Bruce J. Gantz

Bio: Bruce J. Gantz is an academic researcher from University of Iowa Hospitals and Clinics. The author has contributed to research in topics: Cochlear implant & Hearing loss. The author has an hindex of 63, co-authored 268 publications receiving 13870 citations. Previous affiliations of Bruce J. Gantz include University of Iowa & Ohio State University.

Cochlear implant system component having multiple electrode assemblies

Abstract: An electrode array ( 30 ) which is able to be inserted to a desired depth within the cochlea to provide useful percepts for the recipient which will also preferably not cause damage to the sensitive structures of the cochlea. The electrode array ( 30 ) is insertable through an opening in the cochlea and into at least the basal region of the cochlea and comprises an elongate carrier ( 31 ) having a proximal end, a distal end, and a plurality of electrodes ( 32 ) supported by the carrier at respective spaced locations thereon in a region between the proximal end and the distal end. A stabilizing collar ( 35 ) extends outwardly from the elongate carrier ( 31 ) at or adjacent a proximal end thereof and has an abutment surface adapted to abut a portion of the cochlea surface around the cochleostomy and at least substantially prevent movement of the carrier ( 31 ) following completion of insertion of the array ( 30 ) into the cochlea.

Preservation of Hearing in Cochlear Implant Surgery: Advantages of Combined Electrical and Acoustical Speech Processing

Abstract: Objectives/Hypothesis: This study documents the importance of preserving residual low-frequency acoustic hearing as those with more residual hearing are selected for cochlear implantation. Surgical strategies used for hearing preservation with a short hybrid cochlear implant are outlined. The benefits of preserved residual low-frequency hearing, improved word understanding in noise, and music appreciation are described. Study Design: Multicenter, prospective, single-subject design. Methods: Records were reviewed of 21 individuals participating in an Food and Drug Administration (FDA) feasibility clinical trial who have received an Iowa/Nucleus 10 mm electrode. A second group of subjects receiving implants at the University of Iowa that have used the 10 mm device between 2 years and 6 months were also reviewed. Outcome measures included standardized tests of monosyllabic word understanding, spondees in noise, and common melody recognition. Results: Lowfrequency hearing was maintained in all individuals immediately postoperative. One subject lost hearing at 2.5 months postoperative after a viral infection. The group has averaged a loss of 9 dB low-frequency acoustic hearing between 125 and 1,000 Hz. Monosyllabic word understanding scores at 6 months for a group being followed for an FDA clinical trial using the implant plus hearing aids was 69% correct. For the long-term group receiving implants at Iowa, monosyllabic word understanding in those who have used the device between 6 months and 2 years is 79%. Other important findings include improved recognition of speech in noise (9 dB improvement) as compared with standard cochlear implant recipients who were matched for speech recognition in quiet and near normal recognition of common melodies. Conclusion: The surgical strategies outlined have been successful in preservation of low-frequency hearing in 96% of individuals. Combined electrical and acoustical speech processing has enabled this group of volunteers to gain improved word understanding as compared with their preoperative hearing with bilateral hearing aids and a group of individuals receiving a standard cochlear implant with similar experience with their device. The improvement of speech in noise and melody recognition is attributed to the ability to distinguish fine pitch differences as the result of preserved residual low-frequency acoustic hearing. Preservation of low-frequency acoustic hearing is important for improving speech in noise and music appreciation for the hearing impaired, both of which are important in real-life situations. Key Words: Hearing Preservation, cochlear implant, hybrid cochlear implant, hearing in noise. Laryngoscope, 115:796–802, 2005

Speech recognition in noise for cochlear implant listeners: benefits of residual acoustic hearing.

Abstract: The purpose of this study was to explore the potential advantages, both theoretical and applied, of preserving low-frequency acoustic hearing in cochlear implant patients. Several hypotheses are presented that predict that residual low-frequency acoustic hearing along with electric stimulation for high frequencies will provide an advantage over traditional long-electrode cochlear implants for the recognition of speech in competing backgrounds. A simulation experiment in normal-hearing subjects demonstrated a clear advantage for preserving low-frequency residual acoustic hearing for speech recognition in a background of other talkers, but not in steady noise. Three subjects with an implanted "short-electrode" cochlear implant and preserved low-frequency acoustic hearing were also tested on speech recognition in the same competing backgrounds and compared to a larger group of traditional cochlear implant users. Each of the three short-electrode subjects performed better than any of the traditional long-electrode implant subjects for speech recognition in a background of other talkers, but not in steady noise, in general agreement with the simulation studies. When compared to a subgroup of traditional implant users matched according to speech recognition ability in quiet, the short-electrode patients showed a 9-dB advantage in the multitalker background. These experiments provide strong preliminary support for retaining residual low-frequency acoustic hearing in cochlear implant patients. The results are consistent with the idea that better perception of voice pitch, which can aid in separating voices in a background of other talkers, was responsible for this advantage.

