A Virtual-Reality Training Simulator for Cochlear Implant Surgery

2019 ◽  
Vol 50 (2) ◽  
pp. 243-258 ◽  
Author(s):  
Blake Jones ◽  
Seyed Alireza Rohani ◽  
Nelson Ong ◽  
Tarek Tayeh ◽  
Ahmad Chalabi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Hearing Loss ◽  
Cochlear Implant ◽  
Contrast Imaging ◽  
Training Simulator ◽  
Profound Hearing Loss ◽  
Surgical Trainees ◽  
Game Engines ◽  
Fluoroscopic Imaging ◽  
High Resolution Models

Background and Objectives. Hearing loss is one of the most prevalent chronic conditions and can significantly impact an individual’s quality of life. Cochlear implantation (CI) is a widely applicable treatment for severe to profound hearing loss, however CI surgery can be difficult for surgical trainees to master. Training environments that are safe, controlled, and affordable are needed. To this end, we present a virtual-reality (VR) cochlear implant surgical simulator developed with a popular, commercial game engine. Method. Unity3D was used to develop the simulator and model the delicate instruments involved. High-resolution models of human cochleae were created from images obtained from synchrotron-radiation phase-contrast imaging (SR-PCI). The physical-realism of the simulator was assessed via a comparison with fluoroscopic images of an actual cochlear implant insertion. Different resolutions of cochlear models were used to benchmark the real-time capabilities of the simulator with the number of frames per second (FPS) serving as the performance metric. Results. Quantitative analysis comparing the simulated procedure to fluoroscopic imaging revealed no significant differences. Qualitatively, the behaviour of the inserted and simulated implants were similar throughout the entirety of the procedure. The simulator was able to maintain 25 FPS even when experiencing an artificially high computational load. Conclusion. VR simulators provide a new and exciting avenue to enhance current medical education. Continued use of widely available and supported game engines in the development of medical simulators will hopefully result in lowered costs. Preliminary feedback from expert surgeons of the simulator presented here has been positive and future work will focus on evaluating face, content and construct validity.

scholarly journals Subjective Benefits of Bimodal Listening in Cochlear Implant Recipients with Asymmetric Hearing Loss

2020 ◽  
Vol 162 (6) ◽  
pp. 933-941 ◽  
Author(s):  
Nicholas J. Thompson ◽  
Margaret T. Dillon ◽  
Emily Buss ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Word Recognition ◽  
Cochlear Implant ◽  
Sound Field ◽  
Profound Hearing Loss ◽  
Sentence Recognition ◽  
Academic Center ◽  
Asymmetric Hearing Loss

Objective To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL). Study Design Prospective clinical trial. Setting Tertiary academic center. Subjects and Methods Subjects included CI recipients with AHL (n = 20), defined as moderate-to-profound hearing loss in the affected ear and mild-to-moderate hearing loss in the contralateral ear. Quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ) pragmatic subscales, which assess binaural benefits. Subjective benefit on the pragmatic subscales was compared to word recognition in quiet and spatial hearing abilities (ie, masked sentence recognition and localization). Results Subjects demonstrated an early, significant improvement ( P < .01) in abilities with the CI as compared to preoperative abilities on the SSQ pragmatic subscales by the 1-month interval. Perceived abilities were either maintained or continued to improve over the study period. There were no significant correlations between results on the Speech in Quiet subscale and word recognition in quiet, the Speech in Speech Contexts subscale and masked sentence recognition, or the Localization subscale and sound field localization. Conclusions CI recipients with AHL report a significant improvement in quality of life as measured by the SSQ pragmatic subscales over preoperative abilities. Reported improvements are observed as early as 1 month postactivation, which likely reflect the binaural benefits of listening with bimodal stimulation (CI and contralateral hearing aid). The SSQ pragmatic subscales may provide a more in-depth insight into CI recipient experience as compared to behavioral sound field measures alone.

scholarly journals Current criteria for selecting cochlear implant in deaf patients: a review

2021 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Neural Plasticity ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Electrode Arrays ◽  
Profound Hearing Loss ◽  
Unilateral Deafness

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

Qualification of unilateral cochlear implant recipients for a second device

2019 ◽  
Vol 73 (6) ◽  
pp. 8-17 ◽  
Author(s):  
Maria Drela ◽  
Karolina Haber ◽  
Iwona Wrukowska ◽  
Michael Puricelli ◽  
Anna Sinkiewicz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Short Interval ◽  
Binaural Hearing ◽  
Speech Development ◽  
Vestibular Organ ◽  
Profound Hearing Loss ◽  
Potential Benefits ◽  
Effective Use

Introduction: Although it is recommended to perform cochlear implantation in both ears at the same time for management of profound hearing loss in children, many centers prefer to perform sequential implantation. There are many reasons as to why a simultaneous bilateral implantation is not commonly accepted and performed. The major risk is the possibility of bilateral vestibular organ impairment. However, it is beyond doubt that children who received the first implant should be given a chance for binaural hearing and associated benefits. In the literature, there are no homogenous criteria for bilateral implantation, and it is hard to find uniform and convincing algorithms for second cochlear implantation. The aim of this study is an attempt to identify a safe way of qualifying for second cochlear implantation in children. Material and methods: Forty children with one cochlear implant were qualified for the second implantation. During qualification, the following were taken into account: time of the first implantation, audiometry results, use of the hearing aid in the ear without an implant and benefit of the device, speech and hearing development, and vestibular organ function. R esults: Fifteen out of forty children (38%) were qualified for the second implantation. In 35% of children, the decision was delayed with possible second implantation in the future. Eleven children (27%) were disqualified from the second surgery. Discussion: During evaluation according to the protocol presented in our study, 38% of children with a single cochlear implant were qualified for the second implantation with a chance for an optimal development and effective use of the second cochlear implant. We are convinced that sequential implantation with a short interval between surgeries and with an examination of the vestibular organ, hearing and speech development as well as an assessment of potential benefits from the second implant (bimodal stimulation) before the second implantation is the safest and most beneficial solution for children with severe hearing loss.

Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation

2017 ◽  
Vol 26 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Laura Greaver ◽  
Hannah Eskridge ◽  
Holly F. B. Teagle
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Clinical Report ◽  
Loss Assessment ◽  
Profound Hearing Loss ◽  
Single Sided Deafness ◽  
Asymmetric Hearing Loss ◽  
Case Basis ◽  
Moderate Hearing Loss

Purpose The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Method Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. Results The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Conclusions Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.

scholarly journals Prevalence & features of inner ear malformations among children with congenital sensorineural hearing loss: A Public Cochlear Implant Centre Experience

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Jawwad Ahmed ◽  
Ghulam Saqulain ◽  
Muhammad Iqbal javed Khan ◽  
Mobeen Kausar
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Demographic Data ◽  
Sensorineural Hearing ◽  
Profound Hearing Loss ◽  
Creative Commons ◽  
Inner Ear Malformations ◽  
Ear Malformations

Objective: To determine the prevalence and features of inner ear anomalies in children with congenital profound hearing loss who presented at our cochlear implant center based on imaging studies. Methods: This retrospective study reviewed charts of children with congenital SNHL, who presented to Department of Otolaryngology & Auditory Implant Centre, Capital Hospital Islamabad over a period of 2 years from 1st May 2017 to 30th April 2019. These included 481 cases of both genders aged between 1 to 12 years. After gathering demographic data, audiological data, computed tomography findings of the temporal bone were analyzed. Data was analyzed using SPSS 22. Results: The Inner Ear Malformations were identified in 48(10%) children including 28 (58.33%) males and 20 (41.67%) female. Most 20(41.67%) presented at >3-5 years of age followed by 19(39.58%) at 2-3 years. However, no significant association of gender (p=0.57, p=0.076) and age of presentation (p=0.344, p=0.697) for right and left ears was noted with inner ear malformations. The most common anomaly noted were CLA, CH-III and CH-II in decreasing order of frequency in both ears. Conclusion: The prevalence of IEM’s was found to be 48(10%). Commonest anomalies noted were CLA, CH-III and CH-II. No significant association of gender and age of presentation was noted with type of anomaly in both ears. doi: https://doi.org/10.12669/pjms.36.7.3134 How to cite this:Ahmed J, Saqulain G, Khan MIJ, Kausar M. Prevalence & features of inner ear malformations among children with congenital sensorineural hearing loss: A Public Cochlear Implant Centre Experience . Pak J Med Sci. 2020;36(7):---------.  doi: https://doi.org/10.12669/pjms.36.7.3134 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Assessment and Aural Rehabilitation Tool for Cochlear Implant Recipients With Unilateral Hearing Loss

2019 ◽  
Vol 4 (5) ◽  
pp. 962-970 ◽  
Author(s):  
Maegan Evans ◽  
Margaret Dillon
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Present Report ◽  
Auditory Training ◽  
Unilateral Hearing Loss ◽  
Early Assessment ◽  
Profound Hearing Loss ◽  
Aural Rehabilitation ◽  
Assessment Measure ◽  
Contralateral Ear

Purpose Cochlear implantation may be a viable treatment option for patients with moderate-to-profound hearing loss in 1 ear and normal to near-normal hearing in the contralateral ear. There is a need for modified aural rehabilitation assessment and intervention tools for this unique patient population to support improvements with the cochlear implant (CI). The present report describes the development and implementation of the Assessment and Aural Rehabilitation Tool (AART) created for adult CI recipients with unilateral hearing loss (UHL). Conclusion The tool was used as an early assessment measure for CI in subjects with UHL and as a method to determine individualized auditory training plans. The AART was modified considering the initial abilities of this unique subject group. Ongoing studies are assessing the effectiveness of CI use in pediatric subjects with UHL and developing the pediatric version of the AART.

Contemporary Considerations for Cochlear Implantation for Children With Multiple Disabilities

2009 ◽  
Vol 19 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Susan Waltzman
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Multiple Disabilities ◽  
Profound Hearing Loss ◽  
Contemporary Management

Abstract Due to advances in cochlear implant technology and the remarkable outcomes often achieved by persons with severe to profound hearing loss, cochlear implant candidacy criteria has expanded since the first children were implanted almost twenty years ago. Evidence of this can be seen in the increased willingness to provide cochlear implants for children with multiple disabilities. Over the last decade, several reports have appeared in the peer-reviewed literature describing cochlear implant outcomes of children with multiple disabilities. This paper will summarize those reports, discuss realistic expectations of implantation for children with multiple disabilities, and describe contemporary management protocols for the otologic, audiologic, and rehabilitative management of children with multiple disabilities.

Evaluation of Long-Term Cochlear Implant Use in Subjects With Acquired Unilateral Profound Hearing Loss

2017 ◽  
Vol 38 (1) ◽  
pp. 117-125 ◽  
Author(s):  
Griet Mertens ◽  
Marc De Bodt ◽  
Paul Van de Heyning
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Profound Hearing Loss
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