January 2004 – We’ve been hearing about a hybrid CI for awhile now. It uses CI technology for the high frequencies and hearing aid technology for the low frequencies. Clinical trials are now underway!
March 2006 – Cochlear implants aim for age-related loss
April 2006 – Aging ears get bionic boost
May 2006 – Hybrid cochlear implant works wonders in elderly
June 2006 – More hybrid cochlear implant works wonders in elderly
June 2006 – New Hearing Aid Is ‘Hybrid’
September 2006 – Med-El Hybrid Cochlear Implant Available in Europe
December 2006 – Hybrid Cochlear Implant Provides Hearing Solution
December 2006 – Hybrids the Answer for Partial Hearing Loss
January 2007 – Hybrid Implant a new remedy for hearing loss
May 2007 – MED-EL Introduces Hybrid Implant
June 2007 – Hybrid Cochlear Implant Fits the Bill
September 2007 – UW Implants Hybrid CI
October 2007 – Hybrid CI Effective Remedy for Some People with Hearing Loss
December 2007 – Med-El Hybrid Cochlear Implant
January 2008 – Preservation of Hearing in Cochlear Implant Surgery
April 2008 – NIH funds ASU research to improve hearing
April 2008 – UT Southwestern testing new hybrid CI
July 2008 – Med-El Launches Electric-Acoustic System Clinical Trial
January 2009 – Hybrid Cochlear Implant Suits Some with High Frequency Hearing Loss
February 2009 – MED-EL Announces Second Generation Hybrid Implant
April 2009 – The Cochlear Hybrid CI Nominated for Award
May 2009 – Missouri Woman First in US to Get Hybrid Implant
April 2010 – New hope in the fight to wipe out deafness
April 2010 – Preserving Residual Acoustic Hearing with Combined Acoustic and Electric Hearing
January 2011 – Can People with Partial Hearing Loss Benefit from Hybrid Cochlear Implants?
March 2011 – Combined Acoustic and Electric Stimulation
May 2011 – Hearing preservation with cochlear implantation
December 2011 – Hybrid/EAS Cochlear Implants – New Research and Clinical Tips
Hybrid Cochlear Implant Trial Underway
January 2004
In our discussion of Cochlear’s presentation at the 2003 ALDAcon we reported that they were working on a hybrid implant that uses cochlear implant (CI) technology for the high frequencies and standard hearing aid (HA) technology for the low frequencies. It seems that they were farther along with this technology than we thought, because they are now in clinical trials with the new device.
The device is practical for two reasons. The first is that most people with hearing loss have greater loss at the high frequencies than at the low frequencies; the second is that the cochlear hair cells corresponding to high frequencies are in the outside part of the cochlea. So a short electrode array that only stimulates high frequencies need only be inserted a short way into the cochlea. The hair cells that respond to low frequencies (which are deeper in the cochlea) aren’t disturbed by the array, so low frequency hearing can be assisted by a conventional hearing aid.
The first implantation of the Cochlear Nucleus(r) HybridT cochlear implant was performed by Dr. Joseph Roberson on Dec. 8, 2003 at the Stanford University Hospital.
Cochlear implants aim for age-related loss
March 2006
WASHINGTON –Cochlear implants may not be just for the profoundly deaf anymore: Iowa scientists are developing the next generation, a “hybrid implant” to combine the best of bionics with regular hearing aids for age-related hearing loss. If it works — and early study results are promising — it one day may help thousands of older Americans whose hearing is progressively fading. The key difference: Unlike regular cochlear implants, the hybrid model would let people keep their natural music appreciation even as it helps them hear speech more clearly again.
Aging ears get bionic boost
March 2006
Cochlear implants may not be just for the profoundly deaf anymore: Iowa scientists are developing the next generation, a “hybrid implant” to combine the best of bionics with regular hearing aids for age-related hearing loss. If it works — and early study results are promising — it one day may help thousands of older Americans. The key difference: Unlike regular cochlear implants, the hybrid model would let people keep their natural music appreciation even as it helps them hear speech more clearly again.
Hybrid cochlear implant works wonders in elderly
May 2006
Cochlear implants have long been used as a last resort when hearing aids no longer cut it. Trouble is they tend to accentuate high pitch sounds and destroy any residual low frequency hearing. Ten years ago Dr Bruce Gantz, who heads the otolaryngology department at the University of Iowa, decided the status quo just wasn’t good enough for his patients and set out to come up with an alternative. The result, his experimental hybrid cochlear implant, melds bionic technology with traditional hearing aids. But the key to his device is that it’s far less invasive than traditional cochlear implants and appears to preserve low frequency hearing.
