• 제목/요약/키워드: cochlear implant

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인공와우 이식자의 역행성 청신경 복합활동전위 (Antidromic Electrically Compound Action Potential in Cochlear Implantees)

  • 허승덕;정성욱;정승현
    • 말소리와 음성과학
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    • 제1권4호
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    • pp.203-207
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    • 2009
  • Electrically evoked compound action potentials (ECAP) have originated from the distal end of the auditory nerve. ECAP are characterized as the difference between the clearly large trough (N) and the following positive peak (P). N-wave occurs around $200-400\;{\mu}s$ after stimulus onset and P-wave at around $400-800\;{\mu}s$. Contrary to expectations, positive peaked ECAP (pp-ECAP) was dominated by a relatively large-amplitude positive following negative peak. pp-ECAP can be recorded from the sites on or near the surgically exposed nerve trunk in animal models and/or in cases of monophasic stimulation. This study will provide the causes of the appearance of pp-ECAP in cases of cochlear implant recipients using imaging studies and medical records and statistically analysis between N-P and P-N on the amplitude input-output function (amp-I/O) for the prediction of the possibilities of clinical tools. Thirteen children participated in the study and received a Cochlear CI-24RE (CA). ECAP was recorded using auto-NRT (Cochlear Ltd., Australia) at four to five weeks post surgery. pp-ECAP was measured from 36 electrodes and typical ECAP from 220 electrodes. There was no abnormality in the imaging study and operation finding in patients with typical ECAP. pp-ECAP was found at the inner ear anormaly and ossification in imaging study and gel-state inner ear fluid was observed in the operation finding. The amplitude of pp-ECAP increased depending on current intensities, but amp-I/O increase more gradually than in the case of typical ECAP (p=0.003). pp-ECAP is antidromic potential which can record from the inner ear anormaly and ossified cochlear. Amp-I/O also depends on current intensity as well typical ECAP. These results provide a useful tool for audiological evaluation for the spiral ganglion cell status to the value of pp-ECAP.

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학령기 인공와우 이식 아동과 일반 건청 아동의 음악 선호도에 대한 비교 연구 (A Comparative Study on Music Preference between School-Aged Children with Cochlear Implant and Normal Hearing)

  • 황선영
    • 인간행동과 음악연구
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    • 제8권2호
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    • pp.47-64
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    • 2011
  • 본 연구는 학령기의 인공와우를 이식한 아동과 건청 아동의 음악 선호도에 대해 비교 연구하는데 목적이 있다. 연구 대상은 인공와우를 이식 받은 지 최소 2년 이상 된 아동 12명과 안양에 위치한 A 초등학교에 재학 중인 1~5학년 학생 155명을 무작위로 선정하여 1:1 설문조사를 시행하였다. 연구 결과 음성 선호도에서 인공와우 이식 아동그룹은 아동 목소리를 선호한다고 응답한 반면 건청 아동그룹은 어른 목소리를 선호한다고 응답하였고, 성별에 따른 음성 선호도는 두 그룹 모두 여자 목소리를 선호한다고 응답하였으며, 음고에 따른 선호도 역시 두 그룹 모두 높은 소리를 선호한다고 응답하였다. 연주 형태에 따른 선호도는 인공와우 이식 아동과 건청 아동 두 그룹 모두 악기와 목소리가 공존하는 소리를 선호한다고 응답하였다. 장르별 음악 선호도는 리커드(Likert scale) 5점 척도에서 인공와우 이식 아동그룹은 민요를 선호하는 반면, 건청 아동그룹은 대중음악과 TV음악을 선호하는 것으로 나타났다. 이러한 결과들은 인공와우의 특성과 음악 환경에 영향을 받아 나타난 결과로 음악 환경에 의해 인공와우를 이식 받은 아동의 음악 선호도가 변화 될 수 있음을 나타낸다. 본 연구는 인공와우를 이식한 아동과 건청 아동의 음악 선호도를 비교 분석한 것으로 인공와우이식 아동의 청각 재활에 기초 자료가 될 수 있을 것이다.

