Cochlear implants : fundamentals and applications / Graeme Clark.

Format:

Book

Author/Creator:

Clark, Graeme.

Series:

AIP series in modern acoustics and signal proccesing.

AIP series in modern acoustics and signal proccesing

Language:

English

Subjects (All):

Cochlear implants.

Deaf people--Rehabilitation.

Deaf people.

Cochlear Implants.

Persons With Hearing Impairments--rehabilitation.

Medical Subjects:

Cochlear Implants.

Persons With Hearing Impairments--rehabilitation.

Physical Description:

xxxviii, 830 pages : illustrations ; 25 cm.

Place of Publication:

New York : Springer : AIP Press, [2003]

Summary:

The cochlear implant is a device that bypasses a nonfunctional inner ear and stimulates the auditory nerve directly with patterns of electrical currents derived from incoming sounds. The culmination of investigations in many disciplines, it is the first major advance in helping profoundly deaf children communicate since a sign language for the deaf was systematized at the Institution des Jeunes Sourds in Paris in the early 1800s. Written by the "father" of the multiple-channel implant, this comprehensive text and reference gives an account of the fundamental principles underlying cochlear implants and their clinical application. It thus discusses work in all relevant disciplines. For the clinician, the book will provide guidance in the treatment of patients; for the engineer and researcher, it will provide the background for further research; and for the student, it will provide a thorough understanding of the subject.

Contents:

