MED-EL Elektromedizinische Geraete Gesellschaft m.b.H., Innsbruck, Austria.
Acta Otolaryngol. 2021 Mar;141(sup1):22-62. doi: 10.1080/00016489.2021.1888477.
Electric-acoustic stimulation (EAS) is a special treatment modality for those patients who are profoundly deaf in the high-frequency (HF) region and retain usable hearing in the low-frequency (LF) region. Combining the electric stimulation with cochlear implant (CI) in the HF and acoustic amplification of residual hearing using a conventional hearing aid (HA) in the LF region defines EAS. The EAS concept was first proposed by C. von Ilberg from Frankfurt, Germany in the year 1997. In association with MED-EL, all the necessary safety studies were performed in non-human subjects before the first patient received it in 1997. In association with MED-EL, all the necessary safety studies were performed in non-human subjects before the first patient received it in 1999. For the patient to successfully use the EAS concept, the residual hearing needs to be preserved to a high extent and for several years. This requires a highly flexible electrode array in safeguarding the intra-cochlear structures during and after the CI electrode array insertion. Combining the HA unit with the audio processor unit of the CI was necessary for the convenient wearing of the unified audio processor. Fitting of the unified audio processor is another important factor that contributes to the overall success of the EAS treatment. The key translational research efforts at MED-EL were on the development of flexible electrodes, a unified audio processor, innovations in the fitting process, intra-operative monitoring of cochlear health during electrode insertion, pre-operative soft-ware tool to evaluate the cochlear size and electrode selection and some new innovations tried within EAS topic. This article covers the milestones of translational research from the first concept to the widespread clinical use of EAS.
电声刺激(EAS)是一种特殊的治疗方式,适用于高频(HF)区域重度聋但低频(LF)区域仍有可用听力的患者。将电刺激与高频区的人工耳蜗(CI)相结合,并在 LF 区使用传统助听器(HA)对残余听力进行声学放大,这一定义了 EAS。EAS 概念最初由德国法兰克福的 C. von Ilberg 于 1997 年提出。与 MED-EL 合作,在 1997 年首例患者接受 EAS 治疗之前,已经在非人类受试者中进行了所有必要的安全性研究。与 MED-EL 合作,在 1997 年首例患者接受 EAS 治疗之前,已经在非人类受试者中进行了所有必要的安全性研究。为了使患者能够成功使用 EAS 概念,需要在数年内高度保留和保护残余听力。这需要在 CI 电极插入过程中和之后,使用高度灵活的电极阵列来保护耳蜗内结构。将 HA 单元与 CI 的音频处理器单元相结合,对于方便佩戴统一的音频处理器是必要的。统一音频处理器的适配是 EAS 治疗整体成功的另一个重要因素。MED-EL 的关键转化研究工作集中在开发灵活的电极、统一的音频处理器、适配过程的创新、电极插入过程中的耳蜗健康术中监测、用于评估耳蜗大小和电极选择的术前软件工具,以及在 EAS 主题内尝试的一些新创新。本文涵盖了从最初概念到 EAS 广泛临床应用的转化研究的里程碑。