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1.
PLoS One ; 15(7): e0235435, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628690

RESUMO

OBJECTIVES: In this clinical study, stereo perception of music samples and its contribution to music enjoyment in CI users is investigated. It is studied in free field as well as direct audio presentation. METHODS: 20 bilateral and 9 bimodal CI users performed stereo detection tests and music enjoyment ratings. Music was presented either in mono or in stereo in free field or with direct audio presentation. Stereo detection was assessed with a 3-AFC paradigm. Music enjoyment was studied with scale ratings. RESULTS: For bilateral CI users, stereo detection increased from 52% correct in free field to 86% with direct audio presentation. Increased music enjoyment with improved stereo detection was obtained. Bimodal CI users could not identify stereo sounds. Music enjoyment did not increase for stereo presentations in bimodal subjects. DISCUSSION: For bilateral CI users, improved stereo detection might increase music enjoyment with direct audio presentation, which is likely due to bypassing the room acoustics. In bimodal CI users, no clear improvement was found, which is likely attributed due to the different hearing losses and therefore individually different interaural frequency overlaps between the hearing aid and the cochlear implant. CONCLUSION: Direct audio presentation is an efficient method to improve music enjoyment in bilateral CI users.


Assuntos
Percepção Auditiva , Implante Coclear/instrumentação , Implantes Cocleares , Surdez/terapia , Prazer , Estimulação Acústica/métodos , Acústica , Adulto , Idoso , Idoso de 80 Anos ou mais , Implante Coclear/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música
2.
Otol Neurotol ; 41(1): 33-38, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31746820

RESUMO

OBJECTIVES: Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing. STUDY DESIGN: Retrospective review. SETTING: Tertiary otologic center. PATIENTS: Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array. INTERVENTIONS: CI, intraoperative computed tomography (CT) OUTCOME MEASURES:: Audiologic measures (consonant-nucleus-consonant [CNC] words, AzBio sentences, low-frequency pure tone averages [LFPTA]) and electrode location (scalar location, electrode-to-modiolus distance ((Equation is included in full-text article.)), angular insertion depth). RESULTS: Twenty-four adults with less than 80 dB LFPTA with a precurved electrode array inserted using an external sheath; 16 underwent intraoperative CT. LFPTA was 58.5 dB HL preoperatively, with a 17.3 dB threshold shift at CI activation (p = 0.005). CNC word scores improved from 6% preoperatively to 64% at 6 months postoperatively (p < 0.0001). There was one scalar translocation and no tip fold-overs. The average angular insertion depth was 388.2 degrees, and the average (Equation is included in full-text article.)across all electrodes was 0.36 mm. Multivariate regression revealed a significant correlation between CNC scores at 6 months and angular insertion depth (p = 0.0122; r = 0.45, adjusted r = 0.35). Change in LFPTA was not significantly associated with angular insertion depth or (Equation is included in full-text article.). CONCLUSIONS: A low rate of translocation allows a precurved electrode array inserted using an external sheath to maintain hearing preservation rates comparable to straight electrode arrays. With scala tympani insertion, angular insertion depth is a positive marker of improved speech performance postoperatively but may be a confounder variable based on individual cochlear size.


Assuntos
Implante Coclear/instrumentação , Implante Coclear/métodos , Implantes Cocleares , Audição , Resultado do Tratamento , Adulto , Feminino , Audição/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Otolaryngol Clin North Am ; 53(1): 115-126, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31677739

RESUMO

Recent research has shown promising results for the development of a clinically feasible vestibular implant in the near future. However, correct electrode placement remains a challenge. It was shown that fluoroscopy was able to visualize the semicircular canal ampullae and electrodes, and guide electrode insertion in real time. Ninety-four percent of the 18 electrodes were implanted correctly (<1.5 mm distance to target). The median distances were 0.60 mm, 0.85 mm, and 0.65 mm for the superior, lateral, and posterior semicircular canal, respectively. These findings suggest that fluoroscopy can significantly improve electrode placement during vestibular implantation.