Normal Hearing xxxi

Deafness xxxi

Overall Concept of the Bionic Ear xxxii

Training in the Use of the Bionic Ear xxxiii

Fundamental Objections and Questions xxxiii

1. A History 1

Pre-science 1

Eighteenth Century 1

Nineteenth Century 3

Twentieth Century 3

1900 to 1930s: Early Hearing Aids 3

1930s to 1940s: Initial Indirect Electrical Stimulation in the Human 4

1950s to 1960s: Initial Direct Electrical Stimulation in the Human 6

1960s: Fundamental Research in the Experimental Animal 9

1970s: Fundamental Research in the Experimental Animal and Human 12

1980s: Fundamental Research, Industrial Development, and Clinical Trials 23

1990s: Continuing Fundamental Research and Industrial Development 45

2. Surgical Anatomy 58

Temporal Bone 59

Components 59

Embryology 60

Mastoid Air Cell System and Variations 61

Blood Supply and Innervation 61

Infant and Young Child 62

External Ear 64

Pinna 64

External Auditory Meatus 65

Middle Ear 65

Ossicles 65

Muscles 66

Relationships 67

Posterior Tympanotomy 70

Round Window and Niche 71

Inner Ear 73

Osseous 73

Membranous 77

Histology of the Cochlea 79

Embryology 82

Central auditory system 83

Auditory Nerve 86

Cochlear Nucleus 87

Superior Olivary Complex 89

Lateral Lemniscus 91

Inferior Colliculus 91

Superior Colliculus 92

Medial Geniculate Body 92

Auditory Cortex 93

3. Surgical Pathology 100

Inflammation 100

Classification 101

Etiology 101

Pathophysiology 101

Insertion Trauma 104

Tissue Responses in the Cochlea of the Experimental Animal 104

Tissue Responses in the Human 109

Bio-compatibility of Materials 112

Methods of Investigation 112

Tissue Response 113

Infection 116

Otitis Media 116

Labyrinthitis and Meningitis 117

Experimental Animal Studies 122

Host Factors and Foreign Bodies 136

Clinical Protocol 139

Deafness and the Central Auditory Pathways 140

Spiral Ganglion 140

Cochlear Nucleus 141

Pons and Midbrain 142

Human Brainstem 143

Prenatal (Congenital) and Postnatal Hearing Loss 144

Genetic and Chromosomal 144

Acquired 148

4. Neurobiology 160

Current and Charge 160

Voltage 161

Resistance 161

Capacitance 161

Impedance 161

Electrode/Tissue Interface 162

Polarization 162

Charge Transfer 162

Charge Density 163

Equivalent Circuits 163

Impedance 165

Corrosion-Stimulus Parameters 168

Mechanisms 168

Stimulus Parameters 169

Scanning Electron Microscope Evaluation of Electrodes 171

Electrical Parameters and Neural Stimulation 172

Electrochemically Safe Stimulus Parameters 172

Charge Density and Charge per Phase 173

Biochemical Effects 173

Neural Preservation 174

Electrical Stimulation of the Cochlear Nerve 175

Acute studies on the Effects of Low Rates of Stimulation 175

Chronic Studies on the Effects of Low Rates of Stimulation 176

Acute Studies on the Effects of High Rates of Stimulation 183

Chronic Studies on the Effects of High Rates of Stimulation 187

Electrical Stimulation of the Cochlear Nucleus 189

Acute Studies on the Effects of Low Rates of Stimulation 189

Chronic Studies on the Effects of Low Rates of Stimulation 189

5. Electrophysiology 199

General Neurophysiology 199

Action Potentials 199

Strength-Duration Curves 202

Electrical Models of the Nerve Membrane 203

Convergence and Divergence 204

Auditory Physiology 205

Physics of Sound 206

External and Middle Ear Function 207

Cochlea 208

Auditory Neurophysiology 211

Electrophonic Hearing (Electrical Stimulation of the Cochlea) 233

Mechanisms 233

Electrophonic Hearing and Cochlear Implantation 235

Electrical Stimulation of the Cochlear Nerve 236

Temporal Coding 237

Place Coding 262

Intensity Coding 272

6. Psychophysics 296

Acoustic Stimulation 296

Pitch and Timbre 297

Loudness 302

Critical Band and Ratio 305

Musical Acoustics 308

Bilateral Hearing 311

Electrical Stimulation 315

Temporal Information 315

Temporal Information: Prelinguistically Deaf 323

Place Information: Prelinguistically Deaf 338

Loudness 341

Intensity Information: Prelinguistically Deaf 352

Musical Perception 353

Bimodal Stimulation 356

Bilateral Stimulation 358

7. Speech (Sound) Processing 381

Acoustic 381

Articulators and Vocal Tract Shape 382

Speech Analysis 382

Speech Perception and Production 385

Binaural Hearing 395

Acoustic Models of Cochlear Implant Speech-Processing Strategies 395

Channel Vocoders and Fixed Filters 395

Formant Vocoders 397

Acoustic Representation of Electrical Stimulation 398

Speech Cues 401

Channel Numbers 402

Speech in Noise 404

Channel Selection 404

Electrical Stimulation: Principles 405

Channel Numbers 406

Channel Selection 407

Speech in Noise 408

Speech Processing Strategies 409

Multiple-Channel Strategies: Fixed Filter Schemes 411

Multiple-Electrode Strategies: Formant and Spectral Cue Extraction 415

Adaptive Dynamic Range Optimization (ADRO) 432

Dual Microphones 433

Bimodal Speech Processing 435

Bilateral Speech Processing 438

8. Engineering 454

Electronic and Communications Engineering 456

Speech Processors 465

Receiver-Stimulators 484

Bioengineering 502

Design Principles 502

Design Realization 518

9. Preoperative Selection 550

Adults 550

Children 551

Clinical Protocol 552

Medical History and Examination 553

History 553

Physical Examination 554

Diagnosis-Etiology 554

Adults 554

Children 555

Audiology 559

Pure Tone Thresholds 559

Impedance Audiometry 562

Hearing Aid Evaluation 563

Cochlear Microphonics and ABR Tests for Neuropathy 564

Communication 566

Speech Perception 566

Speech Production 568

Language 568

Special Investigations 569

Radiology 569

Electrical Stimulation of the Promontory 572

Vestibular Assessment 574

Management 575

Hearing and Speech Perception 575

Pedictive Factors 576

Preoperative Counseling 586

10. Surgery 595

Brief History 596

Position Multiple Electrodes Close to the Auditory Nerves 596

Implant Electrode with Minimal Trauma to the Inner Ear 597

Locate the Receiver-Stimulator to Allow Optimal Use of a Microphone, Speech Processor and Transmitting Coil 597

