The history of Cochlear implantation - Dr. Dr. h.c. Monika Lehnhardt
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The history of Cochlear implantation - Dr. Dr. h.c. Monika Lehnhardt Presentation Transcript

  • 1. The history of Cochlear Implantation Dr. Dr. h. c. Monika Lehnhardt Suzdal, November 2011
  • 2. Wever EG, Bray CW (1936) www.monika-lehnhardt.net
  • 3. www.monika-lehnhardt.net Charles Eyries, Otologist in Paris
  • 4. www.monika-lehnhardt.net André Djurno, Engineer Co-working with Eyries
  • 5. www.monika-lehnhardt.net Fritz Zöllner, Otologist in Freiburg
  • 6. www.monika-lehnhardt.net Wolf Dieter Keidel, Physiologist in Erlangen
  • 7. www.monika-lehnhardt.net
  • 8. www.monika-lehnhardt.net
  • 9. www.monika-lehnhardt.net William House, Otologist in Los Angeles
  • 10. www.monika-lehnhardt.net
    • 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.” -Professor Graeme Clark
  • 11.
    • Ernst Lehnhardt
    www.monika-lehnhardt.net
  • 12. www.monika-lehnhardt.net
  • 13. www.monika-lehnhardt.net
  • 14. www.monika-lehnhardt.net
  • 15. www.monika-lehnhardt.net Electrode Array in situ
  • 16.
    • 1984 First adult patients in Hannover, Germany
    www.monika-lehnhardt.net
  • 17.
    • Ernst Lehnhardt with his audiologist Rolf Battmer
    www.monika-lehnhardt.net
  • 18. www.monika-lehnhardt.net
  • 19. www.monika-lehnhardt.net
  • 20. Soft Surgery www.monika-lehnhardt.net
  • 21. www.monika-lehnhardt.net Soft Surgery
  • 22. www.monika-lehnhardt.net
  • 23. www.monika-lehnhardt.net
  • 24. Freedom Cochlear Implant www.monika-lehnhardt.net
    • 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
  • 25. Freedom Speech Processor www.monika-lehnhardt.net
    • 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
  • 26. www.monika-lehnhardt.net
  • 27. www.monika-lehnhardt.net
  • 28. www.monika-lehnhardt.net Мониторинг . Контроль . Управление . Cochlear : Система Nucleus 5 Cochlear : Дистанционное управление Nucleus CR110
  • 29. Exponential Growth- First Choice Worldwide www.monika-lehnhardt.net
  • 30. www.monika-lehnhardt.net 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
  • 31. Trend towards bilateral www.monika-lehnhardt.net
  • 32. www.monika-lehnhardt.net
  • 33. www.monika-lehnhardt.net New Surgical Techniques
  • 34. TIKI Technolog y www.monika-lehnhardt.net Implantable Rechargeable Battery
      • Extremely low power Integrated Circuit incorporating:
      • Audio pre-processing
      • Stimulator module
      • Speech processor
      • Power management
      • High voltage output switches
    High performance implantable microphone that will last a lifetime ?
  • 35. Suppose the electrodes could be in close contact with the nerves… www.monika-lehnhardt.net
  • 36. www.monika-lehnhardt.net Neurotrophins and Auditory Nerve Regeneration Normal Deafened Regeneration Habenula Perforata Wise et al, The Bionic Ear Institute, 2003. Inner Haircells Outer Haircells
  • 37. Nanotechnology: Guidance Molecules www.monika-lehnhardt.net
  • 38. Thank You for your attention! www.monika-lehnhardt.net