The Hybrid cochlear implant: a review.

The Hybrid S or 'short-electrode' cochlear implant was developed to treat patients with a severe to profound hearing loss limited to the high frequencies. The short electrode is implanted into just the base or high-frequency region of the cochlea, with the goal of preserving residual low-frequency hearing. As a result, electric stimulation can be combined with acoustic stimulation in the same ear (and the opposite ear); this is one instance of 'acoustic plus electric' (A + E) stimulation. In this paper, we will review the latest findings from the first two stages of the clinical trial for the Hybrid concept in the United States. Generally, we will review surgical techniques, clinical trial criteria, residual hearing preservation, improvements in speech perception in quiet, and predictive factors for patient benefit. We will also discuss the significant benefit of A + E stimulation for speech perception in noise and musical measures of melody and instrument recognition, as well as valuable insights into central auditory nervous system plasticity gained from the use of a very short electrode array.

[1]  Bruce J. Gantz,et al.  Acoustic plus Electric Speech Processing: Preliminary Results of a Multicenter Clinical Trial of the Iowa/Nucleus Hybrid Implant , 2006, Audiology and Neurotology.

[2]  Marco Pelizzone,et al.  Acoustic to Electric Pitch Comparisons in Cochlear Implant Subjects with Residual Hearing , 2006, Journal of the Association for Research in Otolaryngology.

[3]  Patricia A. Leake,et al.  Frequency Map for the Human Cochlear Spiral Ganglion: Implications for Cochlear Implants , 2007, Journal for the Association for Research in Otolaryngology.

[4]  C. Turner,et al.  Hearing Loss and the Limits of Amplification , 2006, Audiology and Neurotology.

[5]  Bruce J Gantz,et al.  Combining acoustic and electrical speech processing: Iowa/Nucleus hybrid implant , 2004, Acta oto-laryngologica.

[6]  Graeme M. Clark,et al.  Pitch comparisons of acoustically and electrically evoked auditory sensations , 1996, Hearing Research.

[7]  Jan Kiefer,et al.  Hearing preservation in cochlear implantation for electric acoustic stimulation , 2004, Acta oto-laryngologica.

[8]  Mandy Hill,et al.  An Overview of Binaural Advantages for Children and Adults Who Use Binaural/Bimodal Hearing Devices , 2006, Audiology and Neurotology.

[9]  Bruce J Gantz,et al.  Speech recognition in noise for cochlear implant listeners: benefits of residual acoustic hearing. , 2004, The Journal of the Acoustical Society of America.

[10]  Bruce J. Gantz,et al.  Changes in Pitch with a Cochlear Implant Over Time , 2007, Journal for the Association for Research in Otolaryngology.

[11]  Thomas Lenarz,et al.  Preservation of residual hearing with cochlear implantation: How and why , 2005, Acta oto-laryngologica.

[12]  Jacob Oleson,et al.  Music Perception with Cochlear Implants and Residual Hearing , 2006, Audiology and Neurotology.

[13]  Michael F Dorman,et al.  Combined electric and contralateral acoustic hearing: word and sentence recognition with bimodal hearing. , 2007, Journal of speech, language, and hearing research : JSLHR.

[14]  Qian-Jie Fu,et al.  Auditory Training with Spectrally Shifted Speech: Implications for Cochlear Implant Patient Auditory Rehabilitation , 2005, Journal of the Association for Research in Otolaryngology.

[15]  M. Dorman,et al.  Simulating the effect of cochlear-implant electrode insertion depth on speech understanding. , 1997, The Journal of the Acoustical Society of America.

[16]  C. Turner,et al.  Combining acoustic and electrical hearing , 2003 .

[17]  Fan-Gang Zeng,et al.  Speech and melody recognition in binaurally combined acoustic and electric hearing. , 2005, The Journal of the Acoustical Society of America.

[18]  Stuart Rosen,et al.  Simulations of tonotopically mapped speech processors for cochlear implant electrodes varying in insertion depth. , 2003, The Journal of the Acoustical Society of America.

[19]  Bruce J Gantz,et al.  Integration of acoustic and electrical hearing. , 2008, Journal of rehabilitation research and development.

[20]  D Byrne,et al.  Speech recognition of hearing-impaired listeners: predictions from audibility and the limited role of high-frequency amplification. , 1998, The Journal of the Acoustical Society of America.

[21]  Bruce J Gantz,et al.  Cochlear Implant Speech Processor Frequency Allocations May Influence Pitch Perception , 2008, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[22]  Bruce J Gantz,et al.  Preservation of Hearing in Cochlear Implant Surgery: Advantages of Combined Electrical and Acoustical Speech Processing , 2005, The Laryngoscope.

[23]  Thomas Lenarz,et al.  Residual Hearing Conservation and Electroacoustic Stimulation with the Nucleus 24 Contour Advance Cochlear Implant , 2006, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[24]  A. Faulkner,et al.  Adaptation by normal listeners to upward spectral shifts of speech: implications for cochlear implants. , 1999, The Journal of the Acoustical Society of America.

[25]  D. D. Greenwood A cochlear frequency-position function for several species--29 years later. , 1990, The Journal of the Acoustical Society of America.

[26]  J. Oleson,et al.  Hybrid 10 Clinical Trial , 2009, Audiology and Neurotology.