Assuntos
Implante Coclear/métodos , Neuroestimuladores Implantáveis , Canais Semicirculares/cirurgia , Implante Coclear/instrumentação , Estudos de Viabilidade , Fluoroscopia , Humanos , Estudo de Prova de Conceito , Canais Semicirculares/fisiologia , Nervo Vestibular/patologia , Nervo Vestibular/cirurgia
4.
PLoS One ; 14(9): e0222711, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31536550

RESUMO

Cochlear implantation is a surgical procedure, which is performed on severely hearing-impaired patients. Impedance field telemetry is commonly used to determine the integrity of the cochlear implant device during and after surgery. At the Department of Otolaryngology, Cheng Hsin General Hospital (Taipei, Taiwan), the cochlear implant devices are switched on within 24 hours of their implantation. In the present study, the impedance changes of Advanced Bionics™ cochlear implant devices were compared with previous studies and other devices. The aim was to confirm previous hypotheses and to explore other potential associated factors that could influence impedance following cochlear implantation. The current study included 12 patients who underwent cochlear implantation at Cheng Hsin General Hospital with Advanced Bionics cochlear implant devices. The cochlear devices were all switched on within 24 hours of their implantation. The impedance was measured and compared across all contact channels of the electrode, both intra-operatively and post-operatively. The intra-operative impedance was compared with the switch-on impedance (within 24 hours of the cochlear implantation); the impedance was notably increased for all contact channels at switch-on. Of the 16 channels examined, 4 channels had a significant increase in impedance between the intra-operative measurement and the switch-on measurement. To the best of our knowledge, the impedance of a cochlear implant device can be affected by the diameter of the electrode, the position of the electrode arrays in the scala tympani, sheath formation and fibrosis surrounding the electrode after implantation and electrical stimulation during or after surgery. When the results of the current study were compared with previous studies, it was found that the impedance changes were opposite to that of Cochlear™ implant devices. This may be explained by the position of the electrode arrays, sheath formation, the blow-out effect and differences in electrical stimulation.


Assuntos
Cóclea/fisiopatologia , Implante Coclear/instrumentação , Implantes Cocleares , Impedância Elétrica , Eletrodos Implantados , Adulto , Biônica/instrumentação , Biônica/métodos , Implante Coclear/métodos , Estimulação Elétrica , Feminino , Perda Auditiva/fisiopatologia , Perda Auditiva/terapia , Humanos , Masculino , Taiwan , Fatores de Tempo
6.
PLoS One ; 14(9): e0223121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31557251

RESUMO

INTRODUCTION: In cases with residual-hearing (RH) loss after cochlear implantation, a safe method is needed to provide full spectral resolution and as much auditory information as possible without implant replacement. Aim of this study was to prove the feasibility of accessing a partially inserted cochlear-implant-electrode for complete insertion to its maximum length through the external ear canal using a transcanal approach. METHODS: Two CI electrodes were customized with 18 stimulating channels. The electrode design enables the use of 12 active channels available for electrical stimulation inside the cochlea both after partial and full insertion. 10 CI electrodes were implanted in 10 fresh human cadaveric temporal bones. After initial partial insertion by posterior tympanotomy, the electrode was inserted to its maximum length via a transcanal approach. Radiographs and CT scans were performed to confirm the electrode position. The electrodes were investigated via x-ray after removal. RESULTS: X-ray and CT-scans confirmed the electrode prototypes covering an angular insertion depth between 236° to 307° after initial insertion. Accessing the electrode in the middle ear space was feasible and insertion to its full length was successful. Post-insertion CT confirmed insertion of the 28mm and 31.5mm electrode arrays covering an angular insertion depth between 360° and 540° respectively. No tip foldovers were detected. CONCLUSION: This study confirms the feasibility of extending the electrode insertion to its maximum insertion length using a transcanal approach in temporal bone specimens. This constitutes a second stage procedure on demand in EAS-surgery. This may be beneficial for EAS-patients providing electrical stimulation beyond the basal turn of the cochlea once the functional residual hearing is lost, without replacing the entire CI.


