Anpassung von Cochleaimplantatsystemen

Hoppe, Ulrich; Liebscher, T; Hornung, Joachim

doi:10.1007/s00106-016-0226-7

Cited by 15 publications

(14 citation statements)

References 29 publications

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“…The cochlear implant (CI) is a standard procedure for patients with severe to profound hearing loss [Hoppe et al, 2017;Lenarz, 2017]. By using a CI, patients signifi-Bruschke/Baumann/Stöver Audiol Neurotol 2021;26:327-337 DOI: 10.1159/000512760 cantly improve their speech recognition [Sun et al, 2019] and increase the quality of life in everyday situations [Rader et al, 2018].…”

Section: Introductionmentioning

confidence: 99%

“…After surgical placement of the implant under the skin, the external sound processor is individually fitted to (re)activate the patient's hearing function. In the past, a standard healing period of 3-6 weeks occurred after CI surgery before the sound processor was activated for the first time [Hagr et al, 2015;Zeh and Baumann, 2015;Hoppe et al, 2017;Lenarz, 2017]. This relatively long waiting period was scheduled to ensure adequate wound healing and to prevent infections of the skin flap [Alsabellha et al, 2014;Marsella et al, 2014;Vaerenberg et al, 2014;Wolf-Magele et al, 2015].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Follow-Up of Early Cochlear Implant Device Activation

2021

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Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Early Cochlear Implant Device Activation

2021

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“…The lower values are called "threshold values" (T values) and represent the stimulation current at which hearing impression is just triggered. The upper values are the "comfort values" (C or MCL values) representing the stimulation current that is not yet perceived as too loud [93]. Hoppe et al described this process in detail in their publication entitled "Anpassen von Cochlea-Implantatsystemen" (Fitting of implant systems) so that this description can be used as good orientation for the procedure in terms of basic therapy [94].…”

Section: Fitting (Basic Therapy)mentioning

confidence: 99%

“…It includes all measures that are necessary for active improvement of speech understanding with the CI [103,104]. As mentioned above, the socio-medical term of rehabilitation has to be distinguished, which describes a process defined in the Social Code [93]. CI rehabilitation (follow-up therapy) focuses on different aspects of optimizing speech understanding with the CI and aims at medical, audiological, hearing therapeutic, and technical parts of hea-ring therapy.…”

Section: Rehabilitation (Follow-up Therapy)mentioning

confidence: 99%

“…The formal term of rehabilitation has to be distinguished from the general term of CI rehabilitation (follow-up therapy). According to § 8 of the rehabilitation guidelines issued by the Federal Joint Committee, a need for rehabilitation is present when -due to physical, psychological, or mental damage ▪ Not only temporary impairments of the activity that are relevant for everyday situations are present that probably threaten the patients social life ▪ Impairments to participate in daily life already exist ▪ The multi-dimensional and interdisciplinary approach of medical rehabilitation is required in addition to the curative treatment [93] At least two of these aspects are regularly observed in CI recipients so that also a formal necessity of rehabilitation exists.…”

Section: Rehabilitation (Follow-up Therapy)mentioning

confidence: 99%

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Welche Qualität macht den Unterschied in der Cochlea-Implantat-Versorgung?

2020

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ZusammenfassungDie Cochlea-Implantat (CI)-Versorgung hat seit ihrer Einführung eine nicht zu erwartende Entwicklung und Verbreitung erfahren. Neben den technischen Möglichkeiten hat sich auch die Indikationsstellung deutlich gewandelt. Beispiele hierfür sind die Versorgung sehr junger oder sehr alter Menschen, die bilaterale Versorgung oder auch die Nutzung des Restgehörs für eine kombiniert elektrisch-akustische Stimulation (EAS). Diese Entwicklung ist weiterhin sehr dynamisch und bietet enorme Möglichkeiten für die Hörrehabilitation betroffener Patienten. Sie stellt aber gleichzeitig auch erhebliche Ansprüche an die Sicherstellung einer qualitativ am Optimum orientierten Versorgung der Leistungserbringer. In den letzten Jahren hat eine intensive Diskussion stattgefunden, die die Zielsetzung hatte, Qualitätsparameter zu definieren, die als Eckpunkte einer CI-Versorgung dienen sollten. Diese orientierten sich zunächst an der Beschreibung eines festgelegten Ablaufs einer CI-Versorgung und damit an den Teilaspekten einer Prozess-, Struktur- und Ergebnisqualität zur Qualitätssicherung. Praktische Umsetzung erfuhren diese Erwägungen u. a. in dem „Weißbuch CI-Versorgung“ und dem Konzept eines „Nationalen CI-Registers“ der DGHNO-KHC. Neben einer inhaltlich orientierten, innerhalb der Fachgesellschaft DGNHNO-KHC geführten Diskussion, zeigen inzwischen auch Kostenträger Ansätze, auf den Prozess einer CI-Versorgung Einfluss zu nehmen (QuInCI-Initiative der Techniker Krankenkasse). Auch von Seiten des Gesetzgebers sind hierzu Maßnahmen in Vorbereitung, die die CI-Versorgung unmittelbar betreffen werden („Implantateregister-Gesetz“). Die hier vorgelegte Arbeit soll den derzeitigen Wissensstand der Qualitätssicherung in der CI-Versorgung darstellen und eine Standortbestimmung für Deutschland im Vergleich zu anderen Ländern vornehmen.

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Technische Entwicklungen bei Cochleaimplantaten

Büchner

Gärtner

2017

HNO

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Twenty years ago, cochlear implants (CI) were indicated only in cases of profound hearing loss or complete deafness. While from today's perspective the technology was clumsy and provided patients with only limited speech comprehension in quiet scenarios, successive advances in CI technology and the consequent substantial hearing improvements over time have since then resulted in continuous relaxation of indication criteria toward residual hearing. While achievements in implant and processor electronics have been one key factor for the ever-improving hearing performance, development of electro-acoustic CI systems-together with atraumatic implantation concepts-has led to enormous improvements in patients with low-frequency residual hearing. Manufactures have designed special processors with integrated hearing aid components for this patient group, which are capable of conveying acoustic and electric stimulation. A further milestone in improvement of hearing in challenging listening environments was the adoption of signal enhancement algorithms and assistive listening devices from the hearing aid industry. This article gives an overview of the current state of the art in the abovementioned areas of CI technology.

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Anpassung von Cochleaimplantatsystemen

Cited by 15 publications

References 29 publications

Long-Term Follow-Up of Early Cochlear Implant Device Activation

Long-Term Follow-Up of Early Cochlear Implant Device Activation

Welche Qualität macht den Unterschied in der Cochlea-Implantat-Versorgung?

Technische Entwicklungen bei Cochleaimplantaten

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