The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing.
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The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway.To assess the present status of cochlear implants and to describe possibilities for improving them.The present-day devices work well in quiet conditions for the great majority of users. However, not all users have high levels of speech reception in quiet and nearly all users struggle with speech reception in typically noisy acoustic environments. In addition, perception of sounds more complex than speech, such as most music, is generally poor unless residual hearing at low frequencies can be stimulated acoustically in conjunction with the electrical stimuli provided by the implant. Possibilities for improving the present devices include increasing the spatial specificity of neural excitation by reducing masking effects or with new stimulus modes; prudent pruning of interfering or otherwise detrimental electrodes from the stimulation map; a further relaxation in the criteria for implant candidacy, based on recent evidence from persons with high levels of residual hearing and to allow many more people to benefit from cochlear implants; and "top down" or "brain centric" approaches to implant designs and applications.Progress in the development of the cochlear implant and related treatments has been remarkable but room remains for improvements. The future looks bright as there are multiple promising possibilities for improvements and many talented teams are pursuing them.
Published Version (Please cite this version)10.1016/j.wjorl.2017.12.005
Publication InfoWilson, Blake S (2017). The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing. World journal of otorhinolaryngology - head and neck surgery, 3(4). 10.1016/j.wjorl.2017.12.005. Retrieved from https://hdl.handle.net/10161/17086.
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Adjunct Professor in the Department of Head and Neck Surgery & Communication Sciences
Prof. Wilson is the Director of the Duke Hearing Center and is an Adjunct or Consulting Professor in each of three departments at Duke: Surgery, Biomedical Engineering, and Electrical and Computer Engineering. He has been involved in the development of the cochlear implant (CI) for four decades and is the inventor of many of the signal processing strategies used with the present-day CIs. One of his papers, in the journal Nature, is the most highly cited publication in the principal field of CIs.