Assuntos
Estimulação Acústica/métodos , Implante Coclear/métodos , Implantes Cocleares , Terapia por Estimulação Elétrica/métodos , Eletrodos Implantados , Perda Auditiva/cirurgia , Estimulação Acústica/instrumentação , Cóclea/diagnóstico por imagem , Cóclea/cirurgia , Implante Coclear/instrumentação , Terapia por Estimulação Elétrica/instrumentação , Desenho de Equipamento , Estudos de Viabilidade , Humanos , Tomografia Computadorizada por Raios X
7.
Res Dev Disabil ; 93: 103453, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31421305

RESUMO

BACKGROUND AND AIM: It remains unclear how recognition of segmental and suprasegmental phonemes contributes to sentence-level language processing skills in Mandarin-speaking children with cochlear implants (CIs). Our study examined the influence of implantation age on the recognition of consonants, lexical tones and sentences respectively, and more importantly, the contribution of phonological skills to sentence repetition accuracy in Mandarin-speaking children with CIs. METHODS: The participants were three groups of prelingually deaf children who received cochlear implants at various ages and their age-matched controls with normal hearing. Three tasks were administered to assess their consonant perception, lexical tone recognition and language skills in open-set sentence repetition. RESULTS: Children with CIs lagged behind NH peers in all the three tests, and performances on segmental, suprasegmental and sentence-level processing were differentially modulated by implantation age. Furthermore, performances on recognition of consonants and lexical tones were significant predictors of sentence repetition accuracy in the children with CIs. CONCLUSION: Overall, segmental and suprasegmental perception as well as sentence-level processing is impaired in Mandarin-speaking children with CIs compared with age-matched children with NH. In children with CIs recognition of segmental and suprasegmental phonemes at the lower level predicts sentence repetition accuracy at the higher level. More importantly, implantation age plays an important role in the development of phonological skills and higher-order language skills, suggesting that age-appropriate aural rehabilitation and speech intervention programs need to be developed in order to better help CI users who receive CIs at different ages.


Assuntos
Grupo com Ancestrais do Continente Asiático , Percepção Auditiva , Linguagem Infantil , Implantes Cocleares , Correção de Deficiência Auditiva , Surdez , Fatores Etários , Criança , Pré-Escolar , Implante Coclear/instrumentação , Implante Coclear/métodos , Correção de Deficiência Auditiva/métodos , Correção de Deficiência Auditiva/psicologia , Surdez/psicologia , Surdez/reabilitação , Surdez/cirurgia , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Feminino , Humanos , Masculino , Medida da Produção da Fala/métodos
8.
Orv Hetil ; 160(31): 1216-1222, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31352808

RESUMO

Introduction: The cochlear implants vary in electrodes in terms of length, width and proximity to the modiolus. The precurved electrode arrays could be placed closer to the modiolus and the ganglion cells compared to straight electrodes. The two types of electrode arrays provide different electrophysiological characteristics; however, proximity to the modiolus may lead to better hearing performance. Aim: To investigate our preliminary electrophysiological results that suggest that the Slim Modiolar (SM) electrode array has the potential to elicit similar neural responses as the thicker perimodiolar (Contour Advance, CA) electrode from the same generation of implants. Method: Subjects that were implanted either with CA or SM electrodes were enrolled, 54 consecutive subjects in each group. All electrodes were introduced into the cochlea via the round window. The diameter of the largest turn of the electrode arrays within the cochlea was measured through postoperative radiography. The energy consumption parameters were estimated 2 months after implantation. Results: The mean of the largest turns of the arrays within the cochlea was 4.2 ± 0.5 mm in the SM group and 4.9 ± 1.1 mm in the CA group. 'Auto power' was 44.81 ± 5.05% and 50.85 ± 8.35% with SM and CA, respectively. Estimated energy consumption was lower with SM. The differences were statistically significant. Conclusion: Our measurements for a large cohort in each group suggest that the SM electrode array takes a significantly closer position to the modiolus than the CA. This finding supports our earlier electrophysiological result and indicates better performance abilities. Orv Hetil. 2019; 160(31): 1216-1222.


