Zusammenfassung
Seit der Consensus Conference 1995 ist das Cochlear Implant (CI) als Methode der Wahl
bei cochleäer Taubheit etabliert. Mit Hilfe des CI ist es erstmals möglich, den auditiven
Sinneskanal nach dem Funktionsverlust des Perzeptionsorganes wieder zu nutzen. Weltweit
tragen heute mehr als 30 000 Patienten ein CI. Mittlerweile erscheint es bereits selbstverständlich,
die Therapie mit Innenohrimplantaten in das Spektrum der HNO-ärztlichen Behandlung
als eine Standardtherapie einzubeziehen.
In der vorliegenden Arbeit haben wir die historische Entwicklung des CI detailliert
zusammengestellt - von den ersten Pionierversuchen über akustische Wahrnehmungen durch
elektrische Reizung bis hin zum offenen Sprachverstehen mittels intracochleärer Stimulation
-, um aufzuzeigen, welche Forschungsleistungen erbracht werden mussten, um Cochlear
Implantate zu einer klinisch einsetzbaren Methode zu entwickeln. Besonderes Augenmerk
wird dabei auf die kontrovers gebliebene Frage der Vermeidung intracochleärer Schädigung
durch die Stimulationselektroden gelegt.
Schlüsselwörter
Cochlear Implant - Historische Entwicklung - Taubheit - Stimulationselektroden - intracochleäre
Schädigung
Literatur
- 1
NIH Consensus Conference .
Cochlear Implants in adults and children.
JAMA.
1995;
274 (24)
1955-1961
- 2
Brackmann D E.
The cochlear implant: Basic principles.
Laryngoscope.
1976;
86
373-388
- 3
Békésy G.
Zur Theorie des Hörens. Die Schwingungsformen der Basilarmembran.
Physik Z.
1928;
29
793-810
- 4
Wever E G, Bray C W.
The nature of bone conductions shown in the electrical response of the cochlea.
Ann Otol Rhinol Laryngol.
1936;
45
822
- 5
Jones R C, Stevens S, Lurie M.
Three mechanisms of hearing by electrical stimulation.
J Acoust Soc Am.
1949;
12
281-290
- 6
Zöllner F, Keidel W D.
Gehörvermittlung durch elektrische Erregung des Nervus acusticus.
Arch klin exp Ohr-Nas-Kehlk-Heilk.
1963;
181
216-223
- 7
Kiang N YS, Eddington D K, Delgutte B.
Fundamental considerations in designing auditory implants.
Acta Otolaryngol.
1979;
87
204-218
- 8
Djourno A.
Excitation induite localisée à distance.
CR Sciences.
1953;
236
2337-2338
- 9
Djourno A, Eyries C h.
Prothèse auditive par excitation électrique a distance du nerf sensoriel a l’aide
d’un bobinage inclus a demeure.
Presse méd.
1957;
65
1417
- 10 Wullstein H L. Tympanoplastik - osteoplastische Epitympanotomie. Horst L. Wullstein,
Sabrina R. Wullstein Stuttgart, New York; Georg-Thieme-Verlag 1986: 39
- 11
Sheehy J L.
A review of operations on the temporal bone.
Calif Med.
1959;
91
137-142
- 12
Doyle J H, Doyle J B, Turnbull F M.
Electric stimulation of the eighth cranial nerve.
Arch Otolaryngol.
1964;
80
388-391
- 13
House W F.
Cochlear implants. Ann Otol Rhinol.
Laryngol.
1976;
85 (27) (suppl)
1-93
- 14
House W F, Berliner K I, Eisenberg L S.
Present status and future directions of the Ear Research Institute Cochlear implant
program.
Acta Otolaryngol.
1979;
87
176-184
- 15
Johnsson L G, House W F, Linthicum F H.
Bilateral cochlear implants: Histological findings in a pair of temporal bones.
Laryngoscope.
