TY  - JOUR
A1  - Kiefer, Jan
A1  - Tillein, Jochen
A1  - Ilberg, Christoph von
A1  - Pfenningdorff, Thomas
A1  - Stürzebecher, Ekkehard
A1  - Klinke, Rainer
A1  - Gstöttner, Wolfgang
T1  - Fundamentalni  aspekti i prvini rezultati od klinika primena na 
kombinirana elektro i akustična stimulacija na auditiven sistem = Fundamental aspects and first results of the clinical application of combined electric and acoustic stimulation of the auditory system
T2  - Journal of special education and rehabilitation = Дефектолошка теорија и практика
N2  - Electric stimulation of the auditory nerve via cochlear implants has made the treatment of sensory deafness possible. Advanced signal processing and stimulation paradigms have led to continuously improved results in speech understanding. Consequently, indication criteria have been extended to patients with profound and severe-to-profound hearing loss and limited speech understanding with conventional acoustic amplification.
Outside this group, a considerable number of patients presents with rather wellpreserved, low frequency hearing of 30-60 dB up to 1 kHz, but severe loss in the mid to high frequency range of more than 60-70 dB. Monosyllabic word scores in these patients do not generally exceed 35%, due to missing consonant information. But, even increasing the audibility of these high frequencies by acoustic amplification still has very limited efficiency for discriminating speech, and therefore, these patients obtain only minor benefit from conventional hearing aids. On the other hand, standard cochlear implantation would carry a high risk of causing complete hearing loss. This situation has led to considering a combination of both modes of stimulation for these patients who are on the borderline between hearing aids and cochlear implant.
In our present model, the surviving low frequency region of the cochlea could still be stimulated acoustically-combined with additional electrical stimulation of the impaired mid and high frequency region of the cochlea.
Several questions still have to be answered with regard to combined electric and acoustic stimulation (EAS). The possible interaction of electric and acoustic stimuli on the different levels off the auditory system is a major issue. Animal experiments clearly demonstrate that tuning properties of auditory neurons, in response to acute acoustic stimulation, are essentially preserved in the presence of electric stimulation even at high levels of electric stimulation, and that chronic electric stimulation of tie intact inner ear does not have a significant effect on the compound action potentials (CAP) thresholds or inner ear function.
In a previous report, we were able to show that this combined F.A.S of the auditory system is possible in humans, and that it has a synergistic effect on speech understanding. Further major issues regard the surgical feasibility and reproducibility of cochlear implantation with the preservation of residual hearing.
Encouraged by our findings, a clinical study was initiated on the application of EAS. So far, seven adults have been included in this study. In addition, one child has been implanted outside the study.
KW  - cohlear implant
KW  - auditory system
KW  - electric and acustic stymulation
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/44574
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-445749
SN  - 1857-663X
SN  - 1409-6099
N1  - License (for files): Creative Commons Attribution 4.0
VL  - 5
IS  - 1-2
SP  - 75
EP  - 86
PB  - Institute of Special Education and Rehabilitation, Faculty of Philosophy, Skopje ; Macedonian Association of Special Educators
CY  - Skopje
ER  -