Series Preface. Preface. Acknowledgments. Abbreviations

Transcription

1 Contents Series Preface Preface Acknowledgments Abbreviations vii ix xiii xxv Introduction xxxi Definition...xxxi 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 Answers to the Fundamental Objections...xxxiv 1. A History 1 Pre-science...1 Eighteenth Century...1 Nineteenth Century...3 Twentieth Century to 1930s: Early Hearing Aids s to 1940s: Initial Indirect Electrical Stimulation in the Human s to 1960s: Initial Direct Electrical Stimulation in the Human s: Fundamental Research in the Experimental Animal s: Fundamental Research in the Experimental Animal and Human s: Fundamental Research, Industrial Development, and Clinical Trials xv

2 xvi Contents 1990s: Continuing Fundamental Research and Industrial Development References Surgical Anatomy 58 Overview Temporal Bone Components Embryology Mastoid Air Cell System and Variations Blood Supply and Innervation Infant and Young Child External Ear Pinna External Auditory Meatus Middle Ear Ossicles Muscles Relationships Posterior Tympanotomy Round Window and Niche Inner Ear Osseous Membranous Histology of the Cochlea Embryology Central auditory system Overview Auditory Nerve Cochlear Nucleus Superior Olivary Complex Lateral Lemniscus Inferior Colliculus Superior Colliculus Medial Geniculate Body Auditory Cortex References Surgical Pathology 100 Inflammation Classification Etiology Pathophysiology Insertion Trauma Tissue Responses in the Cochlea of the Experimental Animal...104

3 Contents xvii Tissue Responses in the Human Bio-compatibility of Materials Methods of Investigation Tissue Response Infection Otitis Media Labyrinthitis and Meningitis Experimental Animal Studies Host Factors and Foreign Bodies Clinical Protocol Deafness and the Central Auditory Pathways Spiral Ganglion Cochlear Nucleus Pons and Midbrain Human Brainstem Prenatal (Congenital) and Postnatal Hearing Loss Genetic and Chromosomal Acquired References Neurobiology 160 Overview Definition of Terms Current and Charge Voltage Resistance Capacitance Impedance Electrode/Tissue Interface Polarization Charge Transfer Charge Density Equivalent Circuits Impedance Corrosion-Stimulus Parameters Mechanisms Stimulus Parameters Scanning Electron Microscope Evaluation of Electrodes Electrical Parameters and Neural Stimulation Electrochemically Safe Stimulus Parameters Charge Density and Charge per Phase Biochemical Effects Neural Preservation Electrical Stimulation of the Cochlear Nerve Acute studies on the Effects of Low Rates of Stimulation...175

4 xviii Contents Chronic Studies on the Effects of Low Rates of Stimulation Acute Studies on the Effects of High Rates of Stimulation Chronic Studies on the Effects of High Rates of Stimulation Electrical Stimulation of the Cochlear Nucleus Acute Studies on the Effects of Low Rates of Stimulation Chronic Studies on the Effects of Low Rates of Stimulation References Electrophysiology 199 General Neurophysiology Action Potentials Strength-Duration Curves Electrical Models of the Nerve Membrane Convergence and Divergence Auditory Physiology Physics of Sound External and Middle Ear Function Cochlea Auditory Neurophysiology Electrophonic Hearing (Electrical Stimulation of the Cochlea) Mechanisms Electrophonic Hearing and Cochlear Implantation Electrical Stimulation of the Cochlear Nerve Temporal Coding Place Coding Intensity Coding References Psychophysics 296 Acoustic Stimulation Pitch and Timbre Loudness Critical Band and Ratio Musical Acoustics Bilateral Hearing Electrical Stimulation Temporal Information Temporal Information: Prelinguistically Deaf Place Information Place Information: Prelinguistically Deaf Loudness Intensity Information: Prelinguistically Deaf Musical Perception Bimodal Stimulation Bilateral Stimulation...358

5 Contents xix References Speech (Sound) Processing 381 Acoustic Articulators and Vocal Tract Shape Speech Analysis Speech Perception and Production Binaural Hearing Acoustic Models of Cochlear Implant Speech-Processing Strategies Channel Vocoders and Fixed Filters Formant Vocoders Acoustic Representation of Electrical Stimulation Speech Cues Channel Numbers Speech in Noise Channel Selection Electrical Stimulation: Principles Channel Numbers Channel Selection Speech in Noise Speech Processing Strategies Multiple-Channel Strategies: Fixed Filter Schemes Multiple-Electrode Strategies: Formant and Spectral Cue Extraction Adaptive Dynamic Range Optimization (ADRO) Dual Microphones Bimodal Speech Processing Bilateral Speech Processing References Engineering 454 Electronic and Communications Engineering Principles Speech Processors Receiver-Stimulators Bioengineering Design Principles Design Realization Conclusion References Preoperative Selection 550 Aims Adults Children...551

