 7 1/2 years were subdivided into a good (above 65%: GOOD) and a poor (below 45%: POOR) group based on the performance in a speech perception test given 2 years after CI. The preoperative (18)F-FDG-PET (F-18 fluorodeoxyglucose positron emission tomography) images were compared between the two groups in order to examine if regional glucose metabolic difference preexisted before the CI surgery. In the GOOD group, metabolic activity was greater in diverse fronto-parietal regions compared to the POOR group. In the POOR group, the regions related to the ventral visual pathway showed greater metabolic activity relative to the GOOD group. These findings suggest that the deaf children who had developed greater executive and visuospatial functions subserved by the prefrontal and parietal cortices might be successful in auditory language learning after CI. On the contrary, greater dependency on the visual function subserved by the occipito-temporal region due to auditory deprivation may interfere with acquisition of auditory language after CI.

  1. Development and Characterization of Piezoelectric Artificial Cochlear with micro Actuator mimicking Human Cochlear

    NASA Astrophysics Data System (ADS)

    Jung, Y.; Kim, S.; Kwak, J.; Kang, H.; Lee, Y. H.; Park, S.; Kim, W.; Hur, S.

    2013-12-01

    This paper presents the development of piezoelectric artificial cochlear (P-AC) capable of analyzing incoming acoustic or mechanical signals without external power source. The P-AC consists of membrane part and package part. The package part provides liquid environment through which the incoming signal is transmitted to membrane part. The membrane part responds to the transmitted signal and local area of the membrane part vibrates differently depending on its local resonant frequency. Previously in our group, we have demonstrated the feasibility of the P-AC with trapezoidal membrane part as sound analyzer by using mouth simulator as a sound input. In this research, we modified the P-AC to have the membrane part of logarithmically varying width. Also by incorporating mico-actuator into the package part that mimic the function of stapes bone in middle ear, we created similar environment to cochlear where human basilar membrane vibrates. The fabricated P-AC successfully demonstrates frequency separation of incoming mechanical signal from micro-actuator into several frequency bands within human hearing range.

  2. Restudy of malformations of the internal auditory meatus, cochlear nerve canal and cochlear nerve.

    PubMed

    Li, Youjin; Yang, Jun; Liu, Jinfen; Wu, Hao

    2015-07-01

    The present study aims to restudy the correlation between the internal auditory meatus (IAM), the cochlear nerve canal (CNC), the cochlear nerve (CN) and inner ear malformations. In this retrospective study design, the abnormal diameter of the IAM, CNC and CN in patients with any kind of inner ear malformations was evaluated using multi-slice spiral computed tomography (MSCT) (37 patients) and magnetic resonance imaging (MRI) (18 patients). Of 37 MSCT-diagnosed patients, 2 had IAM atresia, 11 IAM stenosis, 22 enlarged IAM, and 2 normal IAM with an abnormal CN. MRI diagnoses of 18 patients revealed 8 cases of aplastic CN, 6 hypoplastic CN, and 4 normal CN. CNC stenosis was associated with CN hypoplasia (P < 0.001). Patients with absent or stenotic IAM had less CN development than those with normal or enlarged IAM (P = 0.001). We propose a modification of the existing classification systems with a view to distinguishing malformations of the IAM, CNC and CN.

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

    PubMed

    Firszt, Jill B; Reeder, Ruth M; Skinner, Margaret W

    2008-01-01

    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.

  4. Cochlear Implantation in Common Forms of Genetic Deafness

    PubMed Central

    Vivero, Richard J.; Fan, Kenneth; Angeli, Simon; Balkany, Thomas J; Liu, Xue Z

    2010-01-01

    Genetic factors are among the main etiologies of severe to profound hearing loss and may play an important role in cochlear implantation (CI) outcomes. While genes for common forms of deafness have been cloned, efforts to correlate the functional outcome of CIs with a genetic form of deafness carried by the patient have been largely anecdotal to date. It has been suggested that the differences in auditory performance may be explained by differences in the number of surviving spiral ganglion cells, etiology of hearing loss, and other factors. Knowledge of the specific loci and mutations involved in patients who receive cochlear implants may elucidate other factors related to CI performance. In this review article, current knowledge of cochlear implants for hereditary hearing loss will be discussed with an emphasis on relevant clinical genotype-phenotype correlations. PMID:20655117

  5. Cochlear implantation in common forms of genetic deafness.

    PubMed

    Vivero, Richard J; Fan, Kenneth; Angeli, Simon; Balkany, Thomas J; Liu, Xue Z

    2010-10-01

    Genetic factors are among the main etiologies of severe to profound hearing loss and may play an important role in cochlear implantation (CI) outcomes. While genes for common forms of deafness have been cloned, efforts to correlate the functional outcome of CIs with a genetic form of deafness carried by the patient have been largely anecdotal to date. It has been suggested that the differences in auditory performance may be explained by differences in the number of surviving spiral ganglion cells, etiology of hearing loss, and other factors. Knowledge of the specific loci and mutations involved in patients who receive cochlear implants may elucidate other factors related to CI performance. In this review article, current knowledge of cochlear implants for hereditary hearing loss will be discussed with an emphasis on relevant clinical genotype-phenotype correlations.

  6. A speech enhancement method for cochlear implant listeners.

    PubMed

    Yuan, Meng; Sun, Yang; Feng, Haihong; Lee, Tan

    2013-01-01

    This paper discusses a single-channel speech enhancement method for cochlear implant listeners. It is assumed that the Fourier Transform coefficients of speech and background noise have different statistical distributions. A statistical-model-based method is adopted to update the signal-to-noise ratio and estimate the background noise so that the musical noise and speech distortion induced by traditional spectral subtraction method can be effectively reduced. This enhancement method was evaluated on seven postlingually deaf Chinese cochlear implant listeners in comparison with other two speech enhancement methods. Test materials were Mandarin sentences corrupted by three different types of background noise. Experimental results showed that the proposed speech enhancement method could benefit the speech intelligibility of Chinese cochlear implant listeners. The results suggest that different noise types may affect the performance of different speech enhancement algorithms.

  7. Neural response imaging (NRI) cochlear mapping: prospects for clinical application.

    PubMed

    Arnold, L; Lindsey, P; Hacking, C; Boyle, P

    2007-12-01

    The objective of the study was to investigate the potential for clinical application of neural response imaging (NRI) cochlear mapping. Cochlear mapping was performed at each fitting session up to at least six months following initial fitting. Stimulation was delivered to one electrode site. NRI was recorded from each of the remaining sites. The procedure was repeated for apical, medial and basal stimulation sites, stimulating at subjective threshold and most comfortable levels. Responses were obtained in five out of six subjects and are discussed in terms of: reproducibility, quality, changes over time. Cochlear mapping provided repeatable data that gave interesting insights into the implanted cochlea. Further work is required to determine whether this approach could contribute to programme optimisation.

