The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing

Background: The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining...

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Autor principal:	Blake S. Wilson
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2017
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/261bebdc72c443e89250120251341f98
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spelling	oai:doaj.org-article:261bebdc72c443e89250120251341f982021-12-02T17:32:20ZThe cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing2095-881110.1016/j.wjorl.2017.12.005https://doaj.org/article/261bebdc72c443e89250120251341f982017-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881117301440https://doaj.org/toc/2095-8811Background: The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway. Objective: To assess the present status of cochlear implants and to describe possibilities for improving them. Results: The present-day devices work well in quiet conditions for the great majority of users. However, not all users have high levels of speech reception in quiet and nearly all users struggle with speech reception in typically noisy acoustic environments. In addition, perception of sounds more complex than speech, such as most music, is generally poor unless residual hearing at low frequencies can be stimulated acoustically in conjunction with the electrical stimuli provided by the implant. Possibilities for improving the present devices include increasing the spatial specificity of neural excitation by reducing masking effects or with new stimulus modes; prudent pruning of interfering or otherwise detrimental electrodes from the stimulation map; a further relaxation in the criteria for implant candidacy, based on recent evidence from persons with high levels of residual hearing and to allow many more people to benefit from cochlear implants; and “top down” or “brain centric” approaches to implant designs and applications. Conclusions: Progress in the development of the cochlear implant and related treatments has been remarkable but room remains for improvements. The future looks bright as there are multiple promising possibilities for improvements and many talented teams are pursuing them. Keywords: Auditory prosthesis, Cochlear implant, Cochlear prosthesis, Deafness, Neural prosthesisBlake S. WilsonKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 3, Iss 4, Pp 200-210 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Blake S. Wilson The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
description	Background: The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway. Objective: To assess the present status of cochlear implants and to describe possibilities for improving them. Results: The present-day devices work well in quiet conditions for the great majority of users. However, not all users have high levels of speech reception in quiet and nearly all users struggle with speech reception in typically noisy acoustic environments. In addition, perception of sounds more complex than speech, such as most music, is generally poor unless residual hearing at low frequencies can be stimulated acoustically in conjunction with the electrical stimuli provided by the implant. Possibilities for improving the present devices include increasing the spatial specificity of neural excitation by reducing masking effects or with new stimulus modes; prudent pruning of interfering or otherwise detrimental electrodes from the stimulation map; a further relaxation in the criteria for implant candidacy, based on recent evidence from persons with high levels of residual hearing and to allow many more people to benefit from cochlear implants; and “top down” or “brain centric” approaches to implant designs and applications. Conclusions: Progress in the development of the cochlear implant and related treatments has been remarkable but room remains for improvements. The future looks bright as there are multiple promising possibilities for improvements and many talented teams are pursuing them. Keywords: Auditory prosthesis, Cochlear implant, Cochlear prosthesis, Deafness, Neural prosthesis
format	article
author	Blake S. Wilson
author_facet	Blake S. Wilson
author_sort	Blake S. Wilson
title	The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
title_short	The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
title_full	The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
title_fullStr	The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
title_full_unstemmed	The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
title_sort	cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing
publisher	KeAi Communications Co., Ltd.
publishDate	2017
url	https://doaj.org/article/261bebdc72c443e89250120251341f98
work_keys_str_mv	AT blakeswilson thecochlearimplantandpossibilitiesfornarrowingtheremaininggapsbetweenprostheticandnormalhearing AT blakeswilson cochlearimplantandpossibilitiesfornarrowingtheremaininggapsbetweenprostheticandnormalhearing
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The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing

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