6 xx Contents Clinical Protocol Medical History and Examination Aims History Physical Examination Diagnosis-Etiology Adults Children Audiology Pure Tone Thresholds Impedance Audiometry Hearing Aid Evaluation Cochlear Microphonics and ABR Tests for Neuropathy Communication Speech Perception Speech Production Language Special Investigations Radiology Electrical Stimulation of the Promontory Vestibular Assessment Management Hearing and Speech Perception Predictive Factors Preoperative Counseling References Surgery 595 Overview Brief History Aims Position Multiple Electrodes Close to the Auditory Nerves Implant Electrode with Minimal Trauma to the Inner Ear Locate the Receiver-Stimulator to Allow Optimal Use of a Microphone, Speech Processor and Transmitting Coil Implant Receiver-Stimulator to be Unaffected by Growth Changes Implant Operation Performed Safely Fundamentals and Clinical Practice Preoperative Measures Incision First Stage Mastoid Cell Removal Creation of a Bed for the Receiver-Stimulator Creation of Gutter for the Lead Wire Assembly Exposure of the Round Window via a Posterior Tympanotomy...607

7 Contents xxi Cochleostomy (Opening into the Inner Ear) Insertion of Arrays Sealing the Opening Perilymph Gusher Fixing the Electrode Array and Receiver-Stimulator Flap and Wound Closure Radiology Postoperative Care Complications and Management Intraoperative Complications Postoperative Complications Special Cases Ossified Cochlea Secretory (Serous) Otitis Media Tympanic Membrane Perforation and Chronic Suppurative Otitis Media Open Mastoid Congenital or Genetic Malformation of the Cochlea Transmastoid Labyrinthectomy and Acoustic Neuroma Insertion and Reinsertion Pedestal (Plug and socket) Magnetic Resonance Imaging (MRI) References Rehabilitation 654 Aims Principles Plasticity in the Experimental Animal Plasticity Psychophysics Plasticity Cross-Modality in Humans Analytic Versus Synthetic Training Mapping and Fitting Procedures in Adults and Children Physiological and Psychophysical Principles Producing a MAP Signal Gain Loudness Summation Patient Preference Training in Adults and Children General Predictive Factors Strategy and Time Course for Learning Analytic Synthetic Environmental Sounds Background Noise...677

8 xxii Contents Music Telephone Television Mapping and Fitting Children Preprogramming Training Conditioning Initial Setting Follow-up Device Settings Neural Response Telemetry Training in Children General Personnel Pragmatics Speech Perception Perception of Environmental Sounds Speech Production Language Education of Children Acoustic Environment Strategies Program for Implanted Children Counseling of Adults and Children References Results 707 Aims Development of Tests Speech and Sound Perception: Test Principles Variability of Materials and Responses Prerecorded Versus Live Voice Training Effects and Experience Closed-Set Tests Speech Features (Consonants and Vowels) Open-Set Tests Speech Reading Speech Tracking Speech in Noise Environmental Sounds Test Batteries Questionnaires Bimodal and Bilateral Speech Processing Speech Production: Test Principles Imitative and Spontaneous Speech Computer Aided Speech and Language Assessment procedure (CASALA)...721

9 Contents xxiii Language: Test Principles Receptive Language Expressive Language Pragmatics Speech perception with Cochlear Implants Predictive Factors Speech-Processing Strategies for Postlinguistically Deaf Adults Speech-Processing Strategies for Pre- and Postlinguistically Deaf Children Speech production with Cochlear Implants Single-Channel System (3M/House) Nucleus Multiple-Channel (F0/F1/F2) and Multipeak Strategies Language Development for Pre- and Postlinguistically Deaf Children Receptive Language Expressive Language Cognition References Socioeconomics and Ethics 767 Speech and Language Benefits Biological Safety Social Benefits Personal Family School Economic Benefits Economic Measures Cost-Effectiveness Cost-Benefit Analysis Quality of Life Ethics Human Experimentation Rights of Children Attitudes of Hearing-Impaired People References Research Directions 787 Improved Sound Fidelity and Speech Processing Selection of Information Optimal Rate Stimulation Improved Coding Improved Speech Perception in Noise Bimodal Speech Processing Bilateral Speech Processing Dual Microphones Improved Speech and Language in Children Totally Implantable Cochlear Prosthesis Auditory Nerve Preservation and Regeneration References Index 813

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