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The history of  Cochlear Implantation Dr. Dr. h. c. Monika Lehnhardt Suzdal, November 2011
Wever EG, Bray CW (1936) www.monika-lehnhardt.net
www.monika-lehnhardt.net Charles Eyries, Otologist in Paris
www.monika-lehnhardt.net André Djurno,  Engineer Co-working with Eyries
www.monika-lehnhardt.net Fritz Zöllner, Otologist in Freiburg
www.monika-lehnhardt.net Wolf Dieter Keidel, Physiologist in Erlangen
www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net William House, Otologist in Los Angeles
www.monika-lehnhardt.net <ul><li>Vision for a technology that   would enable the deaf to hear </li></ul><ul><li>Research s...
<ul><li>Ernst Lehnhardt </li></ul>www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net Electrode Array in situ
<ul><li>1984 First adult patients in Hannover, Germany </li></ul>www.monika-lehnhardt.net
<ul><li>Ernst Lehnhardt with his audiologist Rolf Battmer </li></ul>www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net
Soft Surgery www.monika-lehnhardt.net
www.monika-lehnhardt.net Soft Surgery
www.monika-lehnhardt.net
www.monika-lehnhardt.net
Freedom Cochlear Implant www.monika-lehnhardt.net <ul><li>4th generation ASIC  CMOS internal chip with </li></ul><ul><ul><...
Freedom Speech Processor www.monika-lehnhardt.net <ul><li>Dual microphones  for high quality sound capture and support for...
www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net Мониторинг .  Контроль .  Управление . Cochlear :   Система   Nucleus 5 Cochlear : Дистанционное ...
Exponential Growth-  First Choice Worldwide www.monika-lehnhardt.net
www.monika-lehnhardt.net Development of Candidate Selection Criteria United States (Nucleus Implant Systems) Broadening In...
Trend towards bilateral www.monika-lehnhardt.net
www.monika-lehnhardt.net
www.monika-lehnhardt.net New Surgical Techniques
TIKI Technolog y www.monika-lehnhardt.net Implantable Rechargeable Battery <ul><ul><li>Extremely low power Integrated Circ...
Suppose the electrodes could be in close contact with the nerves… www.monika-lehnhardt.net
www.monika-lehnhardt.net Neurotrophins and   Auditory Nerve Regeneration Normal Deafened Regeneration Habenula Perforata W...
Nanotechnology:   Guidance Molecules www.monika-lehnhardt.net
Thank You   for your attention! www.monika-lehnhardt.net
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The history of Cochlear implantation - Dr. Dr. h.c. Monika Lehnhardt

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

    1. 1. The history of Cochlear Implantation Dr. Dr. h. c. Monika Lehnhardt Suzdal, November 2011
    2. 2. Wever EG, Bray CW (1936) www.monika-lehnhardt.net
    3. 3. www.monika-lehnhardt.net Charles Eyries, Otologist in Paris
    4. 4. www.monika-lehnhardt.net André Djurno, Engineer Co-working with Eyries
    5. 5. www.monika-lehnhardt.net Fritz Zöllner, Otologist in Freiburg
    6. 6. www.monika-lehnhardt.net Wolf Dieter Keidel, Physiologist in Erlangen
    7. 7. www.monika-lehnhardt.net
    8. 8. www.monika-lehnhardt.net
    9. 9. www.monika-lehnhardt.net William House, Otologist in Los Angeles
    10. 10. www.monika-lehnhardt.net <ul><li>Vision for a technology that would enable the deaf to hear </li></ul><ul><li>Research supported by public donation, commenced 1967 </li></ul><ul><li>First cochlear implant, 1978, Melbourne Hospital </li></ul>“ 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. 11. <ul><li>Ernst Lehnhardt </li></ul>www.monika-lehnhardt.net
    12. 12. www.monika-lehnhardt.net
    13. 13. www.monika-lehnhardt.net
    14. 14. www.monika-lehnhardt.net
    15. 15. www.monika-lehnhardt.net Electrode Array in situ
    16. 16. <ul><li>1984 First adult patients in Hannover, Germany </li></ul>www.monika-lehnhardt.net
    17. 17. <ul><li>Ernst Lehnhardt with his audiologist Rolf Battmer </li></ul>www.monika-lehnhardt.net
    18. 18. www.monika-lehnhardt.net
    19. 19. www.monika-lehnhardt.net