National Cancer Data Base Report on Malignant Paragangliomas of the Head and Neck

Abstract: BACKGROUND Malignant paragangliomas of the head and neck are rare, with previous reports limited to nine or fewer patients. The current review included 59 cases extracted from the National Cancer Data Base that were diagnosed between 1985–1996. METHODS The primary criterion for inclusion in the current study was verified metastatic spread from a paraganglioma of the head and neck. Patterns of presentation and treatment as well as clinically relevant associations were demonstrated in contingency tables. Relative survival was used for analysis of outcome. RESULTS The average patient age at presentation was 44 years, and gender distribution was equivalent. Metastases were confined to regional lymph nodes in the majority of cases (68.6%), with carotid body tumors found to have an even higher rate of regional confinement (93.8%). Surgery was the most common treatment (76.3%). The use of adjuvant irradiation for regionally confined disease increased across time, from 27% (1985–1990) to 46% (1991–1996). The 5-year relative survival rate was 59.5% (76.8% for regionally confined carcinoma and 11.8% for distant metastasis). Among patients who were followed until death, those treated with adjuvant irradiation had a longer median survival (45 months) compared with those patients who were treated with surgery alone (12 months). CONCLUSIONS Malignant paraganglioma represents metastatic spread of a tumor type that, when restricted to the site of origin, is considered benign. Metastases from malignant paragangliomas of the head and neck usually are regionally confined. The primary management of a recognized malignancy should be directed toward complete surgical removal of the primary tumor and regional lymph nodes. Postoperative irradiation may be beneficial in slowing the progression of residual disease. Cancer 2002;94:730–7. © 2002 American Cancer Society. DOI 10.1002/cncr.10252

Combining acoustic and electrical hearing

Abstract: There are numerous advantages for patients who can add residual acoustic hearing to the electric stimulation of a cochlear implant. When cochlear implantation was first becoming accepted, patients were typically profoundly deaf in both ears, so any possible advantages of also using acoustic hearing were non-existent. However, as time progressed and the range of patients considered for implantation was expanded to include those with more and more residual hearing, this remaining acoustic hearing became a factor to consider. The residual acoustic hearing was at first most often located in the non-implanted ear, especially since the trend has been to place the implant in the poorer ear if there was any aidable hearing. In recent years, residual acoustic hearing has been preserved even in the implanted ear, whereby acoustic and electric hearing are combined in the same ear. It turns out that the acoustic hearing that remains in either ear after cochlear implantation can still contribute to overall performance in some very significant ways, including cases where, by itself, the acoustic hearing produces only minimal or no word recognition.

Report of two cases

Abstract: Two patients underwent thoracotomy for resection of pulmonary or esophageal carcinoma. Postoperatively, epidural catheters were inserted for pain management. Complaints of severe injection pain over the abdomen or lower extremities were made during one administration of pain medication. Progressive weakness and numbness developed over the lower trunk and lower extremities, with subsequent respiratory difficulties. Potassium chloride (KCl) was suspected to have been mistaken for normal saline as the diluent for morphine. In addition to endotracheal intubation and ventilatory support, steroids were administered both intravenously and epidurally to suppress spinal cord irritation. The two patients regained motor and sensory functions 14 and 18 hours later, respectively, without sequelae.

The National Cancer Data Base: A Powerful Initiative to Improve Cancer Care in the United States

Abstract: The National Cancer Data Base (NCDB) is a nationwide oncology outcomes database that currently collects information on approximately 70% of all new invasive cancer diagnoses in the United States each year and serves as a powerful clinical surveillance and quality improvement mechanism for cancer programs participating in the American College of Surgeons (ACoS) Commission on Cancer (CoC) approvals program.1–3 Currently, the NCDB receives over one million cancer case reports annually from more than 1,430 hospitals. The NCDB now contains data on more than 21 million cancer patients diagnosed between 1985 and 2005, and is recognized as the largest clinical registry in the world. NCDB data are used to explore trends in cancer care, to examine regional and national benchmarks, and to serve as the basis for quality improvement activities (http://www.facs.org/cancer/ncdb) The purposes of this review are: (1) to describe the NCDB and the data collected; (2) to discuss how the NCDB can be used to study clinical outcomes and the quality of cancer care in the United States; and (3) to describe the clinical care improvement tools provided by the NCDB and the CoC to participating hospitals.

Display screen or portion thereof with graphical user interface

Abstract: Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.

Surgical stapling instrument with an articulatable end effector

Abstract: A surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel. The surgical instrument can further comprise a cutting member configured to incise tissue positioned captured between the staple cartridge and the anvil and, in addition, means for stopping the cutting member prior to a distal end datum, wherein the distal end datum can be defined by the distal-most staple cavity in the staple cartridge. In such embodiments, the incision within the tissue may not extend beyond the portion of the tissue that has been stapled.

Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.