Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

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

2,181 views

Published on

Published in: Health & Medicine, Business
  • Be the first to comment

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

×