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The history of Cochlear Implantation
Dr. Dr. h. c. Monika LehnhardtSuzdal, November 2011
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Wever EG, Bray CW (1936)
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Charles Eyries, Otologist in Paris
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André Djurno, Engineer Co-working with Eyries
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Fritz Zöllner, Otologist in Freiburg
www.monika-lehnhardt.netWolf Dieter Keidel, Physiologist in Erlangen
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William House, Otologist in Los Angeles
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Vision for a technology that would enable the deaf to hear
Research supported by public donation, commenced 1967
First cochlear implant, 1978, Melbourne Hospital
“In spite of the problems and criticisms, I just had to go on. A cochlear implant was their only hope of ever hearing.” -Professor Graeme Clark
Ernst Lehnhardt
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Electrode Array in situ
• 1984 First adult patients in Hannover, Germany
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• Ernst Lehnhardt with his audiologist Rolf Battmer
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Soft Surgery
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Soft Surgery
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• 4th generation ASIC CMOS internal chip with
– Increased precision current sources for accurate nerve stimulation
– 4th generation telemetry with less internal noise, enabling AutoNRT
– Improved power efficiency for longer battery life
• Generational mechanical changes for
– improved reliability
Freedom Cochlear Implant
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• Dual microphones for high quality sound capture and support for Pre-processing
• Dual 16-bit analog to digital converters for CD quality 96dB dynamic range processing
• Quad 16 Bit DSP
• In-built Telecoil
• Integrated accessory connector
• IP44 Splash Compliant
Freedom Speech Processor
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Мониторинг. Контроль. Управление.
Cochlear: Система Nucleus 5
Cochlear: Дистанционное управление Nucleus CR110
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Exponential Growth- First Choice Worldwide
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Development of Candidate Selection Criteria United States (Nucleus Implant Systems)
Broadening Indications
Adults Children
1985 FDA approval for implantation of candidates aged 18 years and older
postlingually deafened profound bilateral sensorineuronal deafness no benefit from hearing aid
1990 FDA approval for implantation of candidates aged 2 years and older profound bilateral sensorineuronal deafness little or no benefit from hearing aid candidate and family must be well motivated and possess
realistic expectations
1995 Include pre-and perilinguistically deafened adults Limited benefit from hearing aids defined as 30%
or less in best aided condition on tape recorded tests
of open-set sentences
1998 Limited benefit from hearing aids defined as 40% or
less in best aided condition on tape recorded tests of open-set sentences
18 months and older 3-6 months hearing aid trial <20% score on MLNT or LNT test
2000 Limited benefit from hearing aids defined as 60% or less in best aided condition on tape recorded tests of open-set sentences
12 months and older 3-6 months hearing aid trial Lack of progress in development of auditory skills or <30% score on MLNT or LNT test,
depending on age
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Trend towards bilateral
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New Surgical Techniques
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TIKI Technology
Implantable Rechargeable Battery ?
Extremely low powerIntegrated Circuit incorporating:
• Audio pre-processing • Stimulator module• Speech processor• Power management• High voltage output switches
High performance implantable microphone that will last a lifetime
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Suppose the electrodes could be in close contact with the nerves…
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Normal Deafened Regeneration
Habenula Perforata
Wise et al, The Bionic Ear Institute, 2003.
Inner Haircells
Outer Haircells
Neurotrophins and Auditory Nerve Regeneration
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Nanotechnology: Guidance Molecules
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Thank You for your attention!