1979;
89
759-762
- 16
Johnsson L, House W F, Linthicum F H.
Otopathological findings in a patient with bilateral cochlear implants.
Ann Otol Rhinol Laryngol.
1982;
91
74-89
- 17
Linthicum F H, Galey F R.
Histologic evaluation of temporal bones with cochlear implants.
Ann Otol Rhinol Laryngol.
1983;
92
610-613
- 18
Edgerton B J, House W F, Brimacombe J A, Eisenberg L S.
Status of the cochlear implant program at the House Ear Institute.
Adv Audiol.
1984;
2
68-89
- 19
Berliner K I, Luxford W M, House W F.
Cochlear implants: 1981-1985.
Am J Otol.
1985;
6
173-186
- 20
Simmons F B.
Electrical stimulation of the auditory nerve in man.
Arch Otolaryngol.
1966;
84
2-54
- 21
Simmons F B.
Cochlear implants.
Arch Otolaryngol.
1969;
89
87-92
- 22
Michelson R P.
Cochlear implants.
J Laryngol Otol.
1975;
90
441-444
- 23
Merzenich M M, Schindler R A, White M W.
Feasibility of multichannel scala tympani stimulation.
Laryngoscope.
1974;
84
1887-1893
- 24
Schindler R A, Merzenich M M.
Chronic intracochlear electrode implantation: Cochlear pathology and acoustic nerve
survival.
Ann Otol.
1974;
83
202-215
- 25
Schindler R A, Merzenich M M, White M W, Bjorkroth B.
Multielectrode intracochlear implants. Nerve survival and stimulation patterns.
Arch Otolaryngol.
1977;
103
691-699
- 26
Michelson R P.
Multichannel cochlear implants.
Otol Clin N Am.
1978;
11
209-216
- 27
Merzenich M M, Rebscher S J, Loeb G E, Byers C L, Schindler R A.
The UCSF cochlear implant project (state of development).
Adv Audiol.
1984;
2
119-144
- 28
Clark G M, Krantz H G, Minas H, Nathar J M.
Histopathological findings in cochlear implants in cats.
J Laryngol Otol.
1975;
89
495-504
- 29
Clark G M.
An evaluation of per-scalar cochlear electrode implantation techniques (An histological
study in cats).
J Laryngol Otol.
1977;
91
185-199
- 30
Pialoux P, Chouard C H, MacLeod P.
Physiological and clinical aspects of the rehabilitation of total deafness by implantation
of multiple intracochlear electrodes.
Acta Otolaryngol.
1973;
81
436-441
- 31
Chouard C H.
Multiple intracochlear electrodes for rehabilitation in total deafness.
Otol Clin N Am.
1978;
11 (1)
217-233
- 32
Pialoux P, Chouard C H, Meyer B, Fugain C.
Indications and results of the multichannel cochlear implant.
Acta Otolaryngol.
1979;
87
185-189
- 33
Chouard C H, Fugain C, Meyer B, Lacombe H, Jegu D.
Surgical technique, signal processing and long-term clinical results of the multichannel
cochlear implant.
Adv Audiol.
1984;
2
36-60
- 34
Lacombe H, Meyer B, Chabolle F, Chouard C H.
Surgical procedure and implanted material description.
Acta Otolaryngol.
1984;
411 (suppl)
20-24
- 35
Weber J L, Chouard C H, Alcaras N.
Description of the French 12 channel cochlear implant.
Acta Otolaryngol .
1984;
411 (suppl)
140-143
- 36
Charachon R.
Surgical procedures, Implanted material description.
Acta Otolaryngol.
1984;
411 (suppl)
13-15
- 37
Spoendlin H.
Anatomisch-pathologische Aspekte der Elektrostimulation des ertaubten Innenohres.
Arch Otolaryngol.
1979;
223
1-75
- 38
Burian K, Hochmair E, Hochmair-Desoyer I, Lessel M R.
Designing of and experience with multichannel cochlear implants.
