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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

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  • Третий компонент новой системы Nucleus 5 – устройство дист. управления
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    • 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

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