Hybrid Cochlear Implants
January
2004 - We've been hearing about a hybrid CI for awhile now. It uses CI
technology for the high frequencies and hearing aid technology for the
low frequencies. Clinical trials are now underway!
March 2006 - Cochlear
implants aim for age-related loss
April 2006 - Aging
ears get bionic boost
May 2006 - Hybrid cochlear implant works
wonders in elderly
June 2006 - More hybrid cochlear implant works wonders in
elderly
June 2006 - New Hearing Aid Is 'Hybrid'
September 2006 -
Med-El Hybrid Cochlear Implant Available in Europe
December 2006 - Hybrid Cochlear Implant Provides Hearing
Solution
December 2006 - Hybrids the Answer for Partial Hearing
Loss
January 2007 - Hybrid
Implant a new remedy for hearing loss
May 2007 - MED-EL
Introduces Hybrid Implant
June 2007 - Hybrid
Cochlear Implant Fits the Bill
September 2007 - UW Implants Hybrid CI
October 2007 -
Hybrid CI Effective Remedy for Some People with Hearing
Loss
December 2007 - Med-El Hybrid Cochlear Implant
January 2008 - Preservation of Hearing in Cochlear
Implant Surgery
April 2008 - NIH funds ASU research to improve
hearing
April 2008 - UT Southwestern testing new hybrid CI
July 2008 - Med-El Launches Electric-Acoustic System
Clinical Trial
January 2009 - Hybrid Cochlear Implant Suits Some with
High Frequency Hearing Loss
February 2009 - MED-EL Announces Second Generation
Hybrid Implant
April 2009 - The Cochlear Hybrid CI Nominated for
Award
May 2009 - Missouri Woman First in US to Get Hybrid
Implant
April 2010 - New hope in the fight to wipe out deafness
April 2010 - Preserving Residual Acoustic Hearing with
Combined Acoustic and Electric Hearing
January 2011 - Can People with Partial Hearing Loss
Benefit from Hybrid Cochlear Implants?
March 2011 - Combined Acoustic and Electric Stimulation
May 2011 - Hearing preservation with cochlear
implantation
December 2011 - Hybrid/EAS Cochlear Implants - New
Research and Clinical Tips
More on this and related
topics
~~~~~~~~~~~~~~~~~
January 2004
In our discussion of Cochlear's presentation at the 2003 ALDAcon we
reported that they were working on a hybrid implant that uses cochlear
implant (CI) technology for the high frequencies and standard hearing
aid (HA) technology for the low frequencies. It seems that they were
farther along with this technology than we thought, because they are now
in clinical trials with the new device.
The device is practical for two reasons. The first is that most
people with hearing loss have greater loss at the high frequencies than
at the low frequencies; the second is that the cochlear hair cells
corresponding to high frequencies are in the outside part of the
cochlea. So a short electrode array that only stimulates high
frequencies need only be inserted a short way into the cochlea. The hair
cells that respond to low frequencies (which are deeper in the cochlea)
aren't disturbed by the array, so low frequency hearing can be assisted
by a conventional hearing aid.
The first implantation of the Cochlear Nucleus(r) HybridT cochlear
implant was performed by Dr. Joseph Roberson on Dec. 8, 2003 at the
Stanford University Hospital.
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March
2006
WASHINGTON
--Cochlear implants may not be just for the profoundly deaf anymore:
Iowa scientists are developing the next generation, a "hybrid
implant" to combine the best of bionics with regular hearing aids
for age-related hearing loss. If it works -- and early study results are
promising -- it one day may help thousands of older Americans whose
hearing is progressively fading. The key difference: Unlike regular
cochlear implants, the hybrid model would let people keep their natural
music appreciation even as it helps them hear speech more clearly again.
Full
Story
~~~~~~~~~~~~~~~~~
March
2006
Cochlear
implants may not be just for the profoundly deaf anymore: Iowa
scientists are developing the next generation, a "hybrid
implant" to combine the best of bionics with regular hearing aids
for age-related hearing loss. If it works -- and early study results are
promising -- it one day may help thousands of older Americans. The key
difference: Unlike regular cochlear implants, the hybrid model would let
people keep their natural music appreciation even as it helps them hear
speech more clearly again. Full
Story
~~~~~~~~~~~~~~~~~
May 2006
Cochlear
implants have long been used as a last resort when hearing aids no longer
cut it. Trouble is they tend to accentuate high pitch sounds and destroy
any residual low frequency hearing. Ten years ago Dr Bruce Gantz, who
heads the otolaryngology department at the University of Iowa, decided the
status quo just wasn't good enough for his patients and set out to come up
with an alternative. The result, his experimental hybrid cochlear implant,
melds bionic technology with traditional hearing aids. But the key to his
device is that it's far less invasive than traditional cochlear implants
and appears to preserve low frequency hearing.