전기 자극 청신경 복합활동전위: 변인 영향 (Electrical Compound Action Potential: Effects of different parameters)

  • 허승덕
    • 재활복지공학회논문지
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    • 제8권1호
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    • pp.9-17
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    • 2014
  • 전기 자극 청신경 복합활동전위(electrical compound action potential; ECAP)는 인공와우로 청신경을 자극하고 동시에 반응을 기록한다. 이 연구는 인공와우에서 ECAP의 효용성을 높이기 위하여 자극과 기록에 대하여 연구하고자 한다. 대상은 문헌 또는 사례 연구를 제외한 연구 논문 34 편으로 하였다. 연구는 펄스 및 자극 조건, 잡파 억제 및 기록 조건 등을 분석하였다. 효과적인 신경 발화, 안정적인 역치 확인, 신경 퇴행 방지 등을 위해서는 펄스폭과 위상 간격이 가급적 짧고, (-)위상이 앞선 양위상 펄스를 사용하였다. 자극은 펄스 간격, 자극비율, 자극 방식 등을 정하여 와우의 첨부, 중간, 기저회전으로 C-level 정도로 하였다. 잡파는 전방차폐법, 거푸집소거법으로 제거하였고, 분명한 파형을 획득하기 위해서는 전극 간격, 증폭 정도, 평균 가산 회수 등의 추가 조절이 필요하다.

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인공 와우를 위한 신호 처리 및 전달부의 구현 (Signal Processing and Implementation of Transmitter for Cochlear Implant)

  • 채대곤;최두일;변정근;백승화;공형호;박상희
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 1993년도 하계학술대회 논문집 A
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    • pp.284-286
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    • 1993
  • Software and hardware for cochlear implant system have been developed to create a speech signal processing system which, in real-time, extracts model parameter including formants, pitch, amplitude information. The system is based on the Texas Instruments TMS320 family. In hardware, computer interface has been desisted and implemented that allows presentation of biphasic pulse stimuli to patients with the hearing handicapped. The host computer sends a stream of bytes to the parallel port. Upon receipt of the data the interface generates the appropriate burst sequence that is delivered to the patient's external transmitter coil. The coded information is interpreted by the Nucleus-22 internal receiver that delivers the pulse to the specified electrodes at the specified amplitude and pulse width.

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Longitudinal music perception performance of postlingual deaf adults with cochlear implants using acoustic and/or electrical stimulation

  • Chang, Son A;Shin, Sujin;Kim, Sungkeong;Lee, Yeabitna;Lee, Eun Young;Kim, Hanee;Shin, You-Ree;Chun, Young-Myoung
    • 말소리와 음성과학
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    • 제13권2호
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    • pp.103-109
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    • 2021
  • In this study, we investigated longitudinal music perception of adult cochlear implant (CI) users and how acoustic stimulation with CI affects their music performance. A total of 163 participants' data were analyzed retrospectively. 96 participants were using acoustic stimulation with CI and 67 participants were using electrical stimulation only via CI. The music performance (melody identification, appreciation, and satisfaction) data were collected pre-implantation, 1-year, and 2-year post-implantation. Mixed repeated measures of ANOVA and pairwise analysis adjusted by Tukey were used for the statistics. As result, in both groups, there were significant improvements in melody identification, music appreciation, and music satisfaction at 1-year, and 2-year post-implantation than a pre-implantation, but there was no significant difference between 1 and 2 years in any of the variables. Also, the group of acoustic stimulation with CI showed better perception skill of melody identification than the CI-only group. However, no differences found in music appreciation and satisfaction between the two groups, and possible explanations were discussed. In conclusion, acoustic and/or electrical hearing devices benefit the recipients in music performance over time. Although acoustic stimulation accompanied with electrical stimulation could benefit the recipients in terms of listening skills, those benefits may not extend to the subjective acceptance of music. These results suggest the need for improved sound processing mechanisms and music rehabilitation.

Quality of Life in Older Adults with Cochlear Implantation: Can It Be Equal to That of Healthy Older Adults?

  • Tokat, Taskin;Muderris, Togay;Bozkurt, Ergul Basaran;Ergun, Ugurtan;Aysel, Abdulhalim;Catli, Tolgahan
    • 대한청각학회지
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    • 제25권3호
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    • pp.138-145
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    • 2021
  • Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

Quality of Life in Older Adults with Cochlear Implantation: Can It Be Equal to That of Healthy Older Adults?

