The cochlear implant: historical aspects and future prospects.
The cochlear implant: historical aspects and future prospects.
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DOI：
10.1002/ar.22580
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发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Gupta C
中科院分区：
文献类型：
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作者：
Eshraghi AA;Nazarian R;Telischi FF;Rajguru SM;Truy E;Gupta C
人工耳蜗（CI）是治疗耳聋和严重听力损失的第一种有效方法。因此，CI现在被广泛认为是现代医学的伟大进步之一。本文回顾了导致当前CI系统的关键事件和发现，我们回顾并提出了进一步改进设备设计和性能的许多可能性中的一些。过去的成就包括：(1)开发可在患者一生中使用的可靠设备；(2)开发可刺激耳蜗多个部位的植入电极阵列；(3) ci声音处理策略的进步和重大改进。此外，研究机构和公司之间的合作大大加快了安全有效设备的广泛提供和使用。未来的可能性包括：(1)使用耳保护药物；(2)进一步改进电极设计和放置；(3)进一步完善声音处理策略；(4)利用干细胞替代耳蜗中丢失的感觉毛细胞和神经结构；(5)基因治疗；(6)进一步减少植入手术中电极插入和其他操作造成的创伤；(7)听觉神经的视觉刺激而非电刺激。每一种可能性都是积极研究的主题。尽管迄今为止，人工智能的发展已经取得了很大的进展，包括人类感官的首次实质性恢复，但似乎还可能取得更大的进展，当然也不会让人感到意外。
The cochlear implant (CI) is the first effective treatment for deafness and severe losses in hearing. As such, the CI is now widely regarded as one of the great advances in modern medicine. This paper reviews the key events and discoveries that led up to the current CI systems, and we review and present some among the many possibilities for further improvements in device design and performance. The past achievements include: (1) development of reliable devices that can be used over the lifetime of a patient; (2) development of arrays of implanted electrodes that can stimulate more than one site in the cochlea; and (3) progressive and large improvements in sound processing strategies for CIs. In addition, cooperation between research organizations and companies greatly accelerated the widespread availability and use of safe and effective devices. Possibilities for the future include: (1) use of otoprotective drugs; (2) further improvements in electrode designs and placements; (3) further improvements in sound processing strategies; (4) use of stem cells to replace lost sensory hair cells and neural structures in the cochlea; (5) gene therapy; (6) further reductions in the trauma caused by insertions of electrodes and other manipulations during implant surgeries; and (7) optical rather electrical stimulation of the auditory nerve. Each of these possibilities is the subject of active research. Although great progress has been made to date in the development of the CI, including the first substantial restoration of a human sense, much more progress seems likely and certainly would not be a surprise.