Cochlear Limited

About: Cochlear Limited is a company organization based out in Sydney, New South Wales, Australia. It is known for research contribution in the topics: Cochlear implant & Hearing loss. The organization has 1290 authors who have published 1479 publications receiving 33109 citations. The organization is also known as: кохлеарные Americas & COCHLEAR LIMITED.

How we do it: clinical management of the child receiving a second, bilateral cochlear implant.

Abstract: For children to gain maximum benefit from a second, bilateral cochlear implant clinicians need to be aware of the special needs of the family and child, and to adapt their clinical management appropriately. This article describes how the situation of the family considering a second implant is different, and how the decision to be made differs from that for a first implant. The information specific to sequential implants that should be provided so families can make an informed decision is reviewed. Programming issues unique to sequential bilateral cochlear implants are discussed. Finally, information is provided on how children may respond post-operatively, and what can be done to promote bilateral device use and the development of listening skills with the new implant.

Detection of modiolar proximity through bipolar impedance measurements

Abstract: Objectives To test the hypothesis that bipolar electrical impedance measurements in perimodiolar cochlear implants (CIs) may be used to differentiate between perimodiolar insertion technique favoring proximity to the modiolus or lateral wall. Study Design and Methods Bipolar impedances are a measure of electrical resistance between pairs of electrode contacts in a CI. Stimulation is through biphasic pulses at fixed frequency. Impedance measurements were made in real time through sequential sampling of electrode pairs. Perimodiolar electrodes were inserted in temporal bones using one of two techniques: 1) In the standard insertion technique (SIT), the electrode array slides along the lateral wall during insertion. 2) In the Advance Off Stylet (Cochlear Ltd. Sydney) technique (AOS), the electrode maintains modiolar contact throughout the insertion process. A set of 22 insertions were performed in temporal bone specimens using perimodiolar electrode arrays with both AOS and SIT. Buffered saline was used as a substitute for natural perilymph based on similar electrical conductivity properties. Impedance with and without stylet removal were recorded with a 30-second sampling window at final insertion depth. Results There is a significant difference in bipolar impedance measures between AOS and SIT, with impedances rising in measurements with stylet removal. Evaluation was based on two-sided analysis of variance considering technique and electrode with P < 0.025. Conclusion Bipolar electrical impedance can be used to detect relative motion toward the modiolus inside the cochlea. This detection method has the potential to optimize intraoperative placement of perimodiolar electrode arrays during implantation. We anticipate that this will result in lower excitation thresholds and improved hearing outcome. Level of Evidence N/A. Laryngoscope, 2016

Effect of changing pulse rate on profile parameters of perceptual thresholds and loudness comfort levels and relation to ECAP thresholds in recipients of the Nucleus CI24RE device.

Abstract: The Nucleus CI24RE ‘Freedom' device offers higher stimulation rates and lower noise levels in action potential measurements (ECAPs) than previous devices. A study including ten European implant teams showed that the effect of changes in rate from 250 to 3500 pulses per second on tilt and curvature of the T and C profiles is insignificant. When changing rate one may change the levels at all electrodes by the same amount. Using an automated procedure ECAPs could be measured quickly and reliably at a noise level of only 1 microV, this did not result in improved correlations between the tilt and curvature parameters of the ECAP profiles and those of the T and C profiles. Average C levels appear to differ markedly among implant centers; a better assessment protocol is required. When increasing stimulus rate one should take into account that this requires higher pulse charges per second and more power consumption.

Association of Gel-Forming Mucins and Aquaporin Gene Expression With Hearing Loss, Effusion Viscosity, and Inflammation in Otitis Media With Effusion.

Abstract: Importance Persistent, viscous middle ear effusion in pediatric otitis media (OM) contributes to increased likelihood of anesthesia and surgery, conductive hearing loss, and subsequent developmental delays. Biomarkers of effusion viscosity and hearing loss have not yet been identified despite the potential that such markers hold for targeted therapy and screening. Objective To investigate the association of gel-forming mucins and aquaporin 5 (AQP5) gene expression with inflammation, effusion viscosity, and hearing loss in pediatric OM with effusion (OME). Design, Setting, and Participants Case-control study of 31 pediatric patients (aged 6 months to 12 years) with OME undergoing tympanostomy tube placement and control individuals (aged 1 to 10 years) undergoing surgery for cochlear implantation from February 1, 2013, through November 30, 2014. Those with 1 or more episodes of OM in the previous 12 months, immunologic abnormality, anatomical or physiologic ear defect, OM-associated syndrome (ie, Down syndrome, cleft palate), chronic mastoiditis, or history of cholesteatoma were excluded from the study. All patients with OME and 1 control were recruited from Children’s Hospital of Wisconsin, Milwaukee. The remainder of the controls were recruited from Sick Kids Hospital in Toronto, Ontario, Canada. Main Outcomes and Measures Two to 3 middle ear biopsy specimens, effusions, and preoperative audiometric data (obtained Results Of the 31 study participants, 24 patients had OME (mean [SD] age, 50.4 [31.9] months; 15 [62.5%] male; 16 [66.7%] white) and 7 acted as controls (mean [SD] age, 32.6 [24.4] months; 2 [26.6%] male; 6 [85.7%] white). Mucins andAQP5gene expression were significantly higher in patients with OME relative to controls (MUC2: ratio, 127.6 [95% CI, 33.7-482.7];MUC5AC: ratio, 3748.8 [95% CI, 558.1-25 178.4];MUC5B: ratio, 471.1 [95% CI, 130.7-1697.4];AQP5: ratio, 2.4 [95% CI, 1.1-5.6]). A 2-fold increase inMUC5Bcorrelated with increased hearing loss (air-bone gap: 7.45 dB [95% CI, 2.65-12.24 dB]; sound field: 6.66 dB [95% CI, 6.63-6.69 dB]), effusion viscosity (2.75 mL/mg; 95% CI, 0.89-4.62 mL/mg), middle ear epithelial thickness (3.5 μm; 95% CI, 1.96-5.13 μm), and neutrophil infiltration (odds ratio, 1.7; 95% CI, 1.07-2.72). A 2-fold increase inAQP5correlated with increased effusion viscosity (1.94 mL/mg; 95% CI, 0.08-3.80 mL/mg). Conclusions and Relevance Further exploration of the role ofMUC5Bin the pathophysiology of OME holds promise for development of novel, targeted therapies to reduce effusion viscosity, facilitation of effusion clearance, and prevention of disease chronicity and hearing loss in patients with OME.

Young children's intonational marking of new, given and contrastive referents

Abstract: In the current study we investigate whether 2- and 3-year-old German children use intonation productively to mark the informational status of referents. Using a story-telling task, we compared children’s and adults’ intonational realization via pitch accent (H*, L* and de-accentuation) of New, Given, and Contrastive referents. Both children and adults distinguished these elements with different pitch accents. Adults, however, de-accented Given information much more often than the children, especially the younger children. Since a failure to de-accent Given information may be a characteristic of caregiver speech, in a second study we tested how caregivers talking to their young children realize Given and New referents. In this discourse situation, the caregivers quite often failed to de-accent Given information, raising the possibility that the younger children were simply reproducing the pitch accents they had heard adults using.