  • Tokat, Taskin;Muderris, Togay;Bozkurt, Ergul Basaran;Ergun, Ugurtan;Aysel, Abdulhalim;Catli, Tolgahan
    • Journal of Audiology & Otology
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    • 제25권3호
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    • pp.138-145
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    • 2021
  • Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

3차원 달팽이관 모델에서의 인공와우 전극의 거동에 대한 유한요소해석 (Evaluation of the Cochlear Electrode Behavior in the 3D Human Cochlea Model by FEM Analysis)

  • 임윤섭;박세익;김용협;오승하;김성준
    • 대한의용생체공학회:의공학회지
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    • 제25권3호
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    • pp.207-215
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    • 2004
  • 본 연구에서는 유전 프로그램을 이용하여 6가지 형태의 금속 와이어 배치를 가진 전극을 생성하여 각 전극이 3차원 형태의 달팽이관에 미치는 기계적인 영향과 그 거동을 유한요소법을 이용하여 분석하였다. 그리고 전극이 삽입되는 달팽이관은 helico-spiral 근사방법에 의해 결정된 식을 이용하였으며, 고실계단(scala tympani)의 형태는 실제 고실계단 단면의 영상정보를 추출하여 얻어내었다. 해석결과 금속 와이어가 평행하게 배치될 경우 가장 큰 힘을 달팽이관 외벽에 전달하며, 삽입에도 가장 큰 힘이 필요한 것을 알 수 있었다. 그리고 달팽이관은 3차원 구조이므로 전극이 삽입되면서 삽입 전에 자극 사이트가 바라보도록 설정한 방향보다 조금 돌아감을 확인하였다. 이 연구의 결과로부터 전극의 강성이 외상(trauma)을 줄이는데 중요하다는 것을 알 수 있다.

Neural Spike Train Decoding에 기반한 인공와우 어음처리방식 성능평가 (Performance Evaluation of Cochlear Implants Speech Processing Strategy Using Neural Spike Train Decoding)

  • 김두희;김진호;김경환
    • 대한의용생체공학회:의공학회지
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    • 제28권2호
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    • pp.271-279
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    • 2007
  • We suggest a novel method for the evaluation of cochlear implant (CI) speech processing strategy based on neural spike train decoding. From formant trajectories of input speech and auditory nerve responses responding to the electrical pulse trains generated from a specific CI speech processing strategy, optimal linear decoding filter was obtained, and used to estimate formant trajectory of incoming speech. Performance of a specific strategy is evaluated by comparing true and estimated formant trajectories. We compared a newly-developed strategy rooted from a closer mimicking of auditory periphery using nonlinear time-varying filter, with a conventional linear-filter-based strategy. It was shown that the formant trajectories could be estimated more exactly in the case of the nonlinear time-varying strategy. The superiority was more prominent when background noise level is high, and the spectral characteristic of the background noise was close to that of speech signals. This confirms the superiority observed from other evaluation methods, such as acoustic simulation and spectral analysis.

Academic Performance, Communication, and Psychosocial Development of Prelingual Deaf Children with Cochlear Implants in Mainstream Schools

  • Choi, Ji Eun;Hong, Sung Hwa;Moon, Il Joon
    • Journal of Audiology & Otology
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    • 제24권2호
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    • pp.61-70
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    • 2020
  • Background and Objectives: To assess the academic performance, communication skills, and psychosocial development of prelingual deaf children with cochlear implants (CIs) attending mainstream schools, and to evaluate the impact of auditory speech perception on their classroom performance. Subjects and Methods: As participant, 67 children with CI attending mainstream schools were included. A survey was conducted using a structured questionnaire on academic performance in the native language, second language, mathematics, social studies, science, art, communication skills, self-esteem, and social relations. Additionally, auditory and speech performances on the last follow-up were reviewed retrospectively. Results: Most implanted children attending mainstream school appeared to have positive self-esteem and confidence, and had little difficulty in conversing in a quiet classroom. Also, half of the implanted children (38/67) scored above average in general academic achievement. However, academic achievement in the second language (English), social studies, and science were usually poorer than general academic achievement. Furthermore, half of the implanted children had difficulty in understanding the class content (30/67) or conversing with peers in a noisy classroom (32/67). These difficulties were significantly associated with poor speech perception. Conclusions: Improving the listening environment for implanted children attending mainstream schools is necessary.