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Outer hair cells Inner hair cells Scala vestibull Scala media Scala tympani Bipolar electrodes Primary auditory neuron Figure 1. A cutaway drawing of the cochlea showing the UCSF-Storz multichannel bipolar electrode array lying in the scala ty^mpani. The array is designed so that the platinum-iridium alloy contacts will lie against the medial and upper walls of the scala, thus positioning the contacts as close as possible to the dendrites of the surviving primary auditory neurons. This allows more specific electrical field stimulation patterns and improves pitch discrimination. and the percutaneous cable is removed at a second operation. FDA approval of this device is expected when sufficient numbers have been implanted to demonstrate effectiveness and safety. The Division of Otolaryngology of North Carolina Memorial Hospital is involved in a clinical investigation with the developers of the Australian Nucleus device (H. C. Pillsbury, personal communication). This is a 22 channel implant, programmed after implantation to utilize four or more bipolar channels. Like the UCSF-Storz device, the implant is placed through a separate hole in the cochlear capsule into the scala tympani. anterior and inferior to the round window on the promontory of the basal coil of the inner ear, and approached through the middle ear. A one stage operation is required. Of 80 Nucleus devices placed internationally, 72 are in use. The individual programming of these patients postoperatively allows an expected advantage for perception of different languages. The same may be said of the UCSF-Storz system. FDA approval of the Australian Nucleus device is expected within a few months. The major limitation of the single channel implant is that it does not take advantage of the spatial distribution and frequency specificity of the primary auditory neurons. Despite this, many profoundly deaf individuals implanted with this device have experienced a better quality of life through signal sound (bells, horns, etc.) awareness and improved lip reading skills. For adults with prelingual deafness (i.e., onset prior to speech development) who are felt to have viable primary auditory neurons, sound awareness is possible through single channel implantation or extracochlear round window stimulation. The achievement of speech understanding with any stimulation device in prelingually deaf adults is unlikely, but will probably become more feasible with future improvements in speech processing technology using multichannel implants. The single channel device offers the advantage over the Storz-UCSF device of costs reduction ($4,800 versus $12,000 for the devices alone) and a one-stage versus a two-stage operative procedure. The extra cost and surgery of the multichannel system are justified by the increased probability of speech perception without visual cues and the greater likelihood of being able to use future speech processing improvements without the need to change the 17 Vol.. 47. No. 1
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-Present] |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1986 |
Identifier | NCHH-17-047 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 47 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-047.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-047 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 8 (image) |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1986 |
Identifier | NCHH-17-047-0016 |
Form General | Periodicals |
Page Type | all; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | ncmed471986medi1_0016.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 47 |
Issue Number | 1 |
Page Number | 8 |
Health Discipline | Medicine |
Full Text | Outer hair cells Inner hair cells Scala vestibull Scala media Scala tympani Bipolar electrodes Primary auditory neuron Figure 1. A cutaway drawing of the cochlea showing the UCSF-Storz multichannel bipolar electrode array lying in the scala ty^mpani. The array is designed so that the platinum-iridium alloy contacts will lie against the medial and upper walls of the scala, thus positioning the contacts as close as possible to the dendrites of the surviving primary auditory neurons. This allows more specific electrical field stimulation patterns and improves pitch discrimination. and the percutaneous cable is removed at a second operation. FDA approval of this device is expected when sufficient numbers have been implanted to demonstrate effectiveness and safety. The Division of Otolaryngology of North Carolina Memorial Hospital is involved in a clinical investigation with the developers of the Australian Nucleus device (H. C. Pillsbury, personal communication). This is a 22 channel implant, programmed after implantation to utilize four or more bipolar channels. Like the UCSF-Storz device, the implant is placed through a separate hole in the cochlear capsule into the scala tympani. anterior and inferior to the round window on the promontory of the basal coil of the inner ear, and approached through the middle ear. A one stage operation is required. Of 80 Nucleus devices placed internationally, 72 are in use. The individual programming of these patients postoperatively allows an expected advantage for perception of different languages. The same may be said of the UCSF-Storz system. FDA approval of the Australian Nucleus device is expected within a few months. The major limitation of the single channel implant is that it does not take advantage of the spatial distribution and frequency specificity of the primary auditory neurons. Despite this, many profoundly deaf individuals implanted with this device have experienced a better quality of life through signal sound (bells, horns, etc.) awareness and improved lip reading skills. For adults with prelingual deafness (i.e., onset prior to speech development) who are felt to have viable primary auditory neurons, sound awareness is possible through single channel implantation or extracochlear round window stimulation. The achievement of speech understanding with any stimulation device in prelingually deaf adults is unlikely, but will probably become more feasible with future improvements in speech processing technology using multichannel implants. The single channel device offers the advantage over the Storz-UCSF device of costs reduction ($4,800 versus $12,000 for the devices alone) and a one-stage versus a two-stage operative procedure. The extra cost and surgery of the multichannel system are justified by the increased probability of speech perception without visual cues and the greater likelihood of being able to use future speech processing improvements without the need to change the 17 Vol.. 47. No. 1 |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-047.pdf |
Document Sort | all; nchh-17 |
Article Title | Cochlear Implantation 1986: An Overview |
Article Author | Patrick D. Kenan; Joseph C. Farmer. Jr. |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-047 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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