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History of Cochlear Implants |
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Developmental &
Approval Timeline
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Age of Research
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In the early years of development
cochlear implants were very experimental. No one knew what the effects
of electrical stimulation of the inner ear would be. It was apparent
that a "sense" of hearing occurred with this stimulus.
However, a great deal of experimentation would be needed to determine
whether this could be used to restore useful hearing. Questions
included:
- What is the best way to
"code" the complexities of sound into electrical
pulses?
- Did it matter where the electrodes
were placed inside the inner ear?
- What is the optimal number of
electrodes?
- Would it work in children as well as
adults?
- What are the effects of long term
electrical inner ear stimulation on the hearing nerves and brain,
especially in children?
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Age of Acceptance and Expansion |
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With the advent of
multichannel implants, particularly the Nucleus 22, it soon
became apparent that very useful hearing could be provided
through electrical inner ear stimulation and could be done
safely, even in children. The more advanced processing
strategies produced better and better performance. For the first
time in history the prosthetic restoration of a human special
sense was taking place. More and more patients of all ages could
now benefit from this technology. The question of whether or not
cochlear implants work was clearly answered with a yes. Now the
only question remaining was how well can they be made to work?
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Age of Refinement |
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In the late 1990's, new processing
strategies, miniaturization of the processors, and advancement of
postoperative aural rehabilitative therapy improved rapidly. The Nucleus
24 was approved for implantation in children 12 months of age or older,
as it became apparent the younger a deaf child is implanted, the sooner
the child will assimilate language. Implant performance has improved dramatically in the 1990's that adults who had some residual hearing but
were performing sub optimally with hearing aids became potential
candidates. Some adults were achieving word recognition over 90% with
the implant.
Outcomes studies began to show
the remarkable cost benefit of cochlear implants. Cochlear
implants were found to be one of the most cost effective medical
interventions in terms of the long term impact on a recipients
quality of life relative to their cost. Children who received a
cochlear implant in early childhood were found to be twice as
likely to be in mainstream education classrooms as children
without implants. Cochlear implants in children were found to
save society up to 1 million dollars in educational and
assistive benefits over the life of that individual. |
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