At a glance Figures View all figures Figure 1: The first implantation of a multichannel microelectronic cochlear implant. (a) Eight-channel microelectronic cochlear implant and its long scala tympani electrode. I assembled it myself in the technology laboratory of the Technical University of Vienna. (b,c) Kurt Burian (b) performed the implant surgery (c) on 16 December 1977 in the Ear, Nose and Throat Clinic at the University of Vienna. Full size image View in article Figure 2: An important early patient. (a) C.K. has enjoyed open speech understanding from cochlear implants for the longest period worldwide: 34 years as of September 2013. Twenty-nine years after her original implantation in August 1978 and before receiving a modern PULSAR implant in 2008, she still had 25% open set monosyllabic word understanding with an analog implant, which she had wanted to keep for listening to music. Pioneer users such as C.K. worked hard and contributed a lot to the development of cochlear implants. (b) C.K.'s first four-channel implant and its take-home processor for broadband analog stimulation. Full size image View in article Figure 3: The COMFORT System. (a) Child with behind-the-ear processor. (b) Implant. About 500 adults and children received the COMFORT System for broadband analog stimulation, the only transcutaneous analog system that consistently led to open speech understanding in patients with good temporal processing abilities. Most of them are using modern implants now and enjoy further increased speech understanding. Full size image View in article Figure 4: A unique case. M.H. was the only patient who received an implant that combined analog and pulsatile stimulation. The analog signal conveying the temporal features is presented at one of the apical channels 1–4 together with pulses appearing on any channel depending on the spectral content of the input signal. Full size image View in article Figure 5: Multicenter study results with the implant COMBI 40. This implant implemented a fast CIS strategy in postlingually deaf adults, and it showed for the first time that more than half of the patient population reached a monosyllabic word understanding higher than 50% after just 6 months. This means that these patients can talk to someone unknown to them about an unknown topic over the telephone. (a) Sentence understanding10. (b) Monosyllabic word understanding. Preop., preoperative10. (c) COMBI 40 Implant System with 30-mm-long electrode with 2.8-mm contact separation10. (d) The electrode covers most of the length of the cochlea, reaching out into its apical part, as the X-ray shows12. Full size image View in article Figure 6: More recent pioneer patients. (a) M.R., the first bilaterally implanted (March 1996 and January 1998) child, received his implants at the ages of 2 and 4 years. Bilateral implantation for the purpose of binaural hearing was started in July 1996 (ref. 13). (b) S.S., the first electric and acoustic stimulation patient, suffered from partial hearing loss. Her low-frequency hearing was preserved despite insertion of an electrode into her cochlea for 20 mm. Electric and acoustic stimulation started with her14, as did the entire idea of preserving hearing as well as inner ear structures not only in cases with residual hearing but also in all cases. S.S. and C.K. were presented with an acknowledgement by Erwin Hochmair during the 20-year celebration. Full size image View in article
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