The first case of single channel in Japan was reported. This case was a 56 year—old male with bilateral profound hearing loss caused by labyrinthitis which was affected by meningitis 36 years ago A diagnosis of sensory deaf was carried out by electrical promontory testing (E.P.T.). An internal induction coil was fitted by surgical procedure on Dec. 3. 1980 and the first electrical stimulation was performed on Feb. 3, 1981. As a result of our first experience of single channel , is one of the useful approach to restore the deaf peoples.

抄録全体を表示

Cochlear implants have become the standard of care for patients suffering from profound sensorineural hearing loss. Unfortunately, access to cochlear implantation as well as rehabilitation may be limited. In order to facilitate access to cochlear implantation and rehabilitation, implantation was performed at a satellite medical facility over 250 miles from the Carolina Ear and Hearing Clinic's center, and the implants were programmed over the Internet via a virtual private network (VPN). A separate video conferencing system was used to insure synchronization of the video and audio signals.
Initially, an IRB approved pilot study was conducted comparing the postoperative HINT and CNC word scores for seven patients who had undergone remote mapping and programing of their cochlear implants. Their scores were compared with the mean scores of seven patients who had been programmed at the Carolina Ear and Hearing Clinic by the same audiologist over a twelve-month period. All patients in each group were successfully programmed and there were no statistically significant differences in postoperative HINT and CNC word scores.
Based on the success of this pilot study, the remote programming system was expanded to include young children. Their ages ranged from 22 months to 5 years of age. All five children were successfully programmed remotely. To date, over 48 adult and pediatric patients have been implanted and successfully programmed using this remote programming system. The ability to remotely program patients offers the potential to extend cochlear implantation to areas without a tertiary center. This model, which is safe, effective, and maintains patient confidentiality, may have application for other implant centers attempting to provide patients access to technology.

抄録全体を表示

The first time in Germany that a child who was deaf was fitted with a was in 1988. In the course of that year, cochlear implants were increasingly requested by parents who were mostly people without hearing impairments, because over 90% of children who are deaf have parents without hearing impairments. Nowadays, cochlear implantation is a widely recognized and accepted method of treatment. The situation has been different, however, for of parents who themselves are deaf. Bonded by the Deaf community and culture, the Deaf can communicate with their children from the start via sign language. Nevertheless, more and more Deaf parents are opting for a for their children who are deaf. Background for this decision, based on data from interviews with Deaf parents, is described in this paper.

抄録全体を表示

Provision of binaural hearing should be considered the standard of care for hearing impaired patients whenever it can be provided without significant risks. In the case of patients with severe to profound hearing loss effective binaural hearing may require bilateral cochlear implantation. The combined experience of many centers around the world has provided substantial insight into the benefits of bilateral cochlear implantation. At the Dallas Otolaryngology Program, over 40 children and 40 adults have been implanted bilaterally. Although there are some benefits that require further detailed study to quantify, there are many benefits that have become both objectively and subjectively apparent. Our experience, combined with published results of other centers, has allowed us to define guidelines for which the benefits of bilateral cochlear implantation significantly outweigh the risks. For these patients, bilateral implantation should be considered the standard of care, even as we continue to define the increasing benefits and expand the criteria to more patients over the long term.
This article will review the data available in the scientific literature as well as presentations at respected scientific meetings and will discuss our center's experience and rationale for providing binaural hearing to recipients of all age groups.

抄録全体を表示

Current status of the cochlear prosthesis is overviewed. More than 190 patients underwent single channel implant at the House Ear Institute. Multichannel electrode system was also implanted in many patients in other institutes. Neither of single and multichannel system could have provided a sophisticated hearing for speech communication so far.
However, many patients could discriminate simple words or environmental sounds. Other benefits of the current implant are reduction of tinnitus and improvement of lip reading. Postimplant rehabilitation still plays an important role in improvement of word discrimination.
Problems to be solved lie in 2 major categories; 1) a method to evaluate functioning cochlear nerve for electrical stimulation. 2) improvement of a stimulator which produces an electronic signal for better frequency coding.

抄録全体を表示

Congenitally deaf Japanese children with cochlear implants were tested on their recognition of theme songs from television programs that they watched regularly. The children, who were 4-9 years of age, attempted to identify each song from a closed set of alternatives. Their song identification ability was examined in the context of the original commercial recordings (vocal plus instrumental), the original versions without the words (i.e., karaoke versions), and flute versions of the melody. The children succeeded in identifying the music only from the original versions, and their performance was related to their music listening habits. Children gave favorable appraisals of the music even when they were unable to recognize it. Further research is needed to find means of enhancing cochlear implants users' perception and appreciation of music.

抄録全体を表示

The purpose of this study is to investigate the effect of speech rate to speech recognition in 11 users and 13 hearing-impaired elderly adults. The users were postlingually deafened adults (4 males and 7 females) ranging from 18 to 64 years of age, with a mean age of 50.9, who use Nucleus 22 channel system with SPEAK coding strategy. The elderly adults (4 males and 9 females) ranging from 56 to 80 years of age, with a mean age of 64.0 participated in the study. Three speech rate variations were created for each sentence: fast (11 molar per second), middle (9 molar/s), and slow (6 molar/s). The speech recognition performance was evaluated for the percentage score of syllables that were correctly recalled in a sentence composed of 5 syllables.
Percentage scores in the fast, middle, and slow speech rate were 15.6%, 38.8%, and 57.1% respectively in users and 59.2%, 67.4%, 81.4% respectively in elderly adults. This result revealed a significant effect of speech rate slowing (p<0.0001) in both groups. However, variation to the effect of speech rate slowing was observed in the users, compared with the older adults. The effect of speech rate slowing was high in users who achieved good recognition score at fast speech rate. Although the recall scores were higher for the first syllable of the sentence than for the syllables in mid-sentence at the fast rate, slowing the rate of speech increased the scores of syllables in every position. Speech rate is important factor for improvement of speech recognition in users and elderly adults.

