BIONIC EAR

Bionic Ear
The human ear is vulnerable organ .It is divided into three parts the outer ear, the
middle ear, which is made up of ear drum ( tympanic membrane ) and chain of
tiny bones called ossicles , and the inner ear cochlea . the cochlea contains hair
cells which, when simulated , generate an electric current in the auditory nerve
then transmits the signal to the hearing centers of the brain.
Each region of the ear can suffer the damage and even the most powerful hearing
aids are ineffective the function of both inner ear is impaired.

what is cochlear implant

it is a prosthetic replacement for the inner ear(cochlea) and is only appropriate for
people who receive minimal or no benefit from a conventional hearing aid .
The cochlear implant bypassed the damaged parts of the inner ear and
electronically stimulates the nerve of hearing. Part of the device is surgically
implanted in the skull behind the ear and tiny wires are inserted into the cochlea .
The other part of the device is external and has a microphone , a speech processor
( that convert sound into electrical impulses ), and connecting cabels. It is battery
powered, adjustable and expensive.
Fig 3.2. The internal component of the cochlear implant
For this model the electrode wire is made up of 22 separate electrodes. Each
electrode can send the signal to inner ear. This is therefore called 22-chhanel
electrode.
The implant package (or receiver-stimulator) contains the electronic circuits that
control the flow of electrical pulses into the ear. It also contains an antenna that
receives the radio-frequency signal from the external coil and a magnet that holds
the external coil in place. Attached to the package are wire leads that join to
electrodes. The 22-electrode array is inserted into the shell-like structure in the

inner ear known as the cochlea. The ball electrode is placed under a muscle near
the ear. There is also a plate electrode on the outside of the receiver-stimulator
package. All of the parts shown in Figure 3.2 are placed under the patient's skin
behind the ear during the implant operation. The other parts of the implant system
are worn externally. The coil is held in position against the skin by a magnet and
the microphone is worn behind the ear. The body-worn speech processor can be
worn in a pocket, in a belt pouch or in a harness. The ear-level processor is worn
behind the ear.
Cochlear implants have been performed for over 20 years and have become the
standard treatment for people with profound hearing loss, who desire to use spoken
language . Today, over 12,000 adults and children worldwide have received the
cochlear implant.
How does a cochlear implant work?
Speech and other sounds are picked up by the microphone and sent to the speech
processor. The processor codes the sounds into an electrical signal which is sent via
a cable to the transmitting coil. The coil passes the signal through the skin to the
implant which transforms the signal to electrical pulses. The pulses pass from the
electrode array and stimulate hearing nerve fibers within the cochlea.
The speech processor does not just make sounds louder as does a hearing aid.
Instead, it selects out some of the important information in the speech signal and
then produces a pattern of electrical pulses in the patient's ear. This pattern is
selected to sound as close as possible to the original speech sound.
The hearing process using a cochlear implant can be summarized as follows
(please refer to Figure ):

a. The microphone detects sounds and speech.

b. The information from the microphone is sent to the speech processor.
c. The speech processor analyses the information and converts it into an
Electrical code.

d. The coded signal travels via a cable to the transmitting coil in the headset.
Radio waves from the transmitter coil carry the coded signal through the skin to
the implant inside.
.
e. The implant package decodes the signal. The signal contains information that
determines how much electrical current will be sent to the different electrodes.
f. The appropriate amount of electrical current passes down the appropriate lead
wires to the chosen electrodes.
g. The position of the stimulating electrodes within the cochlea will determine
the frequency or pitch of the sounds. The amount of electrical current will
determine the loudness of the sounds.
h. Once the nerve endings in the cochlea are stimulated, the message is sent up to
the brain along the hearing nerve. The brain can then try to interpret the stimulation
as a meaningful sound.
Today, cochlear implant are very sophisticated. The multichannel implant
stimulates the hearing nerve in a variety of places to give information about pitch,
which is essential for understanding speech. The externally worn processor is
designed to incorporate advances in technology, so there is no need to wait for next
years upgrade. The sooner the person receives the implant after becoming deaf the
better he/she will do with implant.

What is a candidate for Cochlear Implant ?

Candidate for implants are adults or children ( two years or older ) with all of the
following:
Profound or severe hearing loss in both ears (this includes people with so-called
nerve deafness).
Hearing aids but receive little or no benefit from them in understanding speech by
listening alone.
No medical reason to avoid surgery.

 A desire to interact with the hearing world and to communicate with spoken
language.

What is involved in the evaluation and surgery for a cochlear implant?