  8. Cochlear implant considerations in children with additional disabilities

    PubMed Central

    Corrales, C. Eduardo

    2013-01-01

    Early identification and management of disabilities in children are essential to reduce long-term developmental sequelae. Many of the causes of hearing loss also produce cognitive delays resulting in a large number of children with both deafness and developmental disabilities. Children who have hearing loss and additional disabilities require complex, individualized therapy to maximize their long-term quality of life. Hearing loss is often detected early because of widespread newborn hearing screening programs and the decision for cochlear implantation in children presenting with multiple medical and developmental disorders is still evolving. This article will review the literature regarding cochlear implant considerations in children with additional developmental disabilities in areas of family perception, speech and language development, cognitive development including adaptive behavior and intelligence, communication and functional skills, auditory outcomes, quality of life outcomes, predictors of outcomes and realistic expectations after cochlear implantation. PMID:23772353

  9. Imaging cochlear soft tissue displacement with coherent x-rays

    NASA Astrophysics Data System (ADS)

    Rau, Christoph; Richter, Claus-Peter

    2015-10-01

    At present, imaging of cochlear mechanics at mid-cochlear turns has not been accomplished. Although challenging, this appears possible with partially coherent hard x-rays. The present study shows results from stroboscopic x-ray imaging of a test object at audio frequencies. The vibration amplitudes were quantified. In a different set of experiments, an intact and calcified gerbil temporal bone was used to determine displacements of the reticular lamina, tectorial membrane, and Reissner’s membrane with the Lucas and Kanade video flow algorithm. The experiments validated high frequency x-ray imaging and imaging in a calcified cochlea. The present work is key for future imaging of cochlear micromechanics at a high spatial resolution.

  10. Phonological awareness of Cantonese-speaking pre-school children with cochlear implants.

    PubMed

    Tse, Wing Ting; So, Lydia K H

    2012-02-01

    The study investigated the phonological awareness abilities of Cantonese-speaking pre-schoolers with cochlear implants. Participants were 15 Cantonese-speaking children with cochlear implants (CIs) aged 3.08-6.10, chronological-age-matched with 15 children with normal hearing. Each participant performed 10 tasks evaluating different levels of phonological awareness abilities and phonological knowledge. The results showed that pre-schoolers with cochlear implants and their normal hearing peers had similar levels of syllable awareness, phoneme awareness and rhyme awareness. However, cochlear implant users showed significantly poorer performance on tone awareness and phonological knowledge tasks than their normal hearing peers. Cantonese-speaking pre-schoolers with cochlear implants were able to develop phonological awareness. However, the cochlear implants might not provide enough tonal information for children with hearing impairment for tonal lexical comprehension. Incomplete speech and language stimulation may affect phonological knowledge development in Cantonese-speaking pre-schoolers with cochlear implants.

  11. Place-pitch manipulations with cochlear implants

    PubMed Central

    Macherey, Olivier; Carlyon, Robert P.

    2012-01-01

    Pitch can be conveyed to cochlear implant (CI) listeners via both place of excitation and temporal cues. The transmission of place cues may be hampered by several factors including limitations on the insertion depth and number of implanted electrodes, and the broad current spread produced by monopolar stimulation. The following series of experiments investigate several methods to partially overcome these limitations. Experiment 1 compares two recently published techniques that aim to activate more apical fibers than produced by monopolar or bipolar stimulation of the most apical contacts. The first technique (phantom stimulation) manipulates the current spread by simultaneously stimulating two electrodes with opposite-polarity pulses of different amplitudes. The second technique manipulates the neural spread of excitation by using asymmetric pulses and exploiting the polarity-sensitive properties of auditory nerve fibers. The two techniques yielded similar results and were shown to produce lower place pitch percepts than stimulation of monopolar and bipolar symmetric pulses. Furthermore, combining these two techniques may be advantageous in a clinical setting. Experiment 2 proposes a novel method to create place pitches intermediate to those produced by physical electrodes by using charge-balanced asymmetric pulses in bipolar mode with different degrees of asymmetry. PMID:22423718

  12. Cochlear implantation in children: socioeconomic family characteristics.

    PubMed

    Brkic, Fuad; Piric, Lejla; Salihovic, Nevzeta; Kabil, Jasmina

    2010-01-01

    The aim of the study is to analyse the socioeconomic status of implanted children families, candidates for implantation families and families of deaf children whose parents elicit not to proceed with cochlear implantation and to find out if the socioeconomic status has an influence on parental decision-making process. The following variables describe the socioeconomic status: place of living (urban/rural area), parental educational level and household monthly income (in Euro). Forty children divided in two groups were included in the study: Group 1 (23 implanted children and 7 candidates for implantation) and Group 2 (10 deaf children whose parents elicit not to proceed). Data were obtained from parents of children by phone. It was not possible to establish the contact with parents of three children. As for the place of living, 20 families were from urban area, 17 families were from rural area and the place of living of 3 families was unknown. Average number of completed school grades by parents was respectively: Group 1- 5.92 and Group 2 - 5.33. Concerning the place of living, parental educational level and household monthly income no differences can be seen between groups. Therefore, the authors concluded that socioeconomic status has no influence on making decision process.

  13. Modeling Sound Processing in Cochlear Nuclei

    NASA Astrophysics Data System (ADS)

    Meddis, Ray

    2003-03-01

    The cochlear nucleus is an obligatory relay nucleus between the ear and the rest of the brain. It consists of many different types of neurons each responding differently to the same stimulus. Much is known about the wiring diagram of the system but it has so far proved difficult to characterise the signal processing that is going on or what purpose it serves. The solution to this problem is a pre-requisite of any attempt to produce a practical electronic simulation that exploits the brain's unique capacity to recognise the significance of acoustic events and generate appropriate responses. This talk will explain the different types of neural cell and specify hypotheses as to their various functions. Cell-types vary in terms of their size and shape as well as the number and type of minute electrical currents that flow across the cell membranes. Computer models will also be used to illustrate how the physical substrate (the wet-ware) is used to achieve its signal-processing goals.