More hybrid cochlear implant works wonders in elderly
Experimental device ups treble but keeps bass, preserving residual hearing
June 2006
Treating severe hearing loss has always forced doctors to make tough decisions. Cochlear implants have long been used as a last resort when hearing aids no longer cut it. Trouble is they tend to accentuate high pitch sounds and destroy any residual low frequency hearing. Ten years ago Dr Bruce Gantz, who heads the otolaryngology department at the University of Iowa, decided the status quo just wasn’t good enough for his patients and set out to come up with an alternative. The result, his experimental hybrid cochlear implant, melds bionic technology with traditional hearing aids. But the key to his device is that it’s far less invasive than traditional cochlear implants and appears to preserve low frequency hearing. Full Story
New Hearing Aid Is ‘Hybrid’
June 2006
Tens of millions of Americans today have some hearing loss, and with an aging population, this problem threatens to get worse. At UCSF Medical Center, Kathy Barger is hoping to get an earful – thanks to an experimental device. “I am hoping this will return part of my hearing,” said Barger. “To say that it would return it 100% would be absolutely a miracle” Kathy is unhappy with her hearing aids. So, she decided to try out what could be the next best thing to a bionic ear: a hybrid cochlear implant. It’s surgically implanted behind and into, her ear.
Med-El Hybrid Cochlear Implant Available in Europe
September 2006
Many people with severe to profound loss in the high frequencies have not been able to benefit from cochlear implant (CI) technology, because their low frequency hearing is too good. The hybrid CI overcomes that restriction by using hearing aid technology for low frequencies and CI technology for high frequencies. The Cochlear hybrid device has been in clinical trials for a couple of years now, but is not yet generally available. Here’s more information.
Hybrid Cochlear Implant Provides Hearing Solution
December 2006
But this new “hybrid” cochlear implant was designed specifically for partial hearing loss — so that users could enjoy both their own natural hearing plus bionic hearing for sounds where they need an extra boost. Five years after surgery that implanted the device in her inner ear, 34-year-old Yeoman of Humboldt, Iowa, sometimes even forgets it’s turned on. “Everything sounds so crystal-clear,” she says.
Hybrids the Answer for Partial Hearing Loss
December 2006
Jeanne Yeoman had been dealing with her hearing loss for a couple of decades, but listening still exhausted her. And technology wasn’t really helping her patience. She remembers driving down the road one day and coming close to just hurling her hearing aids out the window. “Hearing aids made everything louder, not clearer,” she says. “I didn’t need amplification. I needed clarification.”
Hybrid Implant a new remedy for hearing loss
January 2007
So Davis underwent an experimental surgery last week to implant a hybrid auditory device in his right ear as part of a newly approved Food and Drug Administration study. The UW Medical Center is one of 20 sites in the United States and Europe involved in a clinical trial performing a total of 100 surgeries. So far 90 people have undergone the surgery worldwide. The UW performed three in January, Davis being the third. First established at the University of Iowa, the hybrid auditory implant uses a shorter version of the traditional cochlear implant electrode. Surgeons and researchers hope to restore hearing without damaging the low-frequency hearing, which would happen with a traditional, longer cochlear implant.
Hybrid Cochlear Implant Fits the Bill
June 2007
James A. King has always had poor hearing, but now it’s so bad the Warren County pharmacist often can’t understand patients at his store counter, waiters in restaurants or the high-pitched voices of his six grandchildren — even with the help of hearing aids. King, 64, hopes an innovative surgery he recently underwent at UNC Hospitals in Chapel Hill will change all that. Last month, a surgeon implanted a small device above King’s ear that will directly stimulate nerves involved in hearing. The device, called a cochlear implant, will work in tandem with a special hearing aid to help him hear a more complete range of sounds. King is among the first patients in the country to receive the combination treatment, which is being tested at UNC-Chapel Hill and elsewhere as part of a national clinical trial sponsored by Med-El, the Austrian company that makes the technology. The dual device is aimed at people who, like King, hear too well for a cochlear implant alone but not well enough for hearing aids to be effective. It’s hard to say how many patients might be candidates for the combination treatment. But hearing loss is highly prevalent, affecting about 28 million Americans of all ages.
