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Cochlear Implant

Overview

We are involved in many areas of cochlear implant research ranging from outcome measures, genetic cause of hearing loss, quality of life changes including effect on cognitive function, to sound and music appreciation. We also have devised methods for inserting implants without damaging the cochlear tissue and are working with colleagues at Columbia engineering and Harvard to develop a fully implantable cochlear implant.

Faculty Active in This Area

Active Research

Efficacy of Levels of AR Intervention and Integrated Auditory Self-Training with Adult Cochlear Implant Users

PrincipaI Investigator: Cassandra Bosworth, AuD

Adult aural rehabilitation is defined as the reduction of hearing-loss-induced deficits of function, activity, participation, and quality of life through a combination of sensory management, instruction, perceptual training, and counseling. Effective sensory management may, by itself, lead to improved activity, participation, and quality of life, but there is no guarantee that these outcomes will be automatic or optimal. Tele-rehabilitation is the delivery of rehab services using distance technology, typically computer, when the clinician and the client are not in the same physical location. The purpose of this study is to examine whether short-term auditory training, combining top-down/synthetic and bottom-up/analytic approaches, can significantly improve the speech recognition abilities of post-lingually deafened adult cochlear implant users. The second goal is to assess the additional benefit of communication strategies training in concert with informational counseling.

The Modified Rhyme Word Test Revisited: A Software Tool for the Evaluation of Cochlear Implant Patients Using Commonly Available Technology

PrincipaI Investigator: Ilana Cellum, AuD

The modified rhyme word test (MRT) has been shown to be a reliable method to evaluate spoken messages with voice communication systems and to separate normal listeners with hearing impaired listeners. With the increase of telehealth, the process of mapping and rehabilitation of cochlear implant users is changing. We have developed a software tool to be used for analysis of phonetic elements of the patient’s hearing, and subsequently to be used for mapping modifications.

Harnessing Big Data to Assess Cochlear Implant Outcomes in the Older Old

Principal Investigator: Justin S. Golub, MD, MS

Cochlear implant research has been limited by the difficulty in combining data across centers. Most cochlear implant research to date comes from single institutions. This limits subject numbers and generalizability of findings. We are utilizing a new national web-based cochlear implant database (HERMES, for HIPPA-secure, Encrypted, Research, Management and Evaluation Solution) as well as specialized biostatistical technique to analyze cochlear implant performance on an extremely large scale. This will provide new insights not possible by single institutional studies. Our particular interests are the outcomes of older implantees and what can be done to further improve their performance.

CI Electrode Length

PrincipaI Investigator: Ana Kim, MD

Cochlear implants (CI) are implanted devices that restore hearing to deaf individuals. Despite improvements in hearing, CI users continue to have problems hearing more complex sounds such as music and speech in noisy environments. As a result, there has been increasing attention to understand the importance of different models and lengths of CI. While some studies have shown that longer CI may improve the hearing of lower musical pitches, other studies disagree with these findings. Given the increasing number of CI surgeries and continued development of CI technologies, it is important to understand the benefits of specific CI models and lengths on hearing. Our study therefore aims to evaluate the effect of CI model and length on hearing.

Utility of Cochlear Implants in Treatment of Single-sided Deafness or Tinnitus

PrincipaI Investigators: Ana Kim, MD and Anil K. Lalwani, MD

Persons with deafness in one ear are referred to as having single-sided deafness (SSD). SSD imposes limitations in terms of the difficulty in communication in adverse listening situations [such as noise or echo], inability to determine the location of a sound source (known as localization), and impact on emotional status. Furthermore, persons with SSD often suffer from intractable tinnitus (ringing or other noises in the ear), which may be severely handicapping. There is limited evidence in the literature that use of cochlear implants (CIs) in persons with SSD may be beneficial. We propose to examine the utility of CIs in persons with SSD and/or asymmetrical hearing loss.

Music Appreciation

PrincipaI Investigator: Anil K. Lalwani, MD

The Cochlear Implant (CI) restores hearing to deafened individuals. Despite excellent performance on speech discrimination, appreciation of music among CI listeners remains poor. Diminished music appreciation in CI users has been attributed to decreased music perception related to low resolution and skewed mapping of transmitted frequencies through the CI. In approaching the issue of poor musical enjoyment in CI users, studies have been done to analyze how varying CI devices and sound encoding strategies affect music enjoyment as well as how music appreciation varies across different genres (pop, classical, etc) of music. In a pilot study, we will analyze how normal hearing individuals as well as individuals with hearing loss rate their enjoyment in listening to the same piece of music at varying levels of complexity through cochlear implant simulation software. Our goal is to ultimately identify how the complexity level of music can be altered in order to generate a more enjoyable listening experience for the CI user.

Physiological Measures of Music Enjoyment

PrincipaI Investigator: Anil K. Lalwani, MD

Cochlear implantees are able to achieve excellent word understanding. However, the perception and enjoyment of music remains poor in this population. Several studies have assessed music enjoyment in cochlear implantees, but a major challenge of these studies is the dependence on subjective measures to quantify music enjoyment. While physiological responses to music have been well-studied in psychology as an objective measure for emotions in normal hearing (NH) listeners, no study has applied this model to cochlear implantees. The goal of this study is to identify physiological parameters that may be used as objective measures to evaluate music enjoyment and emotional responses in cochlear implant (CI) and NH individuals.

Speech Enjoyment

PrincipaI Investigator: Anil K. Lalwani, MD

Cochlear implants are devices implanted into the ear to restore hearing to deafened individuals. People who use cochlear implants can perceive speech as well as a normal-hearing person. However, the quality of the speech heard is different than speech heard by a normal-hearing person. The goal of our research is to create a test that can shed light on the best way to describe the kind of speech that cochlear implant users hear and get a sense for how enjoyable the speech that they hear sounds to them.

Single Needle Device Perforation of the Human Round Window Membrane (RWM) to Facilitate Atraumatic Cochlear Implantation

PrincipaI Investigator: Anil K. Lalwani, MD

Cochlear implants are commonly used prosthetic devices that have been shown to improve the hearing, vocalization, mood, and overall quality of life in patients with profound sensorineural hearing loss refractory to hearing aids. In recent years the human round window membrane has become increasingly utilized as a pathway for electrode placement. Use of the round window membrane avoids traumatic disruption of the cochlea’s bony walls, along with the significant risk of hearing loss or vestibular dysfunction that comes with it. However, to date, no device exists to create small, precise holes in the round window membrane to aid in electrode entry. Based on round window membrane mechanical properties, we created a needle device for membrane perforation to test.