The Vibrant Soundbridge® middle ear implant: A historical overview.

OBJECTIVE: To present a historical overview of the Vibrant Soundbridge® (VSB) middle ear implant (MEI), since its beginning in the 1990s to date and to describe its course and contemplate what it might become in the future. HISTORY: MEIs started to take form in researchers' mind in the 1930s with the first experiment of Wilska. In the 1970s, several devices, such as the Goode and Perkins', the Maniglia's, or the Hough and Dormer's were created but remained prototypes. It is only in the 1990s the devices that emerged remained on the market. In 1994, Symphonix, Inc. was created and aimed to manufacture and commercialize its semi-implantable MEI, the VSB. The principle of the VSB lies on a direct drive of the sound to a vibratory structure of the middle ear through an electromagnetic transducer, the floating mass transducer (FMT). The particularity of the system VSB is the simplicity of the transducer which is made of both the magnet and the coil; thus, the FMT, fixed on a vibrating middle ear structure, mimics the natural movement of the ossicular chain by moving in the same direction. The goal of the VSB was to give an alternative to patients with mild-to-severe sensorineural hearing loss who could not wear hearing aids (HAs) or who were unsatisfied conventional HA users. Subsequent to Tjellström's experiment in 1997, implantations started to include etiologies such as otosclerosis, radical mastoidectomy, failed ossiculoplasty/tympanoplasty, and atresia. Nowadays, the VSB, with more than 20 years of experience, is the oldest and most used middle ear implant worldwide. It is well acknowledged that the straightforward design and reliability of the transducer have certainly contributed to the success of the device.

The role of the Utah Artificial Ear project in the development of the modern cochlear implant.

The cochlear implant has provided the first substantial restoration of a human sense by a medical intervention. This accomplishment was brought about by the efforts, over a 50+ year period, of many individuals in laboratories around the world. In this paper, we recount the history of one of the early projects - the Utah Artificial Ear project. In 1970 researchers at the University of Utah began work on an auditory prosthesis. A critical early decision was to create a 'transparent' link between external signal processing and the electrodes implanted in the cochlea, i.e., a percutaneous pedestal. The pedestal allowed D. Eddington, then a graduate student, to conduct, in 1975-1978, the first thorough, parametric, psychophysical studies of electrical stimulation of the cochlea in multiple human volunteers. The early work by Eddington and colleagues evolved in 1983 into the 4-channel, Ineraid cochlear implant. Many years later, highly effective, modern signal processing algorithms, e.g., continuous interleaved sampling (CIS), fine structure processing (FSP), and virtual channel processing, were first tested and developed with the aid of Ineraid patients fit with pedestals of the Utah design. Because for many years the Ineraid provided as high a level of speech understanding as that provided by other devices and because the percutaneous pedestal allowed the first testing of many modern signal processing algorithms, the Utah Artificial Ear project may be viewed as one of the most valuable research projects in the history of cochlear implants.

The master hearing aid.

As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids.

[Hearing training, hearing therapy and auditory rehabilitation in hearing impaired individuals during the last few centuries]. / Hörtraining, Hörtherapie und nichtapparative Hörrehabilitation bei Schwerhörigen im Wandel der Zeiten.

BACKGROUND: The remarkable quality of modern hearing aids enables most hearing impaired individuals to take part in verbal communication without great effort. As a result, auditory training seems to have fallen into oblivion, even though its use is certainly still justified today. This article aims to review the development of these diverse therapy methods. METHODS: For this systematic review, a selective literature research in PubMed using the keywords "auditory training" = 211 hits and "auditory rehabilitation" = 166 hits has been carried out. In addition, handbooks and monographs were taken into consideration. RESULTS: For around 2,000 years, people have tried to restore hearing by acoustic stimulation. Initially it was believed that hearing could be "woken up" by means of acoustic stimulation. From the 19th Century onwards, auditory training was meant to support residual hearing and help understanding in verbal communication. Towards the end of the 20th Century, systematic approaches that were intended to enhance cognitive skills, such as concentration and attentiveness by acoustic stimulation, were developed. DISCUSSION: The wish to integrate deaf individuals into the auditory verbal oriented society, the tremendous number of soldiers suffering from noise-induced hearing loss after World War II, modern hearing aids and cochlear implants, and finally availability of personal computers has fostered the development of auditory training methods. Further research has to investigate whether auditory training combined with drug therapy or other stimulation methods are beneficial.

The history of sign language and deaf education in Turkey.

Sign language is the natural language of the prelingually deaf people particularly without hearing-speech rehabilitation. Otorhinolaryngologists, regarding health as complete physical, mental and psychosocial well-being, aim hearing by diagnosing deafness as deviance from normality. However, it's obvious that the perception conflicted with the behavior which does not meet the mental and social well-being of the individual also contradicts with the definition mentioned above. This article aims to investigate the effects of hearing-speech target ignoring the sign language in Turkish population and its consistency with the history through statistical data, scientific publications and historical documents and to support critical perspective on this issue. The study results showed that maximum 50% of the deaf benefited from hearing-speech program for last 60 years before hearing screening programs; however, systems including sign language in education were not generated. In the light of these data, it is clear that the approach ignoring sign language particularly before the development of screening programs is not reasonable. In addition, considering sign language being part of the Anatolian history from Hittites to Ottomans, it is a question to be answered that why evaluation, habilitation and education systems excluding sign language are still the only choice for deaf individuals in Turkey. Despite legislative amendments in the last 6-7 years, the primary cause of failure to come into force is probably because of inadequate conception of the issue content and importance, as well as limited effort to offer solutions by academicians and authorized politicians. Within this context, this paper aims to make a positive effect on this issue offering a review for the medical staff, particularly otorhinolaryngologists and audiologists.