Acta Otolaryngol.
1979;
87
190-195
- 39
Burian K, Eisenwort B, Hochmair E S, Hochmair-Desoyer I J.
Clinical experience with the „Vienna cochlear implant”.
Adv Audiol.
1984;
2
9-29
- 40
Banfai P, Hortmann G, Karczag A, Kubik S, Wustrow F.
Results with 8-channel cochlear implants.
Adv Audiol.
1984;
2
1-18
- 41
Kubik S, Metry I M.
Eyepiece for localisation of drilling holes.
Acta Otolaryngol.
1984;
411 (suppl)
18-19
- 42
Hortmann G, Banfai P, Kubik S.
Implanted material description.
Acta Otolaryngol.
1984;
411 (suppl)
16-17
- 43
Banfai P, Kubik S, Hortmann G.
Our extra-scalar operating method of Cochlear implantation (experience with 46 cases).
Acta Otolaryngol.
1984;
411 (suppl)
9-12
- 44 Spillmann T, Dillier N.
Round window cochlear implant. In: Schindler RA, Merzenich MM (Ed) Cochlear Implants. Based on the 10th Anniversary
Conference on Cochlear Implants 1983 in San Francisco. New York; Raven press 1985:
157
- 45
Fraysse B, Soulier M J, Urgell H, Levy P, Furia F, Defrennes V.
Extracochlear implantation: Technique and results.
Ann Otol Rhinol Laryngol.
1987;
128 (suppl)
111-113
- 46
Fourcin A J, Rosen S M, Moore B C, Douek E E, Clarke G P, Dodson H, Bannister L H.
External electrical stimulation of the cochlea: Clinical, physiological, speech-perceptual
and histological findings.
Br J Audiol.
1979;
13 (3)
85-107
- 47 Walliker J R, Douek E E, Frampton S, Abberton E, Fourcin A J, Howard D M, Nevard S,
Rosen S M, Moore B C.
Physical and surgical aspects of external single channel electrical stimulation of
the totally deaf. In: Schindler RA, Merzenich MM (Ed) Cochlear Implants. Based on the 10th Anniversary
Conference on Cochlear Implants 1983 in San Francisco. New York; Raven press 1985:
143
- 48
Michelson R P.
Multichannel cochlear implants.
New dimens otorhinolaryngol-head neck surg.
1985;
1
61-63
- 49
Gantz B, McCabe B, Tyler R.
Evaluation of four cochlear implant designs.
Ann Otol Rginol Laryngol.
1987;
128 (suppl)
145-147
- 50
Gantz B J, Tyler R S, Abbas P, Tye-Murray N, Knutson J F, McCabe B F, Lansing C, Brown C,
Woodworth G, Hinrichs J, Kuk F.
Evaluation of five different cochlear implant designs: Audiologic assessment and predictors
of performance.
Laryngoscope.
1988;
98
1100-1106
- 51 Loeb G E.
Single and multichannel cochlear prostheses: Rationale, strategies, and potential. In: Schindler RA, Merzenich MM (Ed) Cochlear Implants. Based on the 10th anniversary
Conference on Cochlear Implants 1983 in San Francisco. New York; Raven press 1985:
17
- 52 Clark G M, Shepherd R K, Patrick J F, Black R C, Tong Y C.
Design and fabrication of the banded electrode array. In: Parkins CW, Anderson SW (Hrsg.) Cochlear Prostheses: An International Symposium. Ann
NY Acad Sci 1983 405: 191-201
- 53
Burian K, Eisenwort B.
Erfahrungen mit der Wiener Hörprothese.
Laryngol Rhinol Otol.
1989;
68
95-97
- 54
Marangos N, Laszig R.
Cochlear Implants. Die prothetische Versorgung bei Taubheit um die Jahrtausendwende.
HNO.
1998;
46
12-26
- 55
Clark G M, Pyman B C, Bailey Q E, Webb R L, Shepherd R K.
