eAudiology
On-Demand- ARC 24: Advances in Implantable Devices - All Sessions (0.5 AAA/Tier 1 CEUs)
Recorded On: 10/24/2024
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This is the ondemand version of the ARC 24: Advances in Implantable Devices - All Sessions (0.5 AAA/Tier 1 CEUs) which broadcasted live on October 24, 2024.
AM Sessions
Welcome and Introductory Remarks
Patricia Gaffney, AuD, MPH,President, American Academy of Audiology
Professor, Nova Southeastern University
Jamie Bogle, AuD, PhD, Principal Investigