Cochlear Implant Using Neural Prosthetics
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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 smart 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 shaped organ in the inner ear, and how various eye cells react to light, have fostered an understanding of how to talk 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.Keywords:
Neuroprosthetics
Bridge (graph theory)
Neural Prosthesis
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Cochlear implant is a small, surgically implanted complex electronic device that can help to provide a sense of sound to a person with severe to profound sensorineural hearing loss.This type of hearing loss, typically involves damage to hair cells in the cochlea, as a result sound cannot reach the auditory nerve which usually receives information from hair cells.A cochlear implant skips the damaged hair cells and to stimulate the auditory nerve directly.An implant does not restore normal hearing, instead it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.I am here presenting this article in relation to the indications, intraoperative and postoperative complications of cochlear implantation in our institute since January 2013.Children who receive implants at earlier age, outperform their peers who are implanted at a later age.This is reflected in all the areas of speech and language development.
Cochlear Implantation
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The cochlear implant, the first device to restore a human sense, is an electronic substitute for lost mechanosensory hair cells. It has been successful at providing hearing to people with severe to profound hearing loss and as of 2012, an estimated 324,000 patients worldwide have received cochlear implants. Users of cochlear implants however, suffer from difficulties in processing complex sounds such as music and in discriminating sounds in noisy environments. Recent advances in regenerative biology and medicine are opening new avenues for enhancing the efficacy of cochlear implants by improving the neural interface in the future and offer the possibility of an entirely biological solution for hearing loss in the long term. This report comprises the latest developments presented in the first Symposium on cochlear implants and regenerative biology, held at the 14th International Conference on Cochlear Implants in 2016 in Toronto, Canada.
Cochlear Implantation
Regenerative Medicine
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Converse
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Inner ear prostheses, or cochlear implants, are neuroprostheses providing profoundly deaf people with sound sensations through electrical stimulation of the auditory nerve. Approximately 2,000 of these devices are currently in use worldwide. Five models are each being used by more than 50 patients. Among other features they differ from one another mainly in the design and placement of electrodes and in the particular speech coding strategy used, periodicity and tonotopy priciple being made use of to a highly varying degree. Nevertheless, 4 of the 5 devices lead to quite comparable degrees of speech understanding without additional lipreading.
Tonotopy
Prosthesis design
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Starting about 10 years ago in Europe, patients who had one normally hearing ear and one deafened ear were fitted with cochlear implants in an effort to suppress tinnitus in the deafened ear. That effort was very successful. More recently, single sided deaf patients without tinnitus have been implanted in an effort to improve health-related quality of life. This effort, too, has been successful. This patient population, with one normal hearing ear and one implanted ear, offers an unprecedented window into the sound quality of a cochlear implant. That is, these patients can tell us whether a candidate stimulus presented to the normally hearing ear sounds like the stimulus presented to the cochlear implant. In this talk, we describe our efforts to reproduce the sound of a cochlear implant.
Stimulus (psychology)
Sound Quality
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Cochlear implants (CIs) are considered the most successful neuroprosthesis as they enable speech comprehension in the majority of half a million CI users suffering from sensorineural hearing loss. By electrically stimulating the auditory nerve, CIs constitute an interface re-connecting the brain and the auditory scene, providing the patient with information regarding the latter. However, since electric current is hard to focus in conductive environments such as the cochlea, the precision of electrical sound encoding-and thus quality of artificial hearing-is limited. Recently, optogenetic stimulation of the cochlea has been suggested as an alternative approach for hearing restoration. Cochlear optogenetics promises increased spectral selectivity of artificial sound encoding, hence improved hearing, as light can conveniently be confined in space to activate the auditory nerve within smaller tonotopic ranges. In this review, we discuss the latest experimental and technological developments of cochlear optogenetics and outline the remaining challenges on the way to clinical translation.
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Hearing loss is one of the commonest congenital anomalies to affect children world-over. The incidence of congenital hearing loss is more pronounced in developing countries like the Indian sub-continent, especially with the problems of consanguinity. Hearing loss is a double tragedy, as it leads to not only deafness but also language deprivation. However, hearing loss is the only truly remediable handicap, due to remarkable advances in biomedical engineering and surgical techniques. Auditory neural prostheses help to augment or restore hearing by integration of an external circuitry with the peripheral hearing apparatus and the central circuitry of the brain. A cochlear implant (CI) is a surgically implantable device that helps restore hearing in patients with severe-profound hearing loss, unresponsive to amplification by conventional hearing aids. CIs are electronic devices designed to detect mechanical sound energy and convert it into electrical signals that can be delivered to the cochlear nerve, bypassing the damaged hair cells of the cochlea. The only true prerequisite is an intact auditory nerve. The emphasis is on implantation as early as possible to maximize speech understanding and perception. Bilateral CI has significant benefits which include improved speech perception in noisy environments and improved sound localization. Presently, the indications for CI have widened and these expanded indications for implantation are related to age, additional handicaps, residual hearing, and special etiologies of deafness. Combined electric and acoustic stimulation (EAS / hybrid device) is designed for individuals with binaural lowfrequency hearing and severe-to-profound high-frequency hearing loss. Auditory brainstem implantation (ABI) is a safe and effective means of hearing rehabilitation in patients with retrocochlear disorders, such as neurofibromatosis type 2 (NF2) or congenital cochlear nerve aplasia, wherein the cochlear nerve is damaged or absent on both sides and hence, a cochlear implant (CI) would be ineffective. In such patients, the brainstem implant bypasses the damaged / absent cochlear nerves and directly stimulates the cochlear nucleus in the brainstem. The auditory midbrain implant (AMI) has been designed for stimulation of the auditory midbrain, particularly the central nucleus of inferior colliculus (ICC). It is used especially in patients with large neurofibromatosis type 2 (NF2) wherein tumor induced damage to the brainstem/cochlear nucleus often coexists. The efficacy and safety of auditory neural prostheses is well proven. Advancements in technology will enhance the benefit provided by these prostheses.
Cochlear nerve
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The auditory implant provides a new mechanism for hearing when a hearing aid is not enough. It is the only medical technology able to functionally restore a human sense i.e. hearing. The auditory implant is very different from a hearing aid. Hearing aids amplify sound. Auditory implants compensate for damaged or non-working parts of the inner ear because they can directly stimulate the acoustic nerve. There are two principal types of auditory implant: the cochlear implant and the auditory brainstem implant. They have common basic characteristics, but different applications. A cochlear implant attempts to replace a function lost by the cochlea, usually due to an absence of functioning hair cells; the auditory brainstem implant (ABI) is a modification of the cochlear implant, in which the electrode array is placed directly into the brain when the acoustic nerve is not anymore able to carry the auditory signal. Different types of deaf or severely hearing-impaired patients choose auditory implants. Both children and adults can be candidates for implants. The best age for implantation is still being debated, but most children who receive implants are between 2 and 6 years old. Earlier implantation seems to perform better thanks to neural plasticity. The decision to receive an implant should involve a discussion with many medical specialists and an experienced surgeon.
Hearing aid
Auditory System
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As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120000 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 in cochlear implant research and development. 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.
Neural Prosthesis
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