the history of cochlear implantation - dr. dr. h.c. monika lehnhardt

The history of Cochlear Implantation

Dr. Dr. h. c. Monika LehnhardtSuzdal, November 2011

www.monika-lehnhardt.net

Wever EG, Bray CW (1936)


Charles Eyries, Otologist in Paris


André Djurno, Engineer Co-working with Eyries


Fritz Zöllner, Otologist in Freiburg

www.monika-lehnhardt.netWolf Dieter Keidel, Physiologist in Erlangen


William House, Otologist in Los Angeles


Vision for a technology that would enable the deaf to hear

Research supported by public donation, commenced 1967

First cochlear implant, 1978, Melbourne Hospital

“In spite of the problems and criticisms, I just had to go on. A cochlear implant was their only hope of ever hearing.” -Professor Graeme Clark

Ernst Lehnhardt



Electrode Array in situ

• 1984 First adult patients in Hannover, Germany


• Ernst Lehnhardt with his audiologist Rolf Battmer



Soft Surgery


• 4th generation ASIC CMOS internal chip with

– Increased precision current sources for accurate nerve stimulation

– 4th generation telemetry with less internal noise, enabling AutoNRT

– Improved power efficiency for longer battery life

• Generational mechanical changes for

– improved reliability

Freedom Cochlear Implant


• Dual microphones for high quality sound capture and support for Pre-processing

• Dual 16-bit analog to digital converters for CD quality 96dB dynamic range processing

• Quad 16 Bit DSP

• In-built Telecoil

• Integrated accessory connector

• IP44 Splash Compliant

Freedom Speech Processor


Мониторинг. Контроль. Управление.

Cochlear: Система Nucleus 5

Cochlear: Дистанционное управление Nucleus CR110


Exponential Growth- First Choice Worldwide


Development of Candidate Selection Criteria United States (Nucleus Implant Systems)

Broadening Indications

Adults Children

1985 FDA approval for implantation of candidates aged 18 years and older

postlingually deafened profound bilateral sensorineuronal deafness no benefit from hearing aid

1990 FDA approval for implantation of candidates aged 2 years and older profound bilateral sensorineuronal deafness little or no benefit from hearing aid candidate and family must be well motivated and possess

realistic expectations

1995 Include pre-and perilinguistically deafened adults Limited benefit from hearing aids defined as 30% or

less in best aided condition on tape recorded tests

of open-set sentences

1998 Limited benefit from hearing aids defined as 40% or less in best aided condition on tape recorded tests of open-set sentences

18 months and older 3-6 months hearing aid trial <20% score on MLNT or LNT test

2000 Limited benefit from hearing aids defined as 60% or less in best aided condition on tape recorded tests of open-set sentences

12 months and older 3-6 months hearing aid trial Lack of progress in development of auditory skills or <30% score on MLNT or LNT test,

depending on age


Trend towards bilateral


New Surgical Techniques


TIKI Technology

Implantable Rechargeable Battery ?

Extremely low powerIntegrated Circuit incorporating:

• Audio pre-processing • Stimulator module• Speech processor• Power management• High voltage output switches

High performance implantable microphone that will last a lifetime


Suppose the electrodes could be in close contact with the nerves…


NormalNormal Deafened Regeneration

Habenula PerforataHabenula Perforata

Wise et al, The Bionic Ear Institute, 2003.

Inner HaircellsInner Haircells

Outer HaircellsOuter Haircells

Neurotrophins and Auditory Nerve Regeneration


Nanotechnology: Guidance Molecules


Thank You for your attention!

the history of cochlear implantation - dr. dr. h.c. monika lehnhardt

Health & Medicine

hearing aids

hearing aid candidate

freedom cochlear implant

ernst lehnhardt

fda approval

best aided condition

implantation of candidatesaged

tests of open