Surgery for an improved multiple-channel cochlear implant.
Ann Otol Rhinol Laryngol.
1984;
93
204-207
- 56
Lehnhardt E.
Intracochleäre Plazierung der Cochlear-Implant-Elektroden in soft surgery technique.
HNO.
1993;
41
56-359
- 57
Lenarz T, Lesinsky-Schiedat A, von der Haar-Heise S, Illg A, Bertram B, Battmer R D.
Cochlear implantation in children under the age of two: The MHH experience with the
CLARION cochlear implant.
Ann Otol Rhinol Laryngol.
1999;
108
4-49
- 58
Jackler R K, Leake P A, McKerrow W S.
Cochlear implant revision: The effects of Reimplantation on the cochlea.
Ann Otol Rhinol Laryngol.
1989;
98
813-820
- 59
Laszig R, Marangos N.
Cochlear Implants - Heutiger Stand.
HNO Praxis heute.
1998;
18
0-67
- 60
Wilson B S, Finley C C, Lawson D T, Wolford R D, Eddington D K, Rabinowitz W M.
Better speech recognition with cochlear implants.
Nature.
1991;
352
236-238
- 61 Lehnhardt E.
Cochlear Implant. In: Naumann HH, Helms J, Herberhold C, Kastenbauer E (Hrsg.) Oto-Rhino-Laryngologie
in Klinik und Praxis. Band 1. Stuttgart, New York; Thieme 1994: 893
- 62
Fraysse B, Dillier N, Klenzner T, Laszig R, Manrique M, Morera Perez P C, Morgon A H,
Muller-Deile J, Ramos Macias M A.
Cochlear implants for adults obtaining marginal benefit from acoustic amplification:
A European study.
Am J Otol.
1998;
19 (5)
91-597
- 63
Gstoettner W, Adunka O, Hamzavi J, Lautischer M, Baumgartner W D.
Sprachdiskrimination bei postlingual ertaubten, Cochlear-implantierten Patienten.
Wien Klin Wochenschr.
2000;
111/12
487-491
- 64
Klenzner T, Stecker M, Marangos N, Laszig R.
Zur Indikationserweiterung des „cochlear-implant”.
HNO.
1999;
47
5-100
- 65
Marangos N, Laszig R.
Restoration of hearing with multichannel prostheses: 10 years’ experience.
Folia Phoniatr Logop.
1996;
48
31-136
- 66
Tykocinski M, Cohen L T, Pyman B C, Roland T Jr, Treaba C, Palamara J, Dahm M C, Shepherd R K,
Xu J, Cowan R S, Cohen N L, Clark G M.
Comparison of electrode position in the human cochlea using various perimodiolar electrode
arrays.
Am J Otol.
2000;
21 (2)
5-211
- 67
Richter B, Aschendorff A, Lohnstein P, Husstedt H, Nagursky H, Laszig R.
The Nucleus Contour™ electrode array: A radiological and histological study.
Laryngoscope.
2001a;
111 (3)
8-514
- 68
Richter B, Jaekel K, Aschendorff A, Marangos N, Laszig R.
Cochlear structures after implantation of a perimodiolar electrode array.
Laryngoscope.
2001b ;
111 (5)
837-843
- 69
Gstoettner W K, Adunka O, Franz P, Hamzavi J Jr, Plenk H Jr, Susani M, Baumgartner W,
Kiefer J.
Perimodiolar electrodes in cochlear implant surgery.
Acta Otolaryngol.
2001;
121 (2)
216-219
- 70
Husstedt H, Aschendorff A, Richter B, Laszig R, Schumacher M.
Nondestructive three-dimensional analysis of electrode to modiolus proximity.
Otol Neurol.
2002;
23 (1)
49-52
Dr. med. Katrin Jaekel
Univ.-HNO-Klinik Freiburg i. Br.
Killianstraße 5 · 79106 Freiburg
