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诺尔通人工耳蜗电极阵列的研发与临床应用

Development and Clinical Introduction of the Nurotron Cochlear Implant Electrode Array.

作者信息

Rebscher Stephen, Zhou David Daomin, Zeng Fan-Gang

机构信息

Department of Otolaryngology, University of California San Francisco, San Francisco, USA.

Nurotron Biotechnology Inc., Irvine, USA.

出版信息

J Int Adv Otol. 2018 Dec;14(3):392-400. doi: 10.5152/iao.2018.6285.

Abstract

As the only medical device used in the treatment for deafness, the cochlear implant has benefited to more than half a million individuals worldwide. However, the device has limited penetration due to its high cost, especially in low- and middle-income countries. China alone has 27.8 million deaf people, but less than 100,000 of them have received a cochlear implant. The Nurotron Venus device was developed to address the need for an affordable yet safe and effective cochlear implant. The present study describes the design, development, and evaluation of the Nurotron intracochlear electrode array. The standard array is 22 mm in length from the round window marker to the apical tip of the carrier and has 24 electrodes, with a surface area of 0.32 mm2 and center-to-center spacing of 0.85 mm. The Nurotron array has been tested to meet the mechanical, chemical, and electrical requirements specified by the ISO Standard 14708-07. Human temporal bone and clinical trial results showed that the Nurotron array is easy to insert (7.8/10 rating with 10 indicating the highest ease of use) and has a low complication rate (12.5%) of severe insertion trauma while achieving high device stability and reliability (6 array failures in 43,000 patient years of experience). As a critical component, the Nurotron array has contributed to the high level of Nurotron implant speech performance, equivalent to that produced by other existing devices. The Nurotron device has benefited 10,000 deaf people and helped reduce the unit cost from US$25,000 in 2011 to US$4,620 in 2017 through the Chinese Government Tender Program. New, slim, and micromachined electrodes are being developed to further improve performance and accessibility.

摘要

作为唯一用于治疗耳聋的医疗设备,人工耳蜗已使全球超过50万人受益。然而,由于成本高昂,该设备的普及率有限,尤其是在低收入和中等收入国家。仅中国就有2780万聋人,但其中接受人工耳蜗植入的不到10万人。诺尔康金星设备的研发旨在满足对价格可承受且安全有效的人工耳蜗的需求。本研究描述了诺尔康植入式耳蜗电极阵列的设计、开发和评估。标准阵列从圆窗标记到载体顶端的长度为22毫米,有24个电极,表面积为0.32平方毫米,电极中心间距为0.85毫米。诺尔康阵列已经过测试,以满足ISO标准14708 - 07规定的机械、化学和电气要求。人类颞骨和临床试验结果表明,诺尔康阵列易于插入(评分为7.8/10,10表示使用最方便),严重插入创伤的并发症发生率低(12.5%),同时实现了高设备稳定性和可靠性(在43000患者年的经验中有6次阵列故障)。作为关键部件,诺尔康阵列有助于实现诺尔康植入物的高水平语音性能,与其他现有设备相当。诺尔康设备已使10000名聋人受益,并通过中国政府招标项目帮助将单位成本从2011年的25000美元降至2017年的4620美元。正在开发新型、纤细和微加工电极,以进一步提高性能和可及性。

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