Cognitive hearing science: the legacy of Stuart Gatehouse.

Stuart Gatehouse was one of the pioneers of cognitive hearing science. The ease of language understanding (ELU) model (Rönnberg) is one example of a cognitive hearing science model where the interplay between memory systems and signal processing is emphasized. The mismatch notion is central to ELU and concerns how phonological information derived from the signal, matches/mismatches phonological representations in lexical and semantic long-term memory (LTM). When signals match, processing is rapid, automatic and implicit, and lexical activation proceeds smoothly. Given a mismatch, lexical activation fails, and working or short-term memory (WM/STM) is assumed to be invoked to engage in explicit repair strategies to disambiguate what was said in the conversation. In a recent study, negative long-term consequences of mismatch were found by means of relating hearing loss to episodic LTM in a sample of old hearing-aid wearers. STM was intact (Rönnberg et al.). Beneficial short-term consequences of a binary masking noise reduction scheme on STM was obtained in 4-talker babble for individuals with high WM capacity, but not in stationary noise backgrounds (Ng et al.). This suggests that individuals high on WM capacity inhibit semantic auditory distraction in 4-talker babble while exploiting the phonological benefits in terms of speech quality provided by binary masking (Wang). Both long-term and short-term mismatch effects, apparent in data sets including behavioral as well as subjective (Rudner et al.) data, need to be taken into account in the design of future hearing instruments.

Historical background of bone conduction hearing devices and bone conduction hearing aids.

During the last 20 years, bone-anchored hearing aids (Baha(®)) became a familiar solution in the treatment of some types of hearing loss. The aim of this chapter is to present the different historical steps which have permitted the production of this new bone conduction hearing device. The recognition of bone conduction hearing is old and was known at least in Antiquity. During the Renaissance, Girolamo Cardano demonstrated a method by which sound may be transmitted to the ear by means of a rod or the shaft of a spear held between one's teeth: this was the beginning of teeth stimulators to improve hearing, firstly in connection with a musical instrument and then, in the second part of the 19th century, with the speaker. The development of the carbon microphone at the beginning of the 20th century allowed the construction of the bone conduction vibrator placed on the mastoid area, notably supported by eyeglasses since the 1950s. Confronted by various problems, and notably the loss of part of sound in the soft tissue of the external mastoid, the idea to implant the vibrator into the mastoid bone was developed in Göteborg, and the first Baha was implanted in 1977 by Anders Tjellström. From that date, various improvements allowed the development of the actual Baha. These different steps are presented in this study, supported by original documentation.

The christian's duty toward the deaf: differing christian views on deaf schooling and education in 19th-century Dutch society.

A historical study is conducted into the founding of three boarding schools for Deaf children in The Netherlands, in 1790, 1840, and 1888. The article focuses on how three different religious views inspired divergent perspectives on citizenship and the role of the state, the church, and charity in helping Deaf people to become well-integrated citizens. For each school, a brief general context and a brief description of its political and religious background is given. The founding of the school, with accompanying difficulties, is then described, as well as the fundamental ideas of the founders regarding the image of the Deaf person, Deaf children and their capacities, societal goals of the institution, subject matter considered important in the school, further relevant organizational aspects, and financing and the responsibilities of state, church, charity, and private enterprise. The views of the three institutions are compared and contrasted.

The work of the Village: creating a new world for children with hearing loss and their families.

Though the health and economic issues in developing countries may create situations in which the development of early hearing detection and intervention (EHDI) programs could seem insurmountable, developing countries have some resources that are not easily available to those in the developed world. Developing countries often have well-organized communities in which members work together for the benefit of the individuals within their communities as well as a willingness to learn strategies that can improve the lives of individuals in their communities. Paradoxically, there also exists societal intolerance for disabilities that can result in stigmatization and ultimate isolation of affected families. Hopefully, education within these communities can begin to overcome historical intolerance. While some might argue that sufficient financial resources are the key to the development of an EHDI system, the Colorado system, although grateful for all financial resources, is dependent, first and foremost upon the human resources. This article provides information about the history of the Colorado system in the hopes that lessons learned will provide valuable input to others facing similar challenges.

History of the technological development of air conduction hearing aids.

This was a study of the history of the technological development of air conduction hearing aids, and a review of international literature on the subject. The technological evolution of amplification devices, from their origin to the present day, can be divided into seven distinct periods: the period of sound collectors, the period of hearing devices constructed from carbon, the period of vacuum tubes, the transistor period, the period of integrated circuits, the microprocessor period and the period of digital hearing instruments. Throughout these different stages, hearing instruments have progressively developed reaching their present state. The current era is itself undergoing constant development and change. With the introduction of new technologies, we expect that the rate of change will increase rapidly in the future.