Hybrid CI Effective Remedy for Some People with Hearing Loss
October 2007
One of the newest applications of implantable hearing technology now in clinical trials combines electric and acoustic stimulation (EAS) into a hybrid device designed for individuals with binaural low-frequency hearing and severe-to-profound high-frequency hearing loss. Research has shown that these individuals may not gain significant benefit from traditional amplification (e.g., Hogan & Turner, 1998; Ching et al., 1998; Turner & Cummings, 1999). One possibility for this lack of amplification benefit is the presence of cochlear dead regions, which are more common with thresholds above 70 dB HL (Vinay & Moore, 2007). Another possibility is that the high levels required to make high-frequency speech audible may, in fact, degrade the signal. Although these individuals may not obtain much benefit from high-frequency amplification, their relatively good low-frequency hearing may disqualify them from conventional cochlear implant candidacy. As a result, individuals with good low-frequency hearing and severe-to-profound high-frequency hearing loss can experience significant difficulty in everyday communication, particularly in noisy backgrounds, where low-frequency information alone is not sufficient to allow high levels of speech understanding. The hybrid devices use a shortened cochlear implant electrode array that is inserted just 10 mm-20 mm into the cochlea (versus 20 mm-30 mm for a conventional implant). A successful surgical outcome allows for monaural electric stimulation of the basal cochlea for high-frequency information without damaging apical cochlear structures that transmit low-frequency acoustic information (e.g., Gantz et al., 2005, 2006; Gstöettner et al., 2005; Kiefer et al., 2005; Leutje et al., 2007; Skarzynski et al., 2006). This combination allows for the integration of electric and acoustic perception in the same ear.
Med-El Hybrid Cochlear Implant
December 2007
She could get a cochlear implant, a device that helps with higher frequencies. But such devices are not ideal for people like Munsch with partial deafness because they don’t allow them to use their remaining hearing of low-frequency sounds. In fact, implanting a cochlear device would increase the risk that she might lose her residual lower-frequency hearing. But when researchers at the Medical College of Wisconsin offered to implant an experimental hearing device that combined a cochlear implant with a hearing aid, Munsch agreed to undergo the surgery. The device already is approved in Europe and is being tested at 10 sites in the U.S. Munsch is the first of five to 10 patients who are expected to be implanted with the device at Froedtert Hospital. The device, which is made by Med-El, a company based in Innsbruck, Austria, amplifies low-frequency sounds with a conventional hearing aid and uses a cochlear implant to pick up higher frequencies.
Preservation of Hearing in Cochlear Implant Surgery
January 2008
The cochlear implant (CI) has been able to restore substantial hearing in profound prelingually deafened children and profound postlingually deafened adults and children. The remarkable word understanding scores obtained by these groups of individuals has enabled those with less than profound deafness to be considered for implantation. Expansion of the selection criteria for implantation to those with more residual hearing is supported by data that residual hearing is one of the few variables identified that directly impacts speech perception results.1 In this article, we describe a somewhat different rationale for considering the patients’ residual hearing in cochlear implantation. The decision to undergo traditional implantation surgery will usually mean that patients’ residual acoustic hearing is usually no longer available. However, the residual low-frequency acoustic hearing, when it can be used by the patient in addition to electrical stimulation, has some important advantages compared with traditional “electric only” CIs. Therefore, there are a number of disadvantages that should be considered before the decision to destroy residual acoustic hearing is undertaken. The electrical signal-processing algorithm and stimulation of the auditory nerve that provides important information for speech perception in quiet is reported by users of CIs as “mechanical” or “raspy” when compared with their memories of acoustic hearing. In addition, the loss of pitch perception, which is primarily a consequence of the limited spectral resolution of current CI speech processing, has unfortunate consequences for the perception of speech in noise and for the accurate perception and enjoyment of music.
Hybrid Cochlear Implant Suits Some with High Frequency Hearing Loss
January 2009
The Nucleus(r) Hybrid(tm) cochlear implant system offers individuals with steeply sloping hearing losses in the high-frequency region an alternative to traditional cochlear implantation. The Nucleus Hybrid cochlear implant system incorporates an internal device that has a shorter electrode array component than a more traditional cochlear implant. Like the traditional length cochlear implant, it uses electrical signals to stimulate the cochlea, but because of its shorter length, the Hybrid cochlear implant only stimulates the basal end of the cochlea where the highequency hearing has deteriorated, preserving the residual low-frequency hearing. This type of combination device, or Hybrid, can result in better hearing preservation than other traditional devices with longer arrays (Turner, Reiss, & Gantz, 2007). In addition, research has suggested that individuals with steeply sloping hearing losses may benefit more from short electrode implantation than longer electrode cochlear implants (Novak, Black, & Koch 2007; Gantz, Turner, Gfeller, & Lowder, 2005) because of the low-frequency hearing preservation.
MED-EL Announces Second Generation Hybrid Implant
February 2009
MED-EL is proud to announce the availability of the new DUET 2 Audio Processor. Offering the fastest, most effective sound coding strategies, the DUET 2 is designed to provide individuals with partial deafness the best possible hearing experience. The DUET 2 is the result of ten years of MED-EL research and development in Electric Acoustic Stimulation (EAS). Combining powerful I100 electronics with an ergonomic design featuring the FineTuner(tm) remote control, users will be attracted to its compact, lightweight design and user friendly interface.