  14. Remote fitting in Nucleus cochlear implant recipients.

    PubMed

    Wesarg, Thomas; Wasowski, Arkadiusz; Skarzynski, Henryk; Ramos, Angel; Falcon Gonzalez, Juan Carlos; Kyriafinis, George; Junge, Friederike; Novakovich, Allan; Mauch, Herbert; Laszig, Roland

    2010-12-01

    Remote programming is a viable alternative to face-to-face programming. The procedure can be regarded as safe, time and cost saving, and clinically feasible. The aim of this study was to determine the suitability of commercially available video conferencing technology and remote control software for remote programming of sound processors in Nucleus cochlear implant recipients by assessing the feasibility, efficiency, risks, and benefits of remote programming compared to face-to-face programming. This was a randomized, prospective study. Seventy Nucleus implant recipients were recruited for a random sequence comparison of one remote and one local programming session each. The time required for local or remote programming was measured and resulting MAP T and C levels were compared. The recipient provided feedback on the local and remote programming session. The audiologist and monitoring clinician were asked for their feedback on remote programming. Remote programming sessions were successfully finished for 69 recipients. No significant differences between T and C levels obtained by local and remote programming were found. The audiologists and monitoring clinicians agreed that the remote programming system provided an acceptable level of performance after most sessions. More than 50 participating recipients considered remote programming an efficient alternative to face-to-face-programming.

  15. Migration of cochlear lateral wall cells.

    PubMed

    Dunaway, George; Mhaskar, Yashanad; Armour, Gary; Whitworth, Craig; Rybak, Leonard

    2003-03-01

    The role of apoptosis and proliferation in maintenance of cochlear lateral wall cells was examined. The methods employed for detection of apoptosis were the Hoechst fluorescence stain and TUNEL (TdT-mediated dUTP-biotin nick-end-labeling) assay, and proliferations were 5-bromo-2'-deoxyuridine (BrdU) incorporation and presence of the proliferating cell nuclear antigen. The incidence of apoptosis in the strial marginal cell was 50% greater (32.9+/-3.7%) than strial intermediate and basal cells but similar to spiral ligament cells. Although division of marginal strial cells was rarely detected, a significant number of proliferating cells in the remaining stria vascularis and spiral ligament were observed. These data implied that replacement of marginal cells arose elsewhere and could be followed by a BrdU-deoxythymidine pulse-chase study. At 2 h post injection, nuclear BrdU in marginal cells was not detected; however, by 24 h post injection, 20-25% of marginal cell nuclei were BrdU-positive. These observations are consistent with the hypothesis that marginal cells were replaced by underlying cells. Cell migration appears to be an important mechanism for preserving the function and structure of the stria vascularis.

  16. Exploring the benefits of bilateral cochlear implants.

    PubMed

    van Hoesel, Richard J M

    2004-01-01

    Several recent reports indicate that both localization and speech intelligibility in spatially separated noise are substantially improved by using cochlear implants (CIs) in both ears rather than in just one. Benefits appear to be largely derived from the effects of level variations at the two ears due to the head shadow whereas contributions from interaural time differences (ITDs) seem smaller than in normal hearing listeners. The effect of binaural unmasking estimated from speech studies to date varies from study to study and is possibly confounded by issues such as listening experience, bias or loudness effects when comparing the performance for the better ear with that using both ears. To improve the contribution from timing information at the two ears, it may be necessary to change present clinical sound-processing schemes that currently preserve only envelope cues so that they also preserve fine-timing information. However, recently published data show that basic psychophysical sensitivity to fine-timing ITDs in CI patients is very poor for rates beyond a few hundred hertz, suggesting that subjects do not actually hear ITD cues at those rates anyway. Data from a number of new studies are presented to discuss these and other issues related to the potential to benefit from bilateral implantation. Copyright 2004 S. Karger AG, Basel

  17. Environmental Sound Training in Cochlear Implant Users

    PubMed Central

    Sheft, Stanley; Kuvadia, Sejal; Gygi, Brian

    2015-01-01

    Purpose The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart, followed by 4 environmental sound training sessions conducted on separate days in 1 week, and concluded with 2 posttest sessions, separated by another week without training. Each testing session included an environmental sound test, which consisted of 40 familiar everyday sounds, each represented by 4 different tokens, as well as the Consonant Nucleus Consonant (CNC) word test, and Revised Speech Perception in Noise (SPIN-R) sentence test. Results Environmental sounds scores were lower than for either of the speech tests. Following training, there was a significant average improvement of 15.8 points in environmental sound perception, which persisted 1 week later after training was discontinued. No significant improvements were observed for either speech test. Conclusions The findings demonstrate that environmental sound perception, which remains problematic even for experienced CI patients, can be improved with a home-based computer training regimen. Such computer-based training may thus provide an effective low-cost approach to rehabilitation for CI users, and potentially, other hearing impaired populations. PMID:25633579

  18. [Applied anatomy of scala tympani inlet related to cochlear implantation].

    PubMed

    Zou, Tuanming; Guo, Menghe; Zhang, Hongzheng; Shu, Fan; Xie, Nanping

    2012-06-01

    To investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach. In a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure. The distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence. These parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.

  19. Auditory Cortex Basal Activity Modulates Cochlear Responses in Chinchillas

    PubMed Central

    León, Alex; Elgueda, Diego; Silva, María A.; Hamamé, Carlos M.; Delano, Paul H.

    2012-01-01

    Background The auditory efferent system has unique neuroanatomical pathways that connect the cerebral cortex with sensory receptor cells. Pyramidal neurons located in layers V and VI of the primary auditory cortex constitute descending projections to the thalamus, inferior colliculus, and even directly to the superior olivary complex and to the cochlear nucleus. Efferent pathways are connected to the cochlear receptor by the olivocochlear system, which innervates outer hair cells and auditory nerve fibers. The functional role of the cortico-olivocochlear efferent system remains debated. We hypothesized that auditory cortex basal activity modulates cochlear and auditory-nerve afferent responses through the efferent system. Methodology/Principal Findings Cochlear microphonics (CM), auditory-nerve compound action potentials (CAP) and auditory cortex evoked potentials (ACEP) were recorded in twenty anesthetized chinchillas, before, during and after auditory cortex deactivation by two methods: lidocaine microinjections or cortical cooling with cryoloops. Auditory cortex deactivation induced a transient reduction in ACEP amplitudes in fifteen animals (deactivation experiments) and a permanent reduction in five chinchillas (lesion experiments). We found significant changes in the amplitude of CM in both types of experiments, being the most common effect a CM decrease found in fifteen animals. Concomitantly to CM amplitude changes, we found CAP increases in seven chinchillas and CAP reductions in thirteen animals. Although ACEP amplitudes were completely recovered after ninety minutes in deactivation experiments, only partial recovery was observed in the magnitudes of cochlear responses. Conclusions/Significance These results show that blocking ongoing auditory cortex activity modulates CM and CAP responses, demonstrating that cortico-olivocochlear circuits regulate auditory nerve and cochlear responses through a basal efferent tone. The diversity of the obtained effects

  20. Localization ability with bimodal hearing aids and bilateral cochlear implants

    NASA Astrophysics Data System (ADS)