    20. 20. Soft Surgery www.monika-lehnhardt.net
    21. 21. www.monika-lehnhardt.net Soft Surgery
    22. 22. www.monika-lehnhardt.net
    23. 23. www.monika-lehnhardt.net
    24. 24. Freedom Cochlear Implant www.monika-lehnhardt.net <ul><li>4th generation ASIC CMOS internal chip with </li></ul><ul><ul><li>Increased precision current sources for accurate nerve stimulation </li></ul></ul><ul><ul><li>4th generation telemetry with less internal noise, enabling AutoNRT </li></ul></ul><ul><ul><li>Improved power efficiency for longer battery life </li></ul></ul><ul><li>Generational mechanical changes for </li></ul><ul><ul><li>improved reliability </li></ul></ul>
    25. 25. Freedom Speech Processor www.monika-lehnhardt.net <ul><li>Dual microphones for high quality sound capture and support for Pre-processing </li></ul><ul><li>Dual 16-bit analog to digital converters for CD quality 96dB dynamic range processing </li></ul><ul><li>Quad 16 Bit DSP </li></ul><ul><li>In-built Telecoil </li></ul><ul><li>Integrated accessory connector </li></ul><ul><li>IP44 Splash Compliant </li></ul>
    26. 26. www.monika-lehnhardt.net
    27. 27. www.monika-lehnhardt.net
    28. 28. www.monika-lehnhardt.net Мониторинг . Контроль . Управление . Cochlear : Система Nucleus 5 Cochlear : Дистанционное управление Nucleus CR110
    29. 29. Exponential Growth- First Choice Worldwide www.monika-lehnhardt.net
    30. 30. www.monika-lehnhardt.net Development of Candidate Selection Criteria United States (Nucleus Implant Systems) Broadening Indications Adults Children 1985 <ul><li>FDA approval for implantation of candidates aged 18 years and older </li></ul><ul><li>postlingually deafened </li></ul><ul><li>profound bilateral sensorineuronal deafness </li></ul><ul><li>no benefit from hearing aid </li></ul>1990 <ul><li>FDA approval for implantation of candidates aged </li></ul><ul><li>2 years and older </li></ul><ul><li>profound bilateral sensorineuronal deafness </li></ul><ul><li>little or no benefit from hearing aid </li></ul><ul><li>candidate and family must be well motivated and possess realistic expectations </li></ul>1995 <ul><li>Include pre-and perilinguistically deafened adults </li></ul><ul><li>Limited benefit from hearing aids defined as 30% or </li></ul><ul><li>less in best aided condition on tape recorded tests of open-set sentences </li></ul>1998 <ul><li>Limited benefit from hearing aids defined as 40% or less in best aided condition on tape recorded tests of open-set sentences </li></ul><ul><li>18 months and older </li></ul><ul><li>3-6 months hearing aid trial </li></ul><ul><li><20% score on MLNT or LNT test </li></ul>2000 <ul><li>Limited benefit from hearing aids defined as 60% or less in best aided condition on tape recorded tests of open-set sentences </li></ul><ul><li>12 months and older </li></ul><ul><li>3-6 months hearing aid trial </li></ul><ul><li>Lack of progress in development of </li></ul><ul><li>auditory skills or <30% score on MLNT or LNT test, depending on age </li></ul>
    31. 31. Trend towards bilateral www.monika-lehnhardt.net
    32. 32. www.monika-lehnhardt.net
    33. 33. www.monika-lehnhardt.net New Surgical Techniques
    34. 34. TIKI Technolog y www.monika-lehnhardt.net Implantable Rechargeable Battery <ul><ul><li>Extremely low power Integrated Circuit incorporating: </li></ul></ul><ul><ul><li>Audio pre-processing </li></ul></ul><ul><ul><li>Stimulator module </li></ul></ul><ul><ul><li>Speech processor </li></ul></ul><ul><ul><li>Power management </li></ul></ul><ul><ul><li>High voltage output switches </li></ul></ul>High performance implantable microphone that will last a lifetime ?
    35. 35. Suppose the electrodes could be in close contact with the nerves… www.monika-lehnhardt.net
    36. 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. 37. Nanotechnology: Guidance Molecules www.monika-lehnhardt.net
    38. 38. Thank You for your attention! www.monika-lehnhardt.net
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