JOURNAL CLUB Cochlear Implantation: Asia–Pacific Symposium Is an Emerging Force By Fan-Gang Zeng, PhD; Shi-Ming Yang, MD, PhD; & Zhiqiang Gao, MD T he 10th Asia–Pacific Symposium on Cochlear Implants and Related Sciences (APSCI 2015) drew about 2,000 professionals to dis- cuss the latest research in Beijing from April 30 to May 3. The number of attendees was unprecedented, the weather cooperative, and the venue splendid, but the science was even better. One hot topic that consistently came up at the conference was how to narrow the re- maining gaps between prosthetic and normal hearing. Bruce J. Gantz, MD, of the University of Iowa designed special electrodes Blake S. Wilson, DSc, DEng, of Duke to produce a hybrid cochlear implant that preserves low-frequency University reviewed the progress of co- acoustic hearing. chlear implant performance from essentially and 1,000 Hz needs to be preserved, preferably using the chance-level success with single-channel short (10-mm) electrodes while saving the long (16- or 20- devices in the 1980s to today’s multichannel devices that mm) electrodes for people who are older than 70 and have even allow most users to carry on cell phone conversations. more than 30 years of profound loss at high frequencies. He also noted a lack of improvement in unilateral cochlear Most surgeons also favored atraumatic insertion and struc- implant performance in the last two decades and suggested tural preservation in cochlear implantation, which are critical that improving unilateral performance serves as a “bedrock” to both short-term protection and long-term maintenance of critical to narrowing the gap between prosthetic and normal residual acoustic hearing. hearing. Using a biological approach in an animal model, Shi-Ming As a means to improve unilateral performance, Ingeborg Yang, MD, PhD, of Chinese People’s Liberation Army Gen- Hochmair, PhD, of MED-EL advocated the use of deep elec- eral Hospital in Beijing demonstrated that stem cells promote trodes to access low-frequency neurons while matching them auditory nerve growth toward the intra-cochlear electrodes, with appropriate temporal fine structure (Hear Res 2015; reducing power consumption while increasing spatial selec- tivity. For people with residual low-frequency acoustic hearing, This technique, similar to a gene-therapy approach (Sci Bruce J. Gantz, MD, of the University of Iowa designed spe- Transl Med 2014;6[233]:233ra54), may still be years away cial electrodes to produce a hybrid cochlear implant that pre- from human application, but it represents a promising future serves low-frequency acoustic hearing, augmenting and direction for enhancing the nerve–electrode interface and ul- enhancing the implant performance. timately the bionic ear performance. To achieve a hybrid hearing advantage, acoustic hearing better than 85 dB pure-tone average (PTA) between 125 Hz Dr. Zeng is chairman of The Hearing Journal Editorial Advisory Board, as well as director of the Center for Hearing Research and professor of anatomy and neurobiology, biomedical engineering, cognitive sciences, and otolaryngology at the University of Cali- fornia, Irvine. Dr. Yang is chairman of the Department of Otolaryngology–Head and Neck Surgery at the Chinese People’s Liberation Army Gen- eral Hospital in Beijing and copresident of the APSCI 2015 Scien- tific Committee. Dr. Gao is chairman of the Department of Otorhinolaryngology at Peking Union Medical College Hospital and the Chinese Acad- emy of Medical Sciences in Beijing, and copresident of the APSCI 2015 Scientific Committee. The Hearing Journal BINAURAL HEARING: SENSITIVE PERIOD Another major area covered at the conference was under- standing and utilizing brain plasticity in cochlear implanta- tion. Robert Briggs, MBBS, of the University of Melbourne re- viewed lessons learned from cochlear implant outcomes in children over the past 30 years, such as the younger the im- plant age, the better the outcome, particularly for children im- planted before their first birthday. Other significant factors are the child’s cognitive status and communication mode, with superior outcomes related to an oral versus a signing environment. A somewhat surprising finding was that children with bilateral implants have better July 2015
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