    Seeber, Bernhard U.; Baumann, Uwe; Fastl, Hugo

    2004-09-01

    After successful cochlear implantation in one ear, some patients continue to use a hearing aid at the contralateral ear. They report an improved reception of speech, especially in noise, as well as a better perception of music when the hearing aid and cochlear implant are used in this bimodal combination. Some individuals in this bimodal patient group also report the impression of an improved localization ability. Similar experiences are reported by the group of bilateral cochlear implantees. In this study, a survey of 11 bimodally and 4 bilaterally equipped cochlear implant users was carried out to assess localization ability. Individuals in the bimodal implant group were all provided with the same type of hearing aid in the opposite ear, and subjects in the bilateral implant group used cochlear implants of the same manufacturer on each ear. Subjects adjusted the spot of a computer-controlled laser-pointer to the perceived direction of sound incidence in the frontal horizontal plane by rotating a trackball. Two subjects of the bimodal group who had substantial residual hearing showed localization ability in the bimodal configuration, whereas using each single device only the subject with better residual hearing was able to discriminate the side of sound origin. Five other subjects with more pronounced hearing loss displayed an ability for side discrimination through the use of bimodal aids, while four of them were already able to discriminate the side with a single device. Of the bilateral cochlear implant group one subject showed localization accuracy close to that of normal hearing subjects. This subject was also able to discriminate the side of sound origin using the first implanted device alone. The other three bilaterally equipped subjects showed limited localization ability using both devices. Among them one subject demonstrated a side-discrimination ability using only the first implanted device.

  1. Noise alters hair-bundle mechanics at the cochlear apex

    NASA Astrophysics Data System (ADS)

    Strimbu, C. Elliott; Fridberger, Anders

    2015-12-01

    Exposure to loud sounds can lead to both permanent and short term changes in auditory sensitivity. Permanent hearing loss is often associated with gross changes in cochlear morphology including the loss of hair cells and auditory nerve fibers while the mechanisms of short term threshold shifts are much less well understood and may vary at different locations across the cochlea. Previous reports suggest that exposure to loud sounds leads to a decrease in the cochlear microphonic potential and in the stiffness of the organ of Corti. Because the cochlear microphonic reflects changes in the membrane potential of the hair cells, this suggests that hair-bundle motion should be reversibly altered following exposure to loud sounds. Using an in vitro preparation of the guinea pig temporal bone we investigate changes in the micro-mechanical response near the cochlear apex following a brief (up to 10 - 20 minutes) exposure to loud (˜ 120 dB) tones near the best frequency at this location. We use time-resolved confocal imaging to record the motion of outer hair cell bundles before and after acoustic overstimulation. We have also recorded larger-scale structural views of the organ of Corti before and after exposure to the loud sound. Conventional electrophysiological techniques are used measure the cochlear microphonic potential. As has been previously reported, following acoustic overexposure the cochlear microphonic declines in value and typically recovers on the order of 30 - 60 minutes. Hair-bundle trajectories are affected following the loud sound and typically recover on a somewhat faster time scale than the microphonic potential, although the results vary considerably across preparations. Preliminary results also suggest reversible changes in the hair cell's resting potential following the loud sound.

  2. Achieving early functional auditory access in paediatric cochlear implantation.

    PubMed

    Orzan, E; Muzzi, E; Marchi, R; Falzone, C; Battelino, S; Ciciriello, E

    2016-02-01

    Cochlear implantation (CI) is a viable option for providing access to auditory stimulation in severe-to-profound hearing loss/impairment of cochlear origin. It has been demonstrated that CI is safe and effective for deaf children. Younger age at activation after CI is linked with better outcomes. It is important to study variables and issues that can interfere with an early fitting and access to sound after CI. They range from patient characteristics, family compliance and support, to technical, medical or organisational problems. A SWOT analysis and a subsequent TOWS matrix was conducted to discuss issues and propose recommendations to be considered when operating an early switch on of the CI.

  3. Improvement of cognitive function after cochlear implantation in elderly patients.

    PubMed

    Mosnier, Isabelle; Bebear, Jean-Pierre; Marx, Mathieu; Fraysse, Bernard; Truy, Eric; Lina-Granade, Geneviève; Mondain, Michel; Sterkers-Artières, Françoise; Bordure, Philippe; Robier, Alain; Godey, Benoit; Meyer, Bernard; Frachet, Bruno; Poncet-Wallet, Christine; Bouccara, Didier; Sterkers, Olivier

    2015-05-01

    The association between hearing impairment and cognitive decline has been established; however, the effect of cochlear implantation on cognition in profoundly deaf elderly patients is not known. To analyze the relationship between cognitive function and hearing restoration with a cochlear implant in elderly patients. Prospective longitudinal study performed in 10 tertiary referral centers between September 1, 2006, and June 30, 2009. The participants included 94 patients aged 65 to 85 years with profound, postlingual hearing loss who were evaluated before, 6 months after, and 12 months after cochlear implantation. Cochlear implantation and aural rehabilitation program. Speech perception was measured using disyllabic word recognition tests in quiet and in noise settings. Cognitive function was assessed using a battery of 6 tests evaluating attention, memory, orientation, executive function, mental flexibility, and fluency (Mini-Mental State Examination, 5-word test, clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making test parts A and B). Quality of life and depression were evaluated using the Nijmegen Cochlear Implant Questionnaire and the Geriatric Depression Scale-4. Cochlear implantation led to improvements in speech perception in quiet and in noise (at 6 months: in quiet, 42% score increase [95% CI, 35%-49%; P < .001]; in noise, at signal to noise ratio [SNR] +15 dB, 44% [95% CI, 36%-52%, P < .001], at SNR +10 dB, 37% [95% CI 30%-44%; P < .001], and at SNR +5 dB, 27% [95% CI, 20%-33%; P < .001]), quality of life, and Geriatric Depression Scale-4 scores (76% of patients gave responses indicating no depression at 12 months after implantation vs 59% before implantation; P = .02). Before cochlear implantation, 44% of the patients (40 of 91) had abnormal scores on 2 or 3 of 6 cognition tests. One year after implant, 81% of the subgroup (30 of 37) showed improved global cognitive function (no or 1 abnormal test score

  4. Improvement in speech-reading ability by auditory training: Evidence from gender differences in normally hearing, deaf and cochlear implanted subjects.