A. Evaluation: Evaluation procedures used to determine whether individual
candidate included:
Ear examination to determine cause of hearing loss and absence of infection.
Medical examination for eligibility for surgery and anesthesia.
Hearing ability testing, with or without best-fit hearing aid.
Evaluation of communication skills.
CT scan to determine patency of the inner ear(cochlea).
In adults balance tests to determine the risk of postoperative dizziness.
Optional tests:
Promontory stimulation test to determine if the hearing nerve can be stimulated.
In adults-psychological evaluation to assess motivation and expectations.
Testing can be discontinued at any point if the candidate and/or evaluation team
feels it is not appropriate to continue.
B. Review:
Results of tests are reviewed by the cochlear implant team before a decision is
made on whether to implant. Parents are considered an integral part of their childs
team.
Implantation is recommended only for people we believe will benefit for an
implant.
Pre-authorization for implantation from the third party payer is requested. Often
several weeks are required for authorization and scheduling.

C. Surgery:
The surgical risks are the same as for any other ear surgery and are considered
minimal. the surgery takes approximately 1 hours, and the hospital stay is
usually 1 day for adults and 1 or 2 days for children.
D. Fitting:
In adults , the headset and the speech processor are fitted 4-6 weeks after surgery.
The audiologist obtains soft and comfortable listening levels for each of the
electrodes and uses this information to create a MAP or program. the fitting is done
over several days.
In children, the fitting procedure continues over a 3-month period .young children
are typically seen 2 to 3 times a week for the first month and 1 or 2 times a week
for the next 2 months to obtain a stable MAP.
Hearing speech for the first time with the implant may sound unnatural during the
fitting but over many days to weeks it begins to sound familiar. People who have
never heard before require longer time to adjust the new sounds. For adults who
have heard speech before, the MAP is put onto the speech processor and is
adjusted as necessary to custom fit the individual.
For children who have never had hearing, the initial reaction to sound
varies.some children does not respond to sound at first. Other children may show
surprise, fear, inquisitiveness, or happiness. Dramatic changes in auditory and
speech skills are typically not observed initially. Performance usually continues to
improve over time with auditory and speech training.
Electrodes are checked and adjusted, and instructions in use and care of the
implant are given.
E. Fllow-up:
For adults weekly adjustment of the MAP and communication therapy are done
for the first month after fitting. The treatment focuses on auditory training , speech
reading, music, telephone use, and communication strategies. A family member or
friend is encouraged to attend the weekly sessions to learn how to communicate
most effective with implant recipient.

For children after the initial 3 month period, children are seen every 3-months
for the first year and every 6 months for the second and third years.therafter, the
child is seen annually. The childs MAP as well as his/her auditory, speech,
language, and social emotional development are closely monitored.
For children: Every effort is made to work with the schoolteacher and other
professionals working with child. In service training about the implant and
participation in the childs IEP meetings are available. Realistic expectations about
results.

Technical Details:
Frequency response: 100-10KHz (-3 db response)
Gain Amp cut off at 90dB
Overall system Gain: 40 dB typical
Line in jack Impedance: Max 10V (DC =Peak AC)
Mic Sensitivity:-46 dB (0 dB= 1V/PA)
Power Requirements: 9V
key features:
FOCUS on the sounds in the direction of microphone.
AUTOMATIC SHUT OFF circuit shuts off sounds over 95 decibels so loud
sounds are not amplified .
INDEPENDENT VOLUME CONTROL allows you to select best amplification
for each ear so you can adjust for individual hearing differences..
OUTPU JACK to record what you hear.
OPERATES 9V battery for 40 Hrs.continuous use.
WRIST STRAP ACCESSORY Elastic bands attach the microphone to your
forearm for hands-free operation.

Advantages:
1. Bionic ear is useful even most powerful hearing aids are ineffective
2. It magnifies faint and distinct sound with clarity.
3. Surgery takes approximately 1 hrs &
The hospital stay is just a day for adults.
4. Children deafened since from the birth have been cured after receiving this
implant.
5. Allows you to hear things that were unnoticed before.
6. Highly directional.
7. Loud sounds are not amplified after the sound reaches 95 decibels.
8. bionic ear is highly directional, allow you to easily locate sources of sound and
suppress background noises.
9. The externally worn processor is designed to incorporate advantages in
technology, so there is no need to wait for next years upgrade.

DISADVANTAGES:
1. As the technology is still relatively new it is Highly expensive.
2. It is not possible to make sounds completely natural coz there are 22 electrodes
only to replace the function tens of thousands of hair cells.
3. The electrical patterns are different for each person and speech processor need
to be programmed individually.