Full Story
~~~~~~~~~~~~~~~~~
Experimental device ups treble but keeps bass, preserving residual hearing
June 2006
Treating severe hearing loss has always forced doctors to make tough
decisions. Cochlear implants have long been used as a last resort when
hearing aids no longer cut it. Trouble is they tend to accentuate high
pitch sounds and destroy any residual low frequency hearing. Ten years ago
Dr Bruce Gantz, who heads the otolaryngology department at the University
of Iowa, decided the status quo just wasn't good enough for his patients
and set out to come up with an alternative. The result, his experimental
hybrid cochlear implant, melds bionic technology with traditional hearing
aids. But the key to his device is that it's far less invasive than
traditional cochlear implants and appears to preserve low frequency
hearing.
Full Story
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June 2006
Tens of millions of Americans today have some hearing loss, and with an
aging population, this problem threatens to get worse. At UCSF Medical
Center, Kathy Barger is hoping to get an earful - thanks to an
experimental device. "I am hoping this will return part of my hearing,"
said Barger. "To say that it would return it 100% would be absolutely a
miracle" Kathy is unhappy with her hearing aids. So, she decided to try
out what could be the next best thing to a bionic ear: a hybrid cochlear
implant. It's surgically implanted behind and into, her ear.
Full Story
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September
2006
Many people
with severe to profound loss in the high frequencies have not been able to
benefit from cochlear implant (CI) technology, because their low frequency
hearing is too good. The hybrid CI overcomes that restriction by using
hearing aid technology for low frequencies and CI technology for high
frequencies. The Cochlear hybrid device has been in clinical trials for a
couple of years now, but is not yet generally available.
Here's more information.
~~~~~~~~~~~~~~~~~
December 2006
But this new "hybrid" cochlear implant was
designed specifically for partial hearing loss — so that users could
enjoy both their own natural hearing plus bionic hearing for sounds where
they need an extra boost. Five years after surgery that implanted the
device in her inner ear, 34-year-old Yeoman of Humboldt, Iowa, sometimes
even forgets it's turned on. "Everything sounds so
crystal-clear," she says. Full
Story
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December
2006
Jeanne
Yeoman had been dealing with her hearing loss for a couple of decades, but
listening still exhausted her. And technology wasn't really helping her
patience. She remembers driving down the road one day and coming close to
just hurling her hearing aids out the window. "Hearing aids made
everything louder, not clearer," she says. "I didn't need
amplification. I needed clarification."
Full
Story
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January
2007
So
Davis underwent an experimental surgery last week to implant a hybrid
auditory device in his right ear as part of a newly approved Food and Drug
Administration study. The UW Medical Center is one of 20 sites in the
United States and Europe involved in a clinical trial performing a total
of 100 surgeries. So far 90 people have undergone the surgery worldwide.
The UW performed three in January, Davis being the third. First
established at the University of Iowa, the hybrid auditory implant uses a
shorter version of the traditional cochlear implant electrode. Surgeons
and researchers hope to restore hearing without damaging the low-frequency
hearing, which would happen with a traditional, longer cochlear implant.
Full
Story
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June
2007
James
A. King has always had poor hearing, but now it's so bad the Warren County
pharmacist often can't understand patients at his store counter, waiters
in restaurants or the high-pitched voices of his six grandchildren -- even
with the help of hearing aids. King,
64, hopes an innovative surgery he recently underwent at UNC Hospitals in
Chapel Hill will change all that. Last
month, a surgeon implanted a small device above King's ear that will
directly stimulate nerves involved in hearing. The device, called a
cochlear implant, will work in tandem with a special hearing aid to help
him hear a more complete range of sounds. King is among the first patients
in the country to receive the combination treatment, which is being tested
at UNC-Chapel Hill and elsewhere as part of a national clinical trial
sponsored by Med-El, the Austrian company that makes the technology. The
dual device is aimed at people who, like King, hear too well for a
cochlear implant alone but not well enough for hearing aids to be
effective. It's hard to say how many patients might be candidates for the
combination treatment. But hearing loss is highly prevalent, affecting
about 28 million Americans of all ages.