    PubMed

    Strelnikov, K; Rouger, J; Lagleyre, S; Fraysse, B; Deguine, O; Barone, P

    2009-03-01

    Several neuropsychological and neuroimaging studies on gender differences in speech processing lead to the suggestion that women use the neural network of predictive and integrative analysis of speech to a larger extent than men. During speech-reading there is indeed a lack of reliable clues for word recognition which should emphasize predictive and integrative strategies of the brain. Our study aimed to explore gender differences in deaf and cochlear implanted (CI) patients at different levels during speech-reading, for words or phonemes, that we consider, correspond to increased involvement of predictive and integrative analysis. We collected speech-reading scores in a control group of normally hearing subjects (n=42) and in a group of deaf patients - who are good speech-readers - tested before, early after and late after cochlear implantation (n=97). Patient groups were almost equally distributed between follow-up and new patients. In normally hearing controls, women speech-read words better than men. This difference was also observed in all patients but not in experienced cochlear implant users. We did not observe a gender difference during speech-reading of isolated phonemes neither for controls nor for patients. We conclude that the better speech-reading ability of women for words but not for phonemes is in line with their greater use of predictive and integrative strategies for speech processing. Furthermore, we observed a progressive cross-modal compensation in male CI users after cochlear implantation which suggests a synergetic perceptual facilitation involving the visual and the recovering auditory modalities. This could lead to an improved performance in both auditory and visual modalities, the latter being constantly recruited to complement the crude information provided by the implant. Altogether, our data provide insights into cross-modal compensation in the adult brain following sensory privation.

  5. The Role of Visual Speech Information in Supporting Perceptual Learning of Degraded Speech

    ERIC Educational Resources Information Center

    Wayne, Rachel V.; Johnsrude, Ingrid S.

    2012-01-01

    Following cochlear implantation, hearing-impaired listeners must adapt to speech as heard through their prosthesis. Visual speech information (VSI; the lip and facial movements of speech) is typically available in everyday conversation. Here, we investigate whether learning to understand a popular auditory simulation of speech as transduced by a…

  6. The Role of Visual Speech Information in Supporting Perceptual Learning of Degraded Speech

    ERIC Educational Resources Information Center

    Wayne, Rachel V.; Johnsrude, Ingrid S.

    2012-01-01

    Following cochlear implantation, hearing-impaired listeners must adapt to speech as heard through their prosthesis. Visual speech information (VSI; the lip and facial movements of speech) is typically available in everyday conversation. Here, we investigate whether learning to understand a popular auditory simulation of speech as transduced by a…

  7. [Speaker discrimination in cochlear implant users].

    PubMed

    Mühler, R; Ziese, M; Verhey, J L

    2017-03-01

    Although the word and sentence recognition skills of cochlear implant (CI) users have been studied extensively, little is known about their ability to distinguish between individuals on the basis of voice, an important skill for social communication. Speech material from the Oldenburg Logatome Corpus (OLLO) was used to build a set of 120 logatome pairs spoken by 15 male and 15 female speakers, with no overlap of the fundamental frequencies of the two groups of speakers. Each pair contained two different logatomes. For half of the pairs, the two logatomes were spoken by the same speaker, for the other half they were spoken by different speakers. Using a same-different paradigm, 13 adult normal-hearing listeners and 13 adult post-lingually deafened CI users were asked whether the pair of different logatomes were spoken by the same or by different speakers. Mean speaker discrimination score for the CI users was 74.6 % correct and for the normal-hearing listeners 89.6 % correct. A significant influence of voice gender on speaker discrimination score was found in CI users and in normal hearing listeners. The results of the CI users were significantly above the level of chance and no ceiling effect was observed for the normal-hearing listeners, i. e., the presented set of logatome pairs from the OLLO seems to be very well suited to speaker discrimination experiments in CI users and quantitative comparison to normal-hearing listeners. CI users are able to discriminate between speakers but their performance is slightly worse than that of normal-hearing listeners.

  8. Behavior problems in children with cochlear implants.

    PubMed

    Chao, Wei-Chieh; Lee, Li-Ang; Liu, Tien-Chen; Tsou, Yung-Ting; Chan, Kai-Chieh; Wu, Che-Ming

    2015-05-01

    (1) To examine behavior problems in Mandarin-speaking children with cochlear implants (CIs); (2) to investigate the associated factors of problem behaviors; (3) to understand the relationships between behavior problems and parenting stress. Sixty patients (25 boys, 35 girls) aged 6-18 years (mean=12.2±3.2) who used CIs for a mean duration of eight years participated in the study. Behavior problems were assessed by Achenbach's child behavior checklist (CBCL). Categorical auditory performance (CAP) and speech intelligibility rating (SIR) scales were utilized to investigate auditory performance and speech production intelligibility. Parenting stress index (PSI) was filled out by parents to measure parenting stress level. Significantly more CI subjects had problems with 'Withdrawn/Depressed' (p=0.010), 'Social Problems' (p<0.001), 'Thought Problems' (p<0.001), 'Attention Problems' (p<0.001), 'Aggressive Behavior' (p=0.010) and 'Overall Behavior' (p=0.001) than the normative sample did. 'Social Problems' was the most common problem and could be independently associated with gender, socioeconomic status and CAP (R(2)=0.361). CAP score was also associated with Overall Behaviors (R(2)=0.081). The results of PSI had a significant positive correlation with almost all CBCL subscales (p<0.05). The CI subjects still exhibit social and attention problems, which may in turn increase parenting stress. Good family support as well as aural-verbal rehabilitation are of particular importance in determining behavioral outcomes in CI children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Assessment of a direct acoustic cochlear stimulator.

    PubMed

    Chatzimichalis, Michail; Sim, Jae Hoon; Huber, Alexander M

    2012-01-01

    This study aimed to assess the functional results of a new, active, acoustic-mechanical hearing implant, the Direct Acoustic Cochlear Stimulation Partial Implant (DACS PI), in a preclinical study. The DACS PI is an electromagnetic device fixed to the mastoid by screws and coupled to a standard stapes prosthesis by an artificial incus (AI). The function of the DACS PI-aided reconstruction was assessed by determining: (1) the maximum equivalent sound pressure level (SPL) of the implant, which was obtained from measurements of the volume displacement at the round window in normal and implanted ears, and (2) the quality at the coupling interface between the AI of the DACS and the stapes prosthesis, which was quantified from measurements of relative motions between the AI and the prosthesis. Both measurements were performed with fresh temporal bones using a scanning laser Doppler interferometry system. The expected maximum equivalent SPL with a typical driving voltage of 0.3 V was about 115-125 dB SPL up to 1.5 kHz in reconstruction with the DACS PI, and decreased with a roll-off slope of about 65 dB/decade, reaching 90 dB SPL at 8 kHz. The large roll-off relative to a normal ear was presumed to be a relatively high inductive impedance of the coil of the DACS PI actuator at higher frequencies. Good coupling quality between the AI and the prosthesis was achieved below the resonance (∼1.5 kHz) of the DACS PI for all tested stapes prostheses. Above the resonance, the SMart Piston, which is composed of a shape-memory alloy, had the best coupling quality.