Assuntos
Cóclea/diagnóstico por imagem , Implante Coclear/instrumentação , Implante Coclear/métodos , Implantes Cocleares , Nível de Discriminação Sonora/fisiologia , Radiografia/métodos , Cóclea/cirurgia , Eletrodos Implantados , Humanos
9.
J Laryngol Otol ; 133(7): 575-579, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31250771

RESUMO

OBJECTIVE: To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone. METHODS: Nineteen patients scheduled for cochlear implantation, aged 2-20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings. RESULTS: The mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16-69.37°), 63.81° (58.61-71.35°) and 56.48° (50.37-59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016). CONCLUSION: Pre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.


Assuntos
Implante Coclear/métodos , Tomografia Computadorizada Multidetectores/métodos , Osso Temporal/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Implante Coclear/instrumentação , Feminino , Humanos , Masculino , Período Pré-Operatório , Osso Temporal/cirurgia , Adulto Jovem
10.
Biomed Res Int ; 2019: 6917084, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31240221

RESUMO

Introduction: The distance between the modiolus and the electrode array is one factor that has become the focus of many discussions and studies. Positioning the electrode array closer to the spiral ganglion with the goal of reducing the current spread has been shown to improve hearing outcomes. The perimodiolar electrode arrays can be complemented with a surgical manoeuvre called the pull-back technique. This study focuses its attention on the recently developed 532 slim modiolar electrode. Objective: To investigate the intracochlear movements and pull-back technique for the 532 slim modiolar electrode. Material and Methods: A decapping procedure of the cochlea was performed on 5 temporal bones. The electrode array was inserted, and the intracochlear movements were microscopically examined and digitally captured. Three situations were analysed: the initial insertion, the overinsertion, and the pull-back position. The position of the three white markers of the electrode array in relation to the round window (RW) was evaluated while performing these three actions. Results: The initial insertion achieved an acceptable perimodiolar position of the electrode array, but a gap was still observed between the mid-portion of the array and the modiolus (the first white marker was seen in the RW). When we inserted the electrode more deeply, the mid-portion of the array was pushed away from the modiolus (the second and third white markers were seen in the RW). After applying the pull-back technique, the gap observed during the initial insertion disappeared, resulting in an optimal perimodiolar position (the first white marker was once again visible in the RW). Conclusion: This temporal bone study demonstrated that when applying the pull-back technique for the 532 slim modiolar electrode, a closer proximity to the modiolus was achieved when the first white marker of the electrode array was visible in the round window.


Assuntos
Cóclea/cirurgia , Implante Coclear/métodos , Eletrodos Implantados , Implante Coclear/instrumentação , Implantes Cocleares , Audição , Humanos , Janela da Cóclea/cirurgia , Gânglio Espiral da Cóclea/cirurgia , Osso Temporal/cirurgia
11.
Int J Pediatr Otorhinolaryngol ; 124: 161-163, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31200318

RESUMO

Silastic magnet casing tear of cochlear implant (CI) due to magnetic resonance imaging (MRI) is an uncommon complication. We report repair of a case with magnet dislocation due to MRI-induced silastic casing tear without re-implantation. We believe that this repair method, which has not been previously defined in the literature, will be interesting and guiding.


Assuntos
Implante Coclear/instrumentação , Implantes Cocleares , Perda Auditiva Neurossensorial/terapia , Imagem por Ressonância Magnética/efeitos adversos , Falha de Prótese/etiologia , Criança , Dimetilpolisiloxanos , Feminino , Humanos , Imãs , Reoperação
12.
J Int Adv Otol ; 15(1): 62-69, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31058597

