Ramos Angel, Rodriguez Carina, Martinez-Beneyto Paz, Perez Daniel, Gault Alexandre, Falcon Juan Carlos, Boyle Patrick
Ear, Neck and Throat Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Acta Otolaryngol. 2009 May;129(5):533-40. doi: 10.1080/00016480802294369.
Remote cochlear implant (CI) programming is a viable, safe, user-friendly and cost-effective procedure, equivalent to standard programming in terms of efficacy and user's perception, which can complement the standard procedures. The potential benefits of this technique are outlined.
We assessed the technical viability, risks and difficulties of remote CI programming; and evaluated the benefits for the user comparing the standard on-site CI programming versus the remote CI programming.
The Remote Programming System (RPS) basically consists of completing the habitual programming protocol in a regular CI centre, assisted by local staff, although guided by a remote expert, who programs the CI device using a remote programming station that takes control of the local station through the Internet. A randomized prospective study has been designed with the appropriate controls comparing RPS to the standard on-site CI programming. Study subjects were implanted adults with a HiRes 90K(R) CI with post-lingual onset of profound deafness and 4-12 weeks of device use. Subjects underwent two daily CI programming sessions either remote or standard, on 4 programming days separated by 3 month intervals. A total of 12 remote and 12 standard sessions were completed. To compare both CI programming modes we analysed: program parameters, subjects' auditory progress, subjects' perceptions of the CI programming sessions, and technical aspects, risks and difficulties of remote CI programming.
Control of the local station from the remote station was carried out successfully and remote programming sessions were achieved completely and without incidents. Remote and standard program parameters were compared and no significant differences were found between the groups. The performance evaluated in subjects who had been using either standard or remote programs for 3 months showed no significant difference. Subjects were satisfied with both the remote and standard sessions. Safety was proven by checking emergency stops in different conditions. A very small delay was noticed that did not affect the ease of the fitting. The oral and video communication between the local and the remote equipment was established without difficulties and was of high quality.
远程人工耳蜗（CI）编程是一种可行、安全、用户友好且具有成本效益的程序，在疗效和用户认知方面与标准编程相当，可作为标准程序的补充。本文概述了该技术的潜在益处。
我们评估了远程CI编程的技术可行性、风险和困难；并通过比较标准现场CI编程与远程CI编程，评估了其对用户的益处。
远程编程系统（RPS）基本流程为，在常规CI中心由当地工作人员协助完成常规编程协议，不过由远程专家指导，远程专家使用通过互联网控制本地站的远程编程站对CI设备进行编程。我们设计了一项随机前瞻性研究，并设置了适当对照，将RPS与标准现场CI编程进行比较。研究对象为植入了HiRes 90K（R）CI的成年患者，这些患者语后聋且深度耳聋，设备使用时长为4至12周。受试者在相隔3个月的4个编程日里，每天接受两次CI编程，编程方式为远程或标准方式。共完成了12次远程编程和12次标准编程。为比较两种CI编程模式，我们分析了：程序参数、受试者的听觉进展、受试者对CI编程过程的认知，以及远程CI编程的技术方面、风险和困难。
从远程站成功实现了对本地站的控制，远程编程过程全部完成且无事故发生。比较了远程和标准程序参数，两组之间未发现显著差异。对使用标准或远程程序3个月的受试者进行的性能评估显示无显著差异。受试者对远程和标准编程过程均感到满意。通过检查不同条件下的紧急停止情况证明了安全性。发现有非常小的延迟，但不影响调试的便利性。本地设备与远程设备之间的语音和视频通信顺利建立且质量很高。
