cochlear implants ryan s. clement, phd neural engineering and applications laboratory bioe 200:...
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Cochlear Implants
Ryan S. Clement, PhDNeural Engineering and Applications Laboratory
BioE 200: September 18, 2002
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Anatomy and Physiology of Hearing
External Ear
Ear Canal
Adapted from: http://funsan.biomed.mcgill.ca/~funnell/AudiLab/501/mmem003.html
Cochlea
Middle Ear Bones
Ear Drum
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Anatomy and Physiology (con’t)
http://www.iurc.montp.inserm.fr/cric/audition/
Traveling Wave Movie
Cochlear Cross-section
http://shark.me.nus.edu.sg/~asme/MechHear.htm
cochleaWeb.mov
©Howard Hughes Medical Institute
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Sound Transduction
Basilar MembraneAuditory Nerve
Cochlear cross-section (single turn)Cochlea Hair Cells
http://www.iurc.montp.inserm.fr/cric/audition/
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Sensorineural Hearing Loss
• Causes– Heredity– Genetic– Aging process– Ototoxic drugs– Excessive
exposure to loud sounds
Microscopic view of hair cells.
OHCs
IHCs
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Electrical Stimulation Can Allow Us to Bypass Damaged Haircells
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A Brief History
• Volta (1790)– metal rods and battery induced sounds like boiling
liquid!
• Djourno and Eyries (1957)– First demonstration of direct electrical stimulation of
auditory nerve
• House and Urban (1972)– Develop and test first prototype (single channel)
– House/3M device gets FDA approval in 1984
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A Brief History (con’t)
• Clark, University of Melborne (1978)– Implant first multi-channel device– FDA approval in 1985
• From then till now:– continual improvements have been made in
speech processing strategies and electrode design
– Many patients can use the devices without the aid of lip-reading (even the telephone!)
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Safety Considerations
• Biomaterials:• with the proper choice of materials there is no infection, just a minor
fibrous sheath around the implant.
• Electrode Insertion trauma:• factors: surgical technique, dimensions, array’s mechanical properties
• If damage occurs to basilar membrane and dendrites, could lead to retrograde deterioration. However, are few and far between in most sensorineural hearing loss cases.
• For most part damage is minimal.
• Chronic Electrical Stimulation• Platinum electrodes: virtually no corrosion or depletion
• Doesn’t destroy AN, in fact can help keep auditory nerve and cells in cochlear nucleus healthy (Leake et al 1992)
• impedances and thresholds stabilize several days post implant
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(The University of Melbourne)
Current Facts About Cochlear Implants
Quick Facts:
• candidacy: severe-to-profound sensorineural deafness
•~70,000 recipients worldwide (~21,000 in the U.S.) *
• 50% children (12 mo-17 years); 50% adults *
• Manufacturers:Cochlear Corporation: NucleusTM
Advanced Bionics: ClarionTM
Med-EL: Combi-40+TM
AllHear: AllHearTM single channelAntwerp Bionic Systems: LauraTM (now owned by Cochlear)MXM Laboratories: DigisonicTM
* FDA survey of venders 11/2001 http://www.nidcd.nih.gov/health/pubs_hb/coch.htm#c
Cochlear Corporation: NucleusTM
FDAapproved
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• Company founded by Dr. House
• Shorter insertion; claims to retain residual hearing in implanted ear
• Single stimulation channel
• Not yet approved for sale in United States
http://www.allhear.com/
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Cochlear Corporation
Contour
Speech Processors
• Company created out of Greame Clark’s work at the University of Melbourne, Australia• First FDA approved multichannel devices• 22 channels available for stimulation
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Advanced BionicsThe Clarion II Implant
• Based on work conducted at UCSF
• Only American Company
• 16 channels with 16 individual current drivers
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Med-El CorporationCombi 40/40+ Implant
• Headquarters in Austria
• case for less signal loss and power consumption
• 12 channels of stimulation
Processors
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micSpeech
Proc.Encoder
Receiver/Decoder
ElectrodesAN and
Aud CNS
TransmissionLink
Block Diagram for Typical Cochlear Implant System
Skin
External Components Internal Components
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The Speech Signal“Never touch a snake with your bare hands.”
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Progression of Speech Processing Strategies
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Speech ProcessingSound Input
Electrical Stimulation
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Cochlear Frequency Tuning
The cochlea is arranged such that different regions of the cochlea correspond to different pitches.
Multichannel cochlear implants take advantage of this fact to encode different frequencies in the speech signal.
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Cochlear Electrodes
CochlearElectrode
Cochlea
AuditoryNerve
Cochlear Corporation’s Nucleus Electrode
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What might cochlear implants sound like?
• Cochlear implant simulations:– Single channel – 2 channels – 3 channels – 4 channels– 6 channels– 8 channels
(created from Bob Shannon and Philip Lizou’s model)
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Med El CIS-Link Nucleus 22 Clarion v1.2
Scores on NU6/CNC words
Nucleus 24 ClarionHi-Focus
C II Hi Res.
Per
cen
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orr
ect
Dorman 2002
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Factors Effecting Cochlear Implant Performance
• Duration of deafness• Age of onset of deafness• Age at implantation• Duration of cochlear implant use• Other:
– Number of remaining auditory nerve fibers– Electrode placement and insertion depth– Dynamic range
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Future Research Directions
• Better understanding of fundamental mechanisms
• Better speech processing algorithms
• Improved enjoyment of music
• Electrode design improvements
• Objective fitting for young children
• Aesthetics (smaller, totally implantable)
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Cochlear Implant Research Team
• Requires integration of many disciplines:– Bioengineering– Physiology– Otolaryngology– Speech Science– Signal Processing