RESUMO

OBJECTIVES: Bimodal stimulation for asymmetric hearing loss is an emerging treatment with proven audiometric outcomes. Our objectives are to assess the changes of the hearing impairment and the quality of life of patients treated with this type of stimulation, when compared to a unilateral Cochlear Implant (CI) stimulated condition. MATERIALS AND METHODS: 31 patients with asymmetric hearing loss (Group 1) were recruited for the study. They were divided into three groups, based on their hearing loss in the ear treated with the hearing aid: Group 1A (Pure Tone Audiometry (PTA) between 41 and 70 decibels (dB)); Group 1B, (PTA between 71 and 80 dB) and Group 1C (PTA between 81 and 90 dB). 30 patients had profound, bilateral hearing loss. Then, users of a unilateral cochlear implant were recruited for the control group. Their hearing impairment and quality of life were analyzed with questionnaires Abbreviated Profile of Hearing Aid Benefit (APHAB), Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Health Utilities Index (HUI). They were followed up for at least 2 years. RESULTS: The group with the asymmetric hearing loss obtains a statistically significant clinical improvement in the APHAB under category "with hearing aid" compared to "without hearing aid". The group with the asymmetric hearing loss benefits more across basically all variables compared with the control group in the SSQ. Group 1A obtains the best outcome of the sample in the HUI. CONCLUSION: Bimodal stimulation and better hearing in the ear treated with the hearing aid reduce hearing impairment and improve the quality of life.


Assuntos
Audiometria de Tons Puros/métodos , Implante Coclear/instrumentação , Perda Auditiva/psicologia , Perda Auditiva/terapia , Adulto , Implantes Cocleares/efeitos adversos , Implantes Cocleares/estatística & dados numéricos , Audição/fisiologia , Auxiliares de Audição/efeitos adversos , Auxiliares de Audição/estatística & dados numéricos , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Bilateral/terapia , Humanos , Qualidade de Vida , Estudos Retrospectivos , Percepção da Fala/fisiologia , Inquéritos e Questionários
13.
Int J Med Robot ; 15(6): e2009, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31099146

RESUMO

Background Internal cochlear anatomy is difficult to discern from external inspection, hindering cochlear implant electrode insertion. Methods A user study characterized the repeatability of standard surgical technique and examined the role of visual inspection and guidance cues in reducing electrode array insertion misalignment. Results Without guidance, a large spread in angles of insertion, up to 30°, was observed, highlighting the need for intraoperative guidance. Visual inspection did not significantly improve overall orientation, suggesting the need for alternate intracochlear visualization methods and/or increased training to effectively improve surgeon understanding of the visualized images. Visual cues and guidance software increased repeatability of surgeon performance, reducing one metric of repeatability to ±2°. Conclusions This study establishes a baseline for surgeon variability in cochlear implant insertion and supports the need and lays the groundwork for future intraoperative guidance techniques.


Assuntos
Cóclea/cirurgia , Implante Coclear/instrumentação , Implante Coclear/métodos , Implantes Cocleares , Eletrodos Implantados , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos , Calibragem , Humanos , Período Intraoperatório , Procedimentos Cirúrgicos Robóticos , Software , Osso Temporal/cirurgia
14.
Trends Hear ; 23: 2331216519843876, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31018790

RESUMO

In users of a cochlear implant (CI) together with a contralateral hearing aid (HA), so-called bimodal listeners, differences in processing latencies between digital HA and CI up to 9 ms constantly superimpose interaural time differences. In the present study, the effect of this device delay mismatch on sound localization accuracy was investigated. For this purpose, localization accuracy in the frontal horizontal plane was measured with the original and minimized device delay mismatch. The reduction was achieved by delaying the CI stimulation according to the delay of the individually worn HA. For this, a portable, programmable, battery-powered delay line based on a ring buffer running on a microcontroller was designed and assembled. After an acclimatization period to the delayed CI stimulation of 1 hr, the nine bimodal study participants showed a highly significant improvement in localization accuracy of 11.6% compared with the everyday situation without the delay line ( p < .01). Concluding, delaying CI stimulation to minimize the device delay mismatch seems to be a promising method to increase sound localization accuracy in bimodal listeners.


