The history of cochlear implantation-eng-ru 2012-06

The history of Cochlear Implantation

The History of

Cochlear Implantation

Dr. Dr. h.c. Monika Lehnhardt

St. Petersburg, May 2012

Wever EG, Bray CW (1936)

…

Charles Eyries, Otologist in Paris

André Djurno, Engineer Co-working with Eyries

Fritz Zöllner, Otologist in Freiburg

Wolf Dieter Keidel, Physiologist in Erlangen

William House, Otologist in Los Angeles

Vision for a technology that would enable the deaf to hear

Research supported by public donation, commenced 1967

First cochlear implant, 1978, Melbourne Hospital

“In spite of the problems and criticisms, I just had to go on. A cochlear implant was their only hope of ever hearing.”

Graeme Clark

Ernst Lehnhardt

Electrode Array in situ

Ernst Lehnhardt, 1984

First adult patients in Hannover, Germany

Ernst Lehnhardt

with his audiologist Rolf Battmer

Ernst und Monika Lehnhardt, 1991 in Moskau

Ernst und Monika Lehnhardt mit George Tavartkiladze

Soft Surgery

Freedom Cochlear Implant

• 4th generation ASIC CMOS internal chip with

– Increased precision current sources for accurate nerve stimulation

– 4th generation telemetry with less internal noise, enabling AutoNRT

– Improved power efficiency for longer battery life

• Generational mechanical changes for

– improved reliability

Freedom Speech Processor

• Dual microphones for high quality sound capture and support for Pre-processing

• Dual 16-bit analog to digital converters for CD quality 96dB dynamic range processing

• Quad 16 Bit DSP

• In-built Telecoil

• Integrated accessory connector

• IP44 Splash Compliant

Мониторинг. Контроль. Управление.

Cochlear: Система Nucleus 5

Cochlear: Дистанционное управление Nucleus CR110

Exponential Growth- First Choice Worldwide

2012

Development of Candidate Selection Criteria United States (Nucleus Implant Systems)

Broadening Indications

Adults Children

1985 FDA approval for implantation of candidates aged 18 years and older

postlingually deafened profound bilateral sensorineuronal deafness no benefit from hearing aid

1990 FDA approval for implantation of candidates aged 2 years and older profound bilateral sensorineuronal deafness little or no benefit from hearing aid candidate and family must be well motivated and possess

realistic expectations

1995 Include pre-and perilinguistically deafened adults Limited benefit from hearing aids defined as 30%

or less in best aided condition on tape recorded tests

of open-set sentences

1998 Limited benefit from hearing aids defined as 40% or less in best aided condition on tape recorded tests of open-set sentences

18 months and older 3-6 months hearing aid trial <20% score on MLNT or LNT test

2000 Limited benefit from hearing aids defined as 60% or less in best aided condition on tape recorded tests of open-set sentences

12 months and older 3-6 months hearing aid trial Lack of progress in development of auditory skills or <30% score on MLNT or LNT test,

depending on age

Trend towards bilateral

New Surgical Techniques

TIKI Technology

? Extremely low powerIntegrated Circuit incorporating:

• Audio pre-processing • Stimulator module• Speech processor• Power management• High voltage output switches

High performance implantable microphone that will last a lifetime

Implantable Rechargeable Battery

Suppose the electrodes could be in close contact with the nerves…

Normal Deafened Regeneration

Habenula Perforata

Wise et al, The Bionic Ear Institute, 2003.

Inner Haircells

Outer Haircells

Neurotrophins and Auditory Nerve Regeneration

Nanotechnology: Guidance Molecules

Thank you for your attention and please feel free to comment

in my personal weblog

www.monika-lehnhardt.net