  10. Management of Cochlear Implant Electrode Migration.

    PubMed

    Rader, Tobias; Baumann, Uwe; Stöver, Timo; Weissgerber, Tobias; Adel, Youssef; Leinung, Martin; Helbig, Silke

    2016-10-01

    The present study reviewed a cochlear implant (CI) patient population after surgery, which received a free-fitting electrode carrier designed for hearing preservation. The aim was to determine the rate of electrode migration of the CI electrodes and present clinical and surgical implications. Retrospective patient review. Tertiary referral university hospital. Two hundred seventy-eight patients implanted uni- or bilaterally with lateral wall electrodes designed for hearing preservation (358 implants). The control group was 323 patients implanted uni- or bilaterally with preformed perimodiolar electrodes (468 implants). Determination of CI electrode migration was conducted according to a clinical test protocol. Revision surgery was offered in confirmed patients of electrode migration. A bone groove was considered to improve the fixation of the electrode. Audiological testing including speech audiometry, subjective sound quality rating, and bilateral pitch comparison in bilateral patients, as well as radiological examinations, were conducted. Electrode migration was observed solely in patients implanted with lateral wall electrodes; 10 of 358 patients with free-fitting electrodes (2.8%) had electrode migration, which was successfully confirmed by the proposed clinical test protocol. Nine of the 10 confirmed patients underwent reinsertion surgery. Mean perception score decreased from 75.0% to 62.1% after electrode migration and recovered completely after reinsertion surgery. A flowchart to detect electrode migration was designed for clinical practice. Although electrode migration is a rare complication in CI surgery, long-term follow-up diagnostics should include a test protocol to detect electrode shifts of lateral wall electrode arrays. A reinsertion surgery should be conducted in confirmed patients to recover speech perception.

  11. Connected speech intelligibility of children with cochlear implants and children with normal hearing.

    PubMed

    Chin, Steven B; Tsai, Patrick L; Gao, Sujuan

    2003-11-01

    The objective of this study was to compare the connected speech intelligibility of children who use cochlear implants with that of children who have normal hearing. Previous research has shown that speech intelligibility improves from before cochlear implantation to after implantation and that the speech intelligibility of children who use cochlear implants compares favorably with that of children who use conventional hearing aids. However, no research has yet addressed the question of how the speech intelligibility of children who use cochlear implants compares to that of children with normal hearing. In the current study, archival data on connected speech intelligibility from 51 children with cochlear implants were compared with newly collected data from 47 children with normal hearing. Results showed that for children with cochlear implants, greater intelligibility was associated with both increased chronological age and increased duration of cochlear implant use. Consistent with previous studies, children with normal hearing achieved adult-like or near-adult-like intelligibility around the age of 4 years, but a similar peak in intelligibility was not observed for the children who used cochlear implants. On the whole, children with cochlear implants were significantly less intelligible than children with normal hearing, when controlling both for chronological age and for length of auditory experience. These results have implications for the socialization and education of children with cochlear implants, particularly with respect to on-time placement in mainstream educational environments with age peers.

  12. Origins and targets of commissural connections between the cochlear nuclei in guinea pigs.

    PubMed

    Schofield, B R; Cant, N B

    1996-11-04

    Our objective was to identify the origins and targets of axons that project from one cochlear nucleus to the other. First, retrograde tracers were injected into one cochlear nucleus to label commissural cells in the opposite nucleus. In the dorsal cochlear nucleus, a few cells in the deep layers were labeled; they were not further classified according to type. In the ventral cochlear nucleus, all commissural cells that could be classified were multipolar cells. Second, an anterograde tracer was injected into one cochlear nucleus, and the distribution of boutons in the opposite cochlear nucleus was examined. Labeled boutons were present throughout the ventral cochlear nucleus, where they appeared to contact multipolar cells, spherical and globular bushy cells, and octopus cells. In the dorsal cochlear nucleus, labeled boutons were present in the fusiform cell and deep layers and appeared to contact fusiform cells and cells of unknown type. Many labeled terminals were also present in the granule cell regions. Injections into regions associated with high or low frequencies labeled boutons in corresponding regions in the contralateral ventral cochlear nucleus. Third, multiple tracers were used to determine whether cells that project to the inferior colliculus are contacted by commissural axons. Boutons labeled by anterograde transport of one tracer placed in the cochlear nucleus were frequently observed to be apposed to cells that were labeled by retrograde transport of a different tracer placed in the contralateral inferior colliculus. We conclude that commissural projections originate from multipolar cells throughout the ventral cochlear nucleus (and from a small number of cells in the dorsal cochlear nucleus) and make contact with all major cell types of the cochlear nuclei, including at least some of those that project to the inferior colliculus.

  13. Using Flanagan's phase vocoder to improve cochlear implant performance

    NASA Astrophysics Data System (ADS)

    Zeng, Fan-Gang

    2004-10-01

    The cochlear implant has restored partial hearing to more than 100000 deaf people worldwide, allowing the average user to talk on the telephone in quiet environment. However, significant difficulty still remains for speech recognition in noise, music perception, and tonal language understanding. This difficulty may be related to speech processing strategies in current cochlear implants that emphasized the extraction and encoding of the temporal envelope while ignoring the temporal fine structure in speech sounds. A novel strategy was developed based on Flanagan's phase vocoder [Flanagan and Golden, Bell Syst. Tech. 45, 1493-1509 (1966)], in which frequency modulation was extracted from the temporal fine structure and then added to amplitude modulation in the current cochlear implants. Acoustic simulation results showed that amplitude and frequency modulation contributed complementarily to speech perception with amplitude modulation contributing mainly to intelligibility whereas frequency modulation contributed to speaker identification and auditory grouping. The results also showed that the novel strategy significantly improved cochlear implant performance under realistic listening situations. Overall, the present result demonstrated that Flanagan's classic work on phase vocoder still shed insight on current problems of both theoretical and practical importance. [Work supported by NIH.

  14. Deaf Teenagers with Cochlear Implants in Conversation with Hearing Peers

    ERIC Educational Resources Information Center

    Ibertsson, Tina; Hansson, Kristina; Maki-Torkko, Elina; Willstedt-Svensson, Ursula; Sahlen, Birgitta

    2009-01-01

    Background: This study investigates the use of requests for clarification in conversations between teenagers with a cochlear implant (CI) and hearing peers. So far very few studies have focused on conversational abilities in children with CI. Aims: The aim was to explore co-construction of dialogue in a referential communication task and the…

  15. Temporal-Gap Detection by Cochlear Prosthesis Users.

    ERIC Educational Resources Information Center

    Preece, John P.; Tyler, Richard S.