Full
Story
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October 2007
One of the newest applications of implantable
hearing technology now in clinical trials combines electric and acoustic
stimulation (EAS) into a hybrid device designed for individuals with
binaural low-frequency hearing and severe-to-profound high-frequency hearing
loss. Research has shown that these individuals may not gain significant
benefit from traditional amplification (e.g., Hogan & Turner, 1998; Ching et
al., 1998; Turner & Cummings, 1999). One possibility for this lack of
amplification benefit is the presence of cochlear dead regions, which are
more common with thresholds above 70 dB HL (Vinay & Moore, 2007). Another
possibility is that the high levels required to make high-frequency speech
audible may, in fact, degrade the signal. Although these individuals may not
obtain much benefit from high-frequency amplification, their relatively good
low-frequency hearing may disqualify them from conventional cochlear implant
candidacy. As a result, individuals with good low-frequency hearing and
severe-to-profound high-frequency hearing loss can experience significant
difficulty in everyday communication, particularly in noisy backgrounds,
where low-frequency information alone is not sufficient to allow high levels
of speech understanding. The hybrid devices use a shortened cochlear implant
electrode array that is inserted just 10 mm-20 mm into the cochlea (versus
20 mm-30 mm for a conventional implant). A successful surgical outcome
allows for monaural electric stimulation of the basal cochlea for
high-frequency information without damaging apical cochlear structures that
transmit low-frequency acoustic information (e.g., Gantz et al., 2005, 2006;
Gstöettner et al., 2005; Kiefer et al., 2005; Leutje et al., 2007;
Skarzynski et al., 2006). This combination allows for the integration of
electric and acoustic perception in the same ear.
Full Story
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December 2007
She could get a cochlear implant, a device that
helps with higher frequencies. But such devices are not ideal for people
like Munsch with partial deafness because they don't allow them to use their
remaining hearing of low-frequency sounds. In fact, implanting a cochlear
device would increase the risk that she might lose her residual
lower-frequency hearing. But when researchers at the Medical College of
Wisconsin offered to implant an experimental hearing device that combined a
cochlear implant with a hearing aid, Munsch agreed to undergo the surgery.
The device already is approved in Europe and is being tested at 10 sites in
the U.S. Munsch is the first of five to 10 patients who are expected to be
implanted with the device at Froedtert Hospital. The device, which is made
by Med-El, a company based in Innsbruck, Austria, amplifies low-frequency
sounds with a conventional hearing aid and uses a cochlear implant to pick
up higher frequencies.
Full Story
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Preservation of Hearing in Cochlear Implant Surgery
January 2008
The cochlear implant (CI) has been able to restore
substantial hearing in profound prelingually deafened children and profound
postlingually deafened adults and children. The remarkable word
understanding scores obtained by these groups of individuals has enabled
those with less than profound deafness to be considered for implantation.
Expansion of the selection criteria for implantation to those with more
residual hearing is supported by data that residual hearing is one of the
few variables identified that directly impacts speech perception results.1
In this article, we describe a somewhat different rationale for considering
the patients' residual hearing in cochlear implantation. The decision to
undergo traditional implantation surgery will usually mean that patients'
residual acoustic hearing is usually no longer available. However, the
residual low-frequency acoustic hearing, when it can be used by the patient
in addition to electrical stimulation, has some important advantages
compared with traditional "electric only" CIs. Therefore, there are a number
of disadvantages that should be considered before the decision to destroy
residual acoustic hearing is undertaken. The electrical signal-processing
algorithm and stimulation of the auditory nerve that provides important
information for speech perception in quiet is reported by users of CIs as
"mechanical" or "raspy" when compared with their memories of acoustic
hearing. In addition, the loss of pitch perception, which is primarily a
consequence of the limited spectral resolution of current CI speech
processing, has unfortunate consequences for the perception of speech in
noise and for the accurate perception and enjoyment of music.
Full Story
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January 2009
The Nucleus(r) Hybrid(tm) cochlear implant system
offers individuals with steeply sloping hearing losses in the high-frequency
region an alternative to traditional cochlear implantation. The Nucleus
Hybrid cochlear implant system incorporates an internal device that has a
shorter electrode array component than a more traditional cochlear implant.
Like the traditional length cochlear implant, it uses electrical signals to
stimulate the cochlea, but because of its shorter length, the Hybrid
cochlear implant only stimulates the basal end of the cochlea where the
highequency hearing has deteriorated, preserving the residual low-frequency
hearing. This type of combination device, or Hybrid, can result in better
hearing preservation than other traditional devices with longer arrays
(Turner, Reiss, & Gantz, 2007). In addition, research has suggested that
individuals with steeply sloping hearing losses may benefit more from short
electrode implantation than longer electrode cochlear implants (Novak,
Black, & Koch 2007; Gantz, Turner, Gfeller, & Lowder, 2005) because of the
low-frequency hearing preservation.
Full Story
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February 2009
MED-EL is proud to announce the availability of the
new DUET 2 Audio Processor. Offering the fastest, most effective sound
coding strategies, the DUET 2 is designed to provide individuals with
partial deafness the best possible hearing experience. The DUET 2 is the
result of ten years of MED-EL research and development in Electric Acoustic
Stimulation (EAS). Combining powerful I100 electronics with an ergonomic
design featuring the FineTuner(tm) remote control, users will be attracted
to its compact, lightweight design and user friendly interface.