The Cochlear Hybrid System Nominated for Award
April 2009
The Cochlear(tm) Hybrid(tm) System seamlessly blends two well-established technologies – cochlear implants and hearing aids – for individuals with severe to profound high frequency hearing loss, who maintain their low frequency hearing. It integrates world-class cochlear implant technology from Cochlear, the global leader for over 25 years, with state-of-the-art hearing aid technology. The higher frequency regions of the cochlea are stimulated electrically, while lower frequencies are preserved for acoustic amplification. By effectively restoring the severe to profound high frequency loss using electrical stimulation, Hybrid enables individuals to regain their ability to communicate easily and enhances their appreciation of environmental sounds.
Missouri Woman First in US to Get Hybrid Implant
May 2009
The St. Joseph woman simply wanted her hearing back – something a traditional cochlear implant could accomplish, if only she were a good candidate for one. But the fact that she wasn’t a good candidate opened the door for Ms. Kerner to become the first person in the United States to receive a version of the device that might benefit not only her but also many others with hearing loss. “It’s sort of a serendipity” that receiving a traditional cochlear implant wasn’t an option for her, says Dr. Charles Luetje, a neurotologist with Midwest Ear Institute in Kansas City, Mo., and the principal investigator of an FDA study of the William House hybrid cochlear implant, which Ms. Kerner received on April 23. “If it works like we think it will, it has the potential to open up possibilities for a lot of people.” Ms. Kerner began wearing a hearing aid in 1990, when she was 39 years old, and her hearing has gradually decreased since then to the point that she can no longer hear high-frequency sounds. But because her low-frequency, or residual, hearing remains and traditional cochlear implants can damage that, receiving a traditional implant wasn’t a wise option for her.
New hope in the fight to wipe out deafness
April 2010
A new treatment is giving partially deaf people the chance to hear the world around them better than they dreamed possible. The technique, known as a soft-surgery cochlear implantation, involves inserting an electrode into the inner ear of patients who have some residual hearing. The treatment was previously offered only to people with total or near-total hearing loss, also called profound deafness. But now, a doctor at Al Mafraq Hospital in the capital is confident that the surgery is safe enough to be performed on patients with some hearing without risk of further loss.
Preserving Residual Acoustic Hearing with Combined Acoustic and Electric Hearing
April 2010
In recent years, a unique approach in the treatment of severe high-frequency sensorineural hearing loss has been explored. This new approach modifies existing cochlear implantation techniques by preserving any remaining hearing in the implanted ear and has already been implemented in more than 100 people worldwide. Many people who receive cochlear implants (CIs) still have some residual hearing in the opposite, non-implanted ear and sometimes wear a hearing aid in this ear to provide additional beneficial sound stimulation. This new technique involves preserving low-frequency hearing in the implanted ear, with the CI filling in high-frequency sounds. The aim is to produce improved speech understanding and other hearing sensations via combined acoustic (A) and electric (E) hearing. With A+E hearing, one uses both acoustic hearing (sound waves entering the ear in typical fashion, amplifi ed by a hearing aid) plus electrical hearing (sound waves being received by a sound processor, which transmits signals to the electrode implanted in the inner ear, or cochlea). The addition of acoustic hearing, either via the opposite, or the implanted ear, can often improve a person’s total hearing abilities.
Combined Acoustic and Electric Stimulation
by Michael F. Dorman
March 2011
The average level of performance with a single cochlear implant for sentence understanding has been very good (80%-90% correct) for a long time. The average level of performance for consonant-nucleus-consonant (CNC) word recognition has been poorer, in the range of 50%-60% correct for the same amount of time (Helms et al., 1997). The best chance to improve sentence and word recognition performance significantly may be to provide patients with a combination of electric (E) stimulation and low-frequency acoustic stimulation (A) or EAS.
Hearing preservation with cochlear implantation
May 2011
One area that has received considerable attention in the past ten years is cochlear implantation with hearing preservation using what is referred to as electric and acoustic stimulation (EAS) or a hybrid implant. We just happened to locate an expert on this topic, who is our guest this month for 20Q.
Hybrid/EAS Cochlear Implants – New Research and Clinical Tips
December 2011
There are times when 20 Questions just aren’t enough! We’re back again talking about new developments in cochlear implants. Just in case you missed it, last month our 20Q guest author, René Gifford, Ph.D. of Vanderbilt University started things off by telling us that yes indeed, hearing preservation is possible with cochlear implants. She described a procedure that has been used since 1999, usually referred to as electric and acoustic stimulation (EAS) or a hybrid cochlear implant (e.g., implant and hearing aid used in the same ear). We’re pleased to have René back with us. She covered a lot of territory last month, telling us about the specifics of the implant procedure, implant candidacy, what devices are available, the differences among devices, and the research findings from various clinical trials. You can read last month’s article here. When our “Question Man” reached his final 20th question, Dr. Gifford was just starting to explain some interesting findings related to speech recognition with these patients following implantation. Let’s join them as they resume their conversation to see how that story ends.
