Page 60 - Spring 2019
P. 60

The Flernarkahle Cochlear Irnplant
mo Z Awusuc only words from 54 to 73% correct and a 2-fold increase in the
= §‘;E1"¢°"7Y recognition of the sentences in noise at the SNR of +5 dB.
80 Thus, the barrier of ~55% correct for recognition of mono-
?) syllabic words by experienced. users of unilateral Cls (Figure
g 60 3) can be broken, and recognition of speech in noise can be
8 increased with combined EAS. Excellent results also have
E 40 been obtained with bilateral electrical stimulation, as shown
:2 for example in Miiller et al. (2002).
20 In broad terms, both combined EAS and bilateral Cls can
improve speech reception substantially. Also, combined
EAS can improve music reception and bilateral Cls can en-
0 Wolds semvqulel Sam‘ “O dB sent *5 GB able sound localization abilities. Furthermore, the brain can
Tes‘ integrate the sleemingly éllisparate ipputs }from elecitricfand
acoustic stimu ation, or e in uts romt e two si es rom
Figure 5. Means and SEMs of scores for the recognition of bilateral electrical stimulation,Iinto unitary percepts that for
monosyllabic words (Words). Azliio sentences presented in an speech are more intelligible, often far more intelligible, than
otherwise quiet condition (Sent, quiet), and the sentences pre- either input alone. Step 5 was a major step forward.
sented in competition with speech-babble noise at the SNRs of
+10 dB (Sent, +10 dB) and +5 :13 (Sent, +5 dB). Measures Step 5'?
were made with acoustical stimulation of the ear with residual In my view, the greatest opportunities for the next large step
hearing for each of the 15 subjects; electrical stimulation with forward are
the CI on the opposite side; and combined electric and acoustic (1) increasing access worldwide to the marvelous technol-
stimulation, Damfmm Dorman er nl_ (2003) ogy that already has been developed and proven to be safe
  and highly beneficial;
(2) improving the performance of unilateral Cls, which is
opposite side or with acoustic stimulation, the latter for per- the o_l-fly option for_many pane“?  Pmfipecnvfe Patients
. . . . . . and is the foundation of the adjunctive stimulation treat-
sons with useful residual hearing on either side or both sides. memy and
The effects of the additional stimulation can be large, as seen (3) broadening the eiigibiiiiy and indieaiions for C15 and
in Figure 5, which shows the effects of combined electric and the adjnnetive treatments, Perhaps in ineinde die i-nany
3C°“5tiC 5fi1'l'“113ti01'| (C°mbi1'|9d EAS? 3150 ca11=d“hYbrid” '31’ millions of people worldwide who suffer from disabling
“bimfidil” S1i-|'l'|U131i0n)- T119 data 31? fl‘0lT| Dfifman Ct 31- hearing loss in their sixth decade and beyond (a condition
(2008). They tested 15 subjects who had a full insertion of eafled “Pi—e5byen5i5"')i
a CI on one side; residual hearing at low frequencies on the Any nfihese advances wnnid be 3 woi-diy step 5_
opposite side; and 5 months to 7 years of experience with p
the CI and 5 or more years of experience with a hearing aid. I“""5lf'gAcc_e‘“ ' _
The tests included recognition of monosyllabic words and As lmémloned "1 the Imfoducuon’ slightly more than half
the AzBio sentences with acoustic stimulation of the one ear 3 mllhon People worldwide have_ received a C_1 fix bllateml
only with the hearing aid, electric stimulation of the opposite C15 to flats‘ 1“ Contrast’ approximately 57 mljlllon People
ear only with the CL and Combined EAS As in Figure 4, worldwide have a severe or worse hearing loss in the better
the sentences were presented in an otherwise quiet condition heanng ear (wflson et _a1_'’ 2017)‘ Most of these Pe°_P1e Could
and in competition with noise (4-talker babble noise) at the benefit from a Cl‘ Addmonauy’ m“_-‘yfold m_°re’ Wnh §°_me'
SNRS of +10 and +5 dB‘ x|:'l::t bitter‘ hearing }on the wotrse-Ede oil] :11: subisttantiagy
e er earing on e opposi e si e, co ene grea y
Means and SEMs of the scores are presented in Figure 5 and from combined EAS. A conservative estimate of the num-
demonstrate the large benefits of the combination for all ber of persons who could benefit from a CI or the adjunctive
tests. Compared with electric stimulation only, the combina- stimulation treatments is around 60 million and the actual
tion produces a jump up in the recognition of monosyllabic number is probably very much higher. Taking the conser-
sa 1 AI:uuI:l:I Tbday 1 Spring 2019

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