Full
Story
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April 2009
The Cochlear(tm) Hybrid(tm) System seamlessly blends
two well-established technologies - cochlear implants and hearing aids - for
individuals with severe to profound high frequency hearing loss, who
maintain their low frequency hearing. It integrates world-class cochlear
implant technology from Cochlear, the global leader for over 25 years, with
state-of-the-art hearing aid technology. The higher frequency regions of the
cochlea are stimulated electrically, while lower frequencies are preserved
for acoustic amplification. By effectively restoring the severe to profound
high frequency loss using electrical stimulation, Hybrid enables individuals
to regain their ability to communicate easily and enhances their
appreciation of environmental sounds.
Full Story
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May 2009
The St. Joseph woman simply wanted her hearing back
- something a traditional cochlear implant could accomplish, if only she
were a good candidate for one. But the fact that she wasn't a good candidate
opened the door for Ms. Kerner to become the first person in the United
States to receive a version of the device that might benefit not only her
but also many others with hearing loss. "It's sort of a serendipity" that
receiving a traditional cochlear implant wasn't an option for her, says Dr.
Charles Luetje, a neurotologist with Midwest Ear Institute in Kansas City,
Mo., and the principal investigator of an FDA study of the William House
hybrid cochlear implant, which Ms. Kerner received on April 23. "If it works
like we think it will, it has the potential to open up possibilities for a
lot of people." Ms. Kerner began wearing a hearing aid in 1990, when she was
39 years old, and her hearing has gradually decreased since then to the
point that she can no longer hear high-frequency sounds. But because her
low-frequency, or residual, hearing remains and traditional cochlear
implants can damage that, receiving a traditional implant wasn't a wise
option for her.
Full Story
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April 2010
A new treatment is giving partially deaf people the
chance to hear the world around them better than they dreamed possible. The
technique, known as a soft-surgery cochlear implantation, involves inserting
an electrode into the inner ear of patients who have some residual hearing.
The treatment was previously offered only to people with total or near-total
hearing loss, also called profound deafness. But now, a doctor at Al Mafraq
Hospital in the capital is confident that the surgery is safe enough to be
performed on patients with some hearing without risk of further loss.
Full Story
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April 2010
In recent years, a unique approach in the treatment
of severe high-frequency sensorineural hearing loss has been explored. This
new approach modifies existing cochlear implantation techniques by
preserving any remaining hearing in the implanted ear and has already been
implemented in more than 100 people worldwide. Many people who receive
cochlear implants (CIs) still have some residual hearing in the opposite,
non-implanted ear and sometimes wear a hearing aid in this ear to provide
additional beneficial sound stimulation. This new technique involves
preserving low-frequency hearing in the implanted ear, with the CI filling
in high-frequency sounds. The aim is to produce improved speech
understanding and other hearing sensations via combined acoustic (A) and
electric (E) hearing. With A+E hearing, one uses both acoustic hearing
(sound waves entering the ear in typical fashion, amplifi ed by a hearing
aid) plus electrical hearing (sound waves being received by a sound
processor, which transmits signals to the electrode implanted in the inner
ear, or cochlea). The addition of acoustic hearing, either via the opposite,
or the implanted ear, can often improve a person's total hearing abilities.
Full Story
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by Michael F. Dorman
March 2011
The average level of performance with a single
cochlear implant for sentence understanding has been very good (80%-90%
correct) for a long time. The average level of performance for
consonant-nucleus-consonant (CNC) word recognition has been poorer, in the
range of 50%-60% correct for the same amount of time (Helms et al., 1997).
The best chance to improve sentence and word recognition performance
significantly may be to provide patients with a combination of electric (E)
stimulation and low-frequency acoustic stimulation (A) or EAS.
Full Story
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May 2011
One area that has received considerable attention in
the past ten years is cochlear implantation with hearing preservation using
what is referred to as electric and acoustic stimulation (EAS) or a hybrid
implant. We just happened to locate an expert on this topic, who is our
guest this month for 20Q.
Full Story
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December 2011
There are times when 20 Questions just aren’t enough!
We’re back again talking about new developments in cochlear implants. Just
in case you missed it, last month our 20Q guest author, René Gifford, Ph.D.
of Vanderbilt University started things off by telling us that yes indeed,
hearing preservation is possible with cochlear implants. She described a
procedure that has been used since 1999, usually referred to as electric and
acoustic stimulation (EAS) or a hybrid cochlear implant (e.g., implant and
hearing aid used in the same ear). We’re pleased to have René back with us.
She covered a lot of territory last month, telling us about the specifics of
the implant procedure, implant candidacy, what devices are available, the
differences among devices, and the research findings from various clinical
trials. You can read last month's article here. When our “Question Man”
reached his final 20th question, Dr. Gifford was just starting to explain
some interesting findings related to speech recognition with these patients
following implantation. Let’s join them as they resume their conversation to
see how that story ends.
Full Story