Assuntos
Implantes Cocleares/normas , Auxiliares de Audição , Localização de Som/fisiologia , Adulto , Idoso , Percepção Auditiva , Implante Coclear/instrumentação , Feminino , Auxiliares de Audição/normas , Humanos , Masculino , Pessoa de Meia-Idade , Percepção da Fala
15.
Int J Audiol ; 58(9): 587-597, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31012771

RESUMO

Objective: The objective of the current study was to examine the longitudinal effect of deactivating stimulation sites estimated to produce broad neural excitation on speech recognition. Design: Spatial patterns of neural excitation were estimated based on a previously established psychophysical measure, that is, detection threshold for low-rate pulse trains. Stimulation sites with relatively poor thresholds were deactivated in an experimental map. The acute effect was evaluated, in quiet and in noise, immediately after the experimental map was created (baseline), after the subjects practiced with the experimental map for two months (treatment), and after the subjects' daily map was switched back again to the clinical map for another two months (withdrawal). Study sample: Eight Cochlear Nucleus device users participated in the study. Results: For both listening in noise and in quiet, the greatest effect of deactivation was observed after the subjects were given time to adapt to the new frequency allocations. The effect was comparable for listening in fluctuating and steady-state noises. All subjects benefited from deactivation for listening in noise, but subjects with greater variability in thresholds were more likely to benefit from deactivation for listening in quiet. Conclusion: The benefit of electrode deactivation for speech recognition can increase with practice.


Assuntos
Estimulação Acústica/métodos , Limiar Auditivo , Implantes Cocleares , Surdez/fisiopatologia , Percepção da Fala , Idoso , Idoso de 80 Anos ou mais , Implante Coclear/instrumentação , Surdez/reabilitação , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
16.
IEEE Trans Biomed Eng ; 66(11): 3156-3167, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30802846

RESUMO

OBJECTIVE: To develop and verify a CMOS bone-guided cochlear implant (BGCI) microsystem with electrodes placed on the bone surface of the cochlea and the outside of round window for treating high-frequency hearing loss. METHODS: The BGCI microsystem consists of an external unit and an implanted unit. The external system-on-chip is designed to process acoustic signals through an acquisition circuit and an acoustic DSP processor to generate stimulation patterns and commands that are transmitted to the implanted unit through a 13.56 MHz wireless power and bidirectional data telemetry. In the wireless power telemetry, a voltage doubler/tripler (2X/3X) active rectifier is used to enhance the power conversion efficiency and generate 2 and 3 V output voltages. In the wireless data telemetry, phase-locked loop based binary phase-shift keying and load-shift keying modulators/demodulators are adopted for the downlink and uplink data through high-Q coils, respectively. The implanted chip with four-channel high-voltage-tolerant stimulator generates biphasic stimulation currents up to 800 µA. RESULTS: Electrical tests on the fabricated BGCI microsystem have been performed to verify the chip functions. The in vivo animal tests in guinea pigs have shown the evoked third wave of electrically evoked auditory brainstem response waveforms. It is verified that auditory nerves can be successfully stimulated and acoustic hearing can be partially preserved. CONCLUSION AND SIGNIFICANCE: Different from traditional cochlear implants, the proposed BGCI microsystem is less invasive, preserves partially acoustic hearing, and provides an effective alternative for treating high-frequency hearing loss.


Assuntos
Implante Coclear/instrumentação , Implantes Cocleares , Microtecnologia/instrumentação , Animais , Cóclea/fisiologia , Cóclea/cirurgia , Nervo Coclear/fisiologia , Desenho de Equipamento , Cobaias , Humanos , Semicondutores
17.
Int J Pediatr Otorhinolaryngol ; 120: 64-67, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30771555

RESUMO

Despite various studies that have demonstrated risk of cochlear implant magnet displacement following MRI, minimal literature is available on radiologic recognition of magnet displacement. Current literature emphasizes the status and placement of the electrode component of the implant. This case report examines the consequences of a delay in radiologic diagnosis of a displaced magnet including hospital admission, unnecessary radiation, and prolonged patient discomfort. Additionally, it provides a framework for successful radiologic recognition of a displaced magnet, detailing specific imaging modalities and magnet characteristics that should be evaluated to expedite and facilitate radiologic recognition of displacement.