抄録全体を表示

The auditory evoked responses were recorded from a 26-year-old male with a . The patient received the on October 25, 1984, in the left ear. The device was the 3M/House (alpha design) single channel type. And he is the second patient who received the surgery in Japan.
The device was activated 2 months after the surgery and the patient recognized the speech and environmental sounds through the device. The auditory evoked responses were recorded 8 months after the surgery under normal use condition that is the sound stimuli delivered through loud speaker in the open field, so that the sound was conducted via microphone, signal processor, external coil, internal coil and then active electrode in the cochlea. The slow vertex response could be evoked by 70dB SPL tone bursts at the frequencies of 500Hz and 90dB SPL at 1000Hz. The auditory brainstem response, however, was not be able to record by click stimuli. Thus, the auditory evoked response, especially the slow vertex response in this recording situation, is useful indicator for the objective evaluation of the function of the device.

抄録全体を表示

We are generally able to identify sounds and understand speech with ease, despite the large variations in the acoustics of each sound, which occur due to factors such as different talkers, background noise, and room acoustics. This form of perceptual constancy is likely to be mediated in part by the auditory system's ability to adapt to the ongoing environment or context in which sounds are presented. Auditory context effects have been studied under different names, such as spectral contrast effects in speech and auditory enhancement effects in psychoacoustics, but they share some important properties and may be mediated by similar underlying neural mechanisms. This review provides a survey of recent studies from our laboratory that investigate the mechanisms of speech spectral contrast effects and auditory enhancement in people with normal hearing, hearing loss, and cochlear implants. We argue that a better understanding of such context effects in people with normal hearing may allow us to restore some of these important effects for people with hearing loss via signal processing in hearing aids and cochlear implants, thereby potentially improving auditory and speech perception in the complex and variable everyday acoustic backgrounds that surround us.

抄録全体を表示

Superficial siderosis is a disease in which iron from hemoglobin is deposited in the central nervous system, resulting in conditions such as progressive sensorineural hearing loss, cerebellar ataxia, dementia, and pyramidal signs. A 30-year-old man with superficial siderosis received a

in the left ear, which had shown complete hearing loss. Good auditory responses were obtained at 14 days after implantation. The postoperative average hearing level with the was 56.7 dB at 3 months and 55.0 dB at 6 months. However, the patient showed gradual hearing loss, and the dynamic range changed each time the electrode parameters were adjusted. To assess residual hearing ability, single-photon emission computed tomography was performed together with an assessment of electrical auditory brainstem response, which showed a good response and increased blood flow in both the temporal lobes. Based on this result, we asked the patient to continue using the to see whether a perception of speech response would be obtained. However, the patient discontinued using the because he could not hear satisfactorily. Hearing outcomes after surgery for patients with superficial siderosis are not necessarily good. Therefore, the possibility of unsatisfactory results should be fully explained before recommending this surgery to patients.

抄録全体を表示

Depending on the etiology of sensory neural hearing loss and patient age, it is postulated that a significant number of candidates today have a rich neural substrate consisting of nondegenerated dendrites and a large number of spiral ganglion cells with associated axons. In addition, many patients have some residual hearing especially in the low frequencies, demonstrating neural survival in the apical regions. With long electrodes covering the scala tympani from base to apex, it has become feasible to improve tonotopic stimulation. Key to the long-term success of implantation is preservation of intracochlear structures during electrode insertion. Round window membrane insertion combined with free-fitting lateral wall electrode placement tends to preserve residual hearing. New coding strategies providing fine structure information in the apex can enhance patient performance. Delicate intracochlear tissues must also be preserved during the multiple explantations and reimplantations that young patients face during their 80+ year life span, otherwise some benefits will be lost over time.

抄録全体を表示

感覚器障害戦略研究「聴覚障害児の療育等により言語能力等の発達を確保する手段の研究」事業として平成21年から1年間に調査した症例対照研究のうち, 人工内耳装用児の現状と語音明瞭度・言語発達に関する検討を行った。対象は幼稚園年中から小学校6年までの両耳聴力レベル70dB以上の言語習得期前の聴覚障害児で, 124施設が参加した。言語検査が実施できた638名のうち人工内耳装用児は285名 (44.7%) であり, 言語発達検査の検討はハイリスク児を除外した190名であった。人工内耳+補聴器併用児が69.5%, 片側人工内耳のみが29.8%, 両側人工内耳が0.7%を占めた。難聴発見年齢は平均11.7ヶ月, 人工内耳装用開始年齢は平均3歳6ヶ月であった。人工内耳装用月齢と最高語音明瞭度とは高い相関を認め, 人工内耳装用開始時期が24ヶ月前とその後で言語発達検査を比較するとすべての検査項目で早期人工内耳装用児群で高い値が得られ, 早期人工内耳の有効性を支持する結果となった。

抄録全体を表示