Implant Receiver-Stimulator to be Unaffected by Growth Changes 597

Implant Operation Performed Safely 597

Fundamentals and Clinical Practice 597

Preoperative Measures 598

Incision 599

First Stage Mastoid Cell Removal 603

Creation of a Bed for the Receiver-Stimulator 603

Creation of Gutter for the Lead Wire Assembly 606

Exposure of the Round Window via a Posterior Tympanotomy 607

Cochleostomy (Opening into the Inner Ear) 608

Insertion of Arrays 612

Sealing the Opening 617

Perilymph "Gusher" 618

Fixing the Electrode Array and Receiver-Stimulator 619

Flap and Wound Closure 620

Radiology 620

Postoperative Care 621

Complications and Management 621

Intraoperative Complications 621

Postoperative Complications 623

Special Cases 639

Ossified Cochlea 639

Secretory (Serous) Otitis Media 642

Tympanic Membrane Perforation and Chronic Suppurative Otitis Media 642

Open Mastoid 642

Congenital or Genetic Malformation of the Cochlea 643

Transmastoid Labyrinthectomy and Acoustic Neuroma 643

Insertion and Reinsertion 644

Pedestal (Plug and socket) 644

Magnetic Resonance Imaging (MRI) 645

11. Rehabilitation 654

Plasticity in the Experimental Animal 655

Plasticity

Psychophysics 656

Cross-Modality in Humans 661

Analytic Versus Synthetic Training 661

Mapping and Fitting Procedures in Adults and Children 663

Physiological and Psychophysical Principles 663

Producing a MAP 665

Signal Gain 668

Loudness Summation 670

Patient Preference 670

Training in Adults and Children 670

Predictive Factors 672

Strategy and Time Course for Learning 674

Analytic 676

Synthetic 676

Environmental Sounds 677

Background Noise 677

Music 678

Telephone 678

Television 679

Mapping and Fitting Children 679

Preprogramming Training 680

Conditioning 680

Initial Setting 681

Follow-up Device Settings 682

Neural Response Telemetry 683

Training in Children 684

Personnel 684

Pragmatics 686

Speech Perception 686

Perception of Environmental Sounds 688

Speech Production 689

Language 690

Education of Children 693

Acoustic Environment 693

Strategies 694

Program for Implanted Children 695

Counseling of Adults and Children 696

12. Results 707

Development of Tests 707

Speech and Sound Perception: Test Principles 708

Variability of Materials and Responses 708

Prerecorded Versus Live Voice 709

Training Effects and Experience 710

Closed-Set Tests 710

Speech Features (Consonants and Vowels) 712

Open-Set Tests 713

Speech Reading 714

Speech Tracking 715

Speech in Noise 716

Environmental Sounds 717

Test Batteries 717

Questionnaires 718

Bimodal and Bilateral Speech Processing 718

Speech Production: Test Principles 720

Imitative and Spontaneous Speech 720

Computer Aided Speech and Language Assessment procedure (CASALA) 721

Language: Test Principles 721

Receptive Language 722

Expressive Language 722

Pragmatics 724

Speech perception with Cochlear Implants 724

Predictive Factors 724

Speech-Processing Strategies for Postlinguistically Deaf Adults 726

Speech-Processing Strategies for Pre- and Postlinguistically Deaf Children 738

Speech production with Cochlear Implants 744

Single-Channel System (3M/House) 744

Nucleus Multiple-Channel (F0/F1/F2) and Multipeak Strategies 744

Language Development for Pre- and Postlinguistically Deaf Children 747

Receptive Language 747

Expressive Language 750

Cognition 751

13. Socioeconomics and Ethics 767

Speech and Language Benefits 767

Biological Safety 767

Social Benefits 768

Personal 768

Family 768

School 769

Economic Benefits 769

Economic Measures 769

Cost-Effectiveness 770

Cost-Benefit Analysis 770

Quality of Life 771

Ethics 773

Human Experimentation 773

Rights of Children 779

Attitudes of Hearing-Impaired People 782

14. Research Directions 787

Improved Sound Fidelity and Speech Processing 787

Selection of Information 788

Optimal Rate Stimulation 788

Improved Coding 789

Improved Speech Perception in Noise 795

Bimodal Speech Processing 795

Bilateral Speech Processing 797

Dual Microphones 797

Improved Speech and Language in Children 797

Totally Implantable Cochlear Prosthesis 801

Auditory Nerve Preservation and Regeneration 802.

Notes:

Includes bibliographical references and index.

ISBN:

0387955836

OCLC:

50494476