Assuntos
Implantes Cocleares/efeitos adversos , Imãs/efeitos adversos , Falha de Prótese/efeitos adversos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Criança , Implante Coclear/efeitos adversos , Implante Coclear/instrumentação , Feminino , Hospitalização , Humanos
18.
Otolaryngol Clin North Am ; 52(2): 363-378, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30765092

RESUMO

The advances in technology leading to rapid developments in implantable auditory devices are constantly evolving. Devices are becoming smaller, less visible, and more efficient. The ability to preserve hearing outcomes with cochlear implantation will continue to evolve as surgical techniques improve with the use of continuous feedback during the procedure as well as with intraoperative delivery of drugs and robot assistance. As engineering methods improve, there may one day be a totally implantable aid that is self-sustaining in hearing-impaired patients making them indistinguishable from patients without hearing loss.


Assuntos
Materiais Revestidos Biocompatíveis , Implante Coclear/instrumentação , Implantes Cocleares , Desenho de Equipamento , Perda Auditiva/terapia , Animais , Audiometria de Resposta Evocada , Implante Coclear/métodos , Eletrodos Implantados , Previsões , Humanos , Modelos Animais , Procedimentos Cirúrgicos Robóticos
19.
Otolaryngol Clin North Am ; 52(2): 311-322, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30617011

RESUMO

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear.


Assuntos
Implante Coclear/instrumentação , Implantes Cocleares , Correção de Deficiência Auditiva/métodos , Perda Auditiva/reabilitação , Ajuste de Prótese , Estimulação Acústica , Limiar Auditivo/fisiologia , Correção de Deficiência Auditiva/instrumentação , Estimulação Elétrica , Perda Auditiva/fisiopatologia , Humanos , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Desenho de Prótese , Recuperação de Função Fisiológica , Percepção da Fala
20.
Cochlear Implants Int ; 20(2): 80-90, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30465637

RESUMO

OBJECTIVES: To report on electrode array measurements for the Nucleus® CI532 Slim Modiolar Electrode device including: ECAP thresholds, electrode impedances, and psychophysical comfort levels, as well as speech perception results pre- and post-operatively and standardized evaluations of quality of life. METHODS: Forty-four subjects were implanted with the CI532. Electrically evoked compound action potential (ECAP) thresholds and impedances were measured using automatic Neural Response Telemetry intra-operatively, at activation and at six months post implant. Pre- and post-operative measures of words in quiet and sentences in noise were made in multiple languages. Quality of life was assessed using The Speech Spatial Qualities questionnaire (SSQ) and Glasgow Benefit Inventory (GBI). RESULTS: Intra-operative ECAP thresholds were recorded successfully from 90% of electrodes tested. ECAP thresholds varied across the array and a post-hoc Dunn's test showed that median thresholds for electrodes E1-E13 were significantly greater than those for E17-E22 (all P < 0.001). Impedances increased significantly between surgery and activation. Speech recognition scores for words in quiet and sentences in noise showed a significant improvement for the group at six months, when using the cochlear implant, compared with pre-operative performance (P < 0.001). There was a significant increase compared to pre-operative ratings for all sections of the SSQ at six months post activation (P < 0.001). The GBI gave scores significantly above zero for the 'general' subscale and total score. CONCLUSION: Objective ECAP and impedance measures for this new electrode array were as expected and similar to results reported for other array types. Speech perception and quality of life improved significantly following implantation. (Registered as NCT02392403 on ClinicalTrials.gov PRS).


Assuntos
Implante Coclear/instrumentação , Eletrodos Implantados , Potenciais Evocados Auditivos , Perda Auditiva/fisiopatologia , Percepção da Fala , Adulto , Impedância Elétrica , Feminino , Perda Auditiva/cirurgia , Humanos , Masculino , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
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