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:
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The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway.To assess the present status of cochlear implants and to describe possibilities for improving them.The present-day devices work well in quiet conditions for the great majority of users. However, not all users have high levels of speech reception in quiet and nearly all users struggle with speech reception in typically noisy acoustic environments. In addition, perception of sounds more complex than speech, such as most music, is generally poor unless residual hearing at low frequencies can be stimulated acoustically in conjunction with the electrical stimuli provided by the implant. Possibilities for improving the present devices include increasing the spatial specificity of neural excitation by reducing masking effects or with new stimulus modes; prudent pruning of interfering or otherwise detrimental electrodes from the stimulation map; a further relaxation in the criteria for implant candidacy, based on recent evidence from persons with high levels of residual hearing and to allow many more people to benefit from cochlear implants; and "top down" or "brain centric" approaches to implant designs and applications.Progress in the development of the cochlear implant and related treatments has been remarkable but room remains for improvements. The future looks bright as there are multiple promising possibilities for improvements and many talented teams are pursuing them.
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In recent years, notable progress has been made in the rehabilitation of children with mild to moderate-severe hearing impairment using new and advanced hearing aids. The major problem which remained was the lack of availability of treatment options for those with severe-to-profound sensorineural hearing loss who received little or no benefit from conventional amplification. The purpose of the cochlear implant is to provide these children with direct electrical stimulation of the auditory nerve. A hearing aid amplifies incoming stimuli while a cochlear implant attempts to replace a function lost by the cochlea. In a normal hearing ear, the hair cells within the cochlea act as a transducer of mechanical energy of sound vibration to energy capable of enervating the eighth nerve. The consequence of a decrease in the number of hair cells is the loss of ability of the cochlea to perform the functions, which result in eighth nerve stimulation. The implant replaces the task of the lost hair cells by converting mechanical energy into the electrical energy necessary to excite the remaining cochlear neurons.
In order to truly appreciate the application and unfolding of cochlear implants as applied to the pediatric population, it is important to summarize the development of the devices in general.
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In his talk, Shipsey will discuss the cochlear implant, the first device to successfully allow the profoundly deaf to regain some sense of hearing. A cochlear implant is a small electronic apparatus. Unlike a normal hearing aid, which amplifies sound, a cochlear implant is surgically implanted behind the ear where it converts sound waves into electrical impulses. These implants have instigated a popular but controversial revolution in the treatment of deafness, and they serve as a model for research in neuroscience and biomedical engineering. Shipsey will discuss the physiology of natural hearing from the perspective of a physicist. He will also touch on the function of cochlear implants in the context of historical treatments, electrical engineering, psychophysics, clinical evaluation of efficacy and personal experience. Finally, Shipsey will address the social implications of cochlear implantation and the future outlook for auditory prostheses.
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The cochlear implant is the most successful of all neural prostheses developed to date. It is the most effective prosthesis in terms of restoration of function, and the people who have received a cochlear implant outnumber the recipients of other types of neural prostheses by orders of magnitude. The primary purpose of this article is to provide an overview of contemporary cochlear implants from the perspective of two designers of implant systems. That perspective includes the anatomical situation presented by the deaf cochlea and how the different parts of an implant system (including the user's brain) must work together to produce the best results. In particular, we present the design considerations just mentioned and then describe in detail how the current levels of performance have been achieved. We also describe two recent advances in implant design and performance. In concluding sections, we first present strengths and limitations of present systems and then offer some possibilities for further improvements in this technology. In all, remarkable progress has been made in the development of cochlear implants but much room still remains for improvements, especially for patients presently at the low end of the performance spectrum.
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Implants can return the senses of hearing but the brain is by far the most important component, as one user discovered. The paper discusses about Michael Chorost's account on the cochlear implant implanted into his skull. The implant would bypass the damaged and recently failed inner ear. What is remarkable about cochlear implants is that the brain can get by with such sparse information. The typical implant stimulates just 16 nerves, a fraction of the number that pass from the ear to the brain in a hearing person. Not only did Chorost, like others with these implants, have to deal with the huge gaps in information passed to the brain, but the new ways that long unused nerves were being stimulated. The surgeons do not find particular neurons $they simply locate those among a bundle that are known to be involved in hearing.
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Work on cochlear prostheses for the auditory rehabilitation of the profoundly deaf represents a challenging problem. Some early, but perhaps premature, surgical attempts have helped to bring the entire issue into focus. Systemic studies are now under way in many different places. Although the purely engineering problems as well as the surgical ones appear solvable at this time, the remaining unsolved problems lie in two areas: 1) the bioengineering interfacing, i.e., the search for methods needed to connect an engineering (electronic) device to the neural auditory system in an efficient manner; and 2) clinical tests for the assessment of the functional state of the cochlear nerve.
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