    1989-01-01

    Three experiments were undertaken involving three users of multi-electrode cochlear prostheses. The experiments established a scale of stimulus loudness; measured minimum-detectable gaps for sinusoidal stimuli as functions of stimulus level, frequency, and electrode place within the cochlea; and assessed independence of the electrodes using a…

  16. Production of Consonants by Prelinguistically Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Bouchard, Marie-Eve Gaul; Le Normand, Marie-Therese; Cohen, Henri

    2007-01-01

    Consonant production following the sensory restoration of audition was investigated in 22 prelinguistically deaf French children who received cochlear implants. Spontaneous speech productions were recorded at 6, 12, and 18 months post-surgery and consonant inventories were derived from both glossable and non-glossable phones using two acquisition…

  17. Cortical Auditory Evoked Potentials in Unsuccessful Cochlear Implant Users

    ERIC Educational Resources Information Center

    Munivrana, Boska; Mildner, Vesna

    2013-01-01

    In some cochlear implant users, success is not achieved in spite of optimal clinical factors (including age at implantation, duration of rehabilitation and post-implant hearing level), which may be attributed to disorders at higher levels of the auditory pathway. We used cortical auditory evoked potentials to investigate the ability to perceive…

  18. Effects of Talker Variability on Vowel Recognition in Cochlear Implants

    ERIC Educational Resources Information Center

    Chang, Yi-ping; Fu, Qian-Jie

    2006-01-01

    Purpose: To investigate the effects of talker variability on vowel recognition by cochlear implant (CI) users and by normal-hearing (NH) participants listening to 4-channel acoustic CI simulations. Method: CI users were tested with their clinically assigned speech processors. For NH participants, 3 CI processors were simulated, using different…

  19. Cortical Auditory Evoked Potentials in Unsuccessful Cochlear Implant Users

    ERIC Educational Resources Information Center

    Munivrana, Boska; Mildner, Vesna

    2013-01-01

    In some cochlear implant users, success is not achieved in spite of optimal clinical factors (including age at implantation, duration of rehabilitation and post-implant hearing level), which may be attributed to disorders at higher levels of the auditory pathway. We used cortical auditory evoked potentials to investigate the ability to perceive…

  20. Implicit Sequence Learning in Deaf Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Conway, Christopher M.; Pisoni, David B.; Anaya, Esperanza M.; Karpicke, Jennifer; Henning, Shirley C.

    2011-01-01

    Deaf children with cochlear implants (CIs) represent an intriguing opportunity to study neurocognitive plasticity and reorganization when sound is introduced following a period of auditory deprivation early in development. Although it is common to consider deafness as affecting hearing alone, it may be the case that auditory deprivation leads to…

  1. Outcomes from Cochlear Implantation for Child and Family: Parental Perspectives

    ERIC Educational Resources Information Center

    Archbold, Sue; Sach, Tracey; O'Neill, Ciaran; Lutman, Mark; Gregory, Susan

    2008-01-01

    While cochlear implantation is an increasingly routine provision for profoundly deaf children in many countries, parents still require information about the procedure and likely outcomes in order to make an informed decision. Other parents can provide them with the insights of those who have undergone the process themselves and observed outcomes…

  2. Relationship between multipulse integration and speech recognition with cochlear implants

    PubMed Central

    Zhou, Ning; Pfingst, Bryan E.

    2014-01-01

    Comparisons of performance with cochlear implants and postmortem conditions in the cochlea in humans have shown mixed results. The limitations in those studies favor the use of within-subject designs and non-invasive measures to estimate cochlear conditions. One non-invasive correlate of cochlear health is multipulse integration, established in an animal model. The present study used this measure to relate neural health in human cochlear implant users to their speech recognition performance. The multipulse-integration slopes were derived based on psychophysical detection thresholds measured for two pulse rates (80 and 640 pulses per second). A within-subject design was used in eight subjects with bilateral implants where the direction and magnitude of ear differences in the multipulse-integration slopes were compared with those of the speech-recognition results. The speech measures included speech reception threshold for sentences and phoneme recognition in noise. The magnitude of ear difference in the integration slopes was significantly correlated with the magnitude of ear difference in speech reception thresholds, consonant recognition in noise, and transmission of place of articulation of consonants. These results suggest that multipulse integration predicts speech recognition in noise and perception of features that use dynamic spectral cues. PMID:25190399

  3. Implants and Ethnocide: Learning from the Cochlear Implant Controversy

    ERIC Educational Resources Information Center

    Sparrow, Robert

    2010-01-01

    This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

  4. Reading and Writing Skills of Deaf Pupils with Cochlear Implants

    ERIC Educational Resources Information Center

    Mayer, Connie; Watson, Linda; Archbold, Sue; Ng, Zheng Yen; Mulla, Imran

    2016-01-01

    Thirty-three young people with cochlear implants, aged between 9 and 16 years, were assessed for use of their implant system, cognitive abilities, vocabulary, reading, and writing skills. The group came from throughout England and included 26 born deaf, six deafened by meningitis, one with auditory neuropathy, and five with additional needs.…

  5. Relationship between multipulse integration and speech recognition with cochlear implants.

    PubMed

    Zhou, Ning; Pfingst, Bryan E

    2014-09-01

    Comparisons of performance with cochlear implants and postmortem conditions in the cochlea in humans have shown mixed results. The limitations in those studies favor the use of within-subject designs and non-invasive measures to estimate cochlear conditions. One non-invasive correlate of cochlear health is multipulse integration, established in an animal model. The present study used this measure to relate neural health in human cochlear implant users to their speech recognition performance. The multipulse-integration slopes were derived based on psychophysical detection thresholds measured for two pulse rates (80 and 640 pulses per second). A within-subject design was used in eight subjects with bilateral implants where the direction and magnitude of ear differences in the multipulse-integration slopes were compared with those of the speech-recognition results. The speech measures included speech reception threshold for sentences and phoneme recognition in noise. The magnitude of ear difference in the integration slopes was significantly correlated with the magnitude of ear difference in speech reception thresholds, consonant recognition in noise, and transmission of place of articulation of consonants. These results suggest that multipulse integration predicts speech recognition in noise and perception of features that use dynamic spectral cues.

  6. Spelling of Deaf Children Who Use Cochlear Implants

    ERIC Educational Resources Information Center

    Hayes, Heather; Kessler, Brett; Treiman, Rebecca

    2011-01-01

    The spellings of 39 profoundly deaf users of cochlear implants, aged 6 to 12 years, were compared with those of 39 hearing peers. When controlled for age and reading ability, the error rates of the 2 groups were not significantly different. Both groups evinced phonological spelling strategies, performing better on words with more typical…

  7. Examining the Communication Skills of a Young Cochlear Implant Pioneer

    ERIC Educational Resources Information Center

    Connor, Carol McDonald

    2006-01-01

    The purpose of this longitudinal case study was to closely examine one deaf child's experience with a cochlear implant and his speech, language, and communication skills from kindergarten through middle and high school using both developmental and sociocultural frameworks. The target child was one of the first children to receive a cochlear…

  8. Growing up with a Cochlear Implant: Education, Vocation, and Affiliation

    ERIC Educational Resources Information Center

    Spencer, Linda J.; Tomblin, J. Bruce; Gantz, Bruce J.

    2012-01-01

    The long-term educational/vocational, affiliation, and quality-of-life outcomes of the first and second cohorts of children with bilateral, profound hearing loss who received cochlear implants under a large National Institutes of Health-funded study was investigated in 41 of 61 eligible participants. Educational and vocational outcomes were…

  9. TeleCITE: Telehealth--A Cochlear Implant Therapy Exchange

    ERIC Educational Resources Information Center

    Stith, Joanna; Stredler-Brown, Arlene; Greenway, Pat; Kahn, Gary

    2012-01-01

    What might bring the efforts of a physician, a speech-language pathologist, a teacher of the deaf and hard of hearing, and a nurse together? The answer is the innovative use of telepractice to deliver high quality, family-centered early intervention to infants and toddlers with hearing loss. TeleCITE: Telehealth--A Cochlear Implant Therapy…

  10. Interleaved processors improve cochlear implant patients' spectral resolution

    PubMed Central

    Aronoff, Justin M.; Stelmach, Julia; Padilla, Monica; Landsberger, David M.

    2015-01-01

    Objective Cochlear implant patients have difficulty in noisy environments in part because of channel interaction. Interleaving the signal by sending every other channel to the opposite ear has the potential to reduce channel interaction by increasing the space between channels in each ear. Interleaving still potentially provides the same amount of spectral information when the two ears are combined. Although this method has been successful in other populations such as hearing aid users, interleaving with cochlear implant patients has not yielded consistent benefits. This may be because perceptual misalignment between the two ears and the spacing between stimulation locations must be taken into account before interleaving. Design Eight bilateral cochlear implant users were tested. After perceptually aligning the two ears, twelve channel maps were made that spanned the entire aligned portions of the array. Interleaved maps were created by removing every other channel from each ear. Participants' spectral resolution and localization abilities were measured with perceptually aligned processing strategies both with and without interleaving. Results There was a significant improvement in spectral resolution with interleaving. However, there was no significant effect of interleaving on localization abilities. Conclusions The results indicate that interleaving can improve cochlear implant users' spectral resolution. However, it may be necessary to perceptually align the two ears and/or use relatively large spacing between stimulation locations. PMID:26656190

  11. Enduring Advantages of Early Cochlear Implantation for Spoken Language Development

    ERIC Educational Resources Information Center

    Geers, Anne E.; Nicholas, Johanna G.

    2013-01-01

    Purpose: In this article, the authors sought to determine whether the precise age of implantation (AOI) remains an important predictor of spoken language outcomes in later childhood for those who received a cochlear implant (CI) between 12 and 38 months of age. Relative advantages of receiving a bilateral CI after age 4.5 years, better…

  12. Word Learning Processes in Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Walker, Elizabeth A.; McGregor, Karla K.

    2013-01-01

    Purpose: To determine whether 3 aspects of the word learning process--fast mapping, retention, and extension--are problematic for children with cochlear implants (CIs). Method: The authors compared responses of 24 children with CIs, 24 age-matched hearing children, and 23 vocabulary-matched hearing children to a novel object noun training episode.…

  13. Sensitive Periods and Language in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Moreno-Torres, Ignacio; Madrid-Canovas, Sonia; Blanco-Montanez, Gema

    2016-01-01

    This study explores the hypothesis that the existence of a short sensitive period for lower-level speech perception/articulation skills, and a long one for higher-level language skills, may partly explain the language outcomes of children with cochlear implants (CIs). The participants were fourteen children fitted with a CI before their second…

  14. High School Students with Cochlear Implants: Coming Together for Success

    ERIC Educational Resources Information Center

    Nussbaum, Debra; Chisholm, Genie; Galloway, Rebecca; Dzime-Assison, Venita; Doyle, Jane

    2017-01-01

    While many people assume that students with cochlear implants have placements in mainstream schools, almost 25 percent of the approximately 175 students at the Model Secondary School for the Deaf (MSSD), the residential high school on the campus of Gallaudet University in Washington, D.C., have an implanted listening device. Working with these…

  15. Identification and Multiplicity of Double Vowels in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Kwon, Bomjun J.; Perry, Trevor T.

    2014-01-01

    Purpose: The present study examined cochlear implant (CI) users' perception of vowels presented concurrently (i.e., "double vowels") to further our understanding of auditory grouping in electric hearing. Method: Identification of double vowels and single vowels was measured with 10 CI subjects. Fundamental frequencies (F0s) of…

  16. Fricatives, Affricates, and Vowels in Croatian Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Mildner, Vesna; Liker, Marko

    2008-01-01

    The aim of the research was to analyse the speech of children with cochlear implants over approximately a 46-month period, and compare it with the speech of hearing controls. It focused on three categories of sounds in Croatian: vowels (F1 and F2 of /i/, /e/, /a/, /o/ and /u/), fricatives /s/ and /[esh]/ (spectral differences expressed in terms of…

  17. Identification and Multiplicity of Double Vowels in Cochlear Implant Users

    ERIC Educational Resources Information Center

    Kwon, Bomjun J.; Perry, Trevor T.

    2014-01-01

    Purpose: The present study examined cochlear implant (CI) users' perception of vowels presented concurrently (i.e., "double vowels") to further our understanding of auditory grouping in electric hearing. Method: Identification of double vowels and single vowels was measured with 10 CI subjects. Fundamental frequencies (F0s) of…

  18. Speech Perception in Noise by Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Caldwell, Amanda; Nittrouer, Susan

    2013-01-01

    Purpose: Common wisdom suggests that listening in noise poses disproportionately greater difficulty for listeners with cochlear implants (CIs) than for peers with normal hearing (NH). The purpose of this study was to examine phonological, language, and cognitive skills that might help explain speech-in-noise abilities for children with CIs.…

  19. Acoustic and Semantic Enhancements for Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Smiljanic, Rajka; Sladen, Douglas

    2013-01-01

    Purpose: In this study, the authors examined how signal clarity interacts with the use of sentence context information in determining speech-in-noise recognition for children with cochlear implants and children with normal hearing. Method: One hundred and twenty sentences in which the final word varied in predictability (high vs. low semantic…

  20. Linguistic and Pragmatic Skills in Toddlers with Cochlear Implant

    ERIC Educational Resources Information Center

    Rinaldi, Pasquale; Baruffaldi, Francesca; Burdo, Sandro; Caselli, Maria Cristina

    2013-01-01

    Background: An increasing number of deaf children received cochlear implants (CI) in the first years of life, but no study has focused on linguistic and pragmatic skills in children with CI younger than 3 years of age. Aims: To estimate the percentage of children who had received a CI before 2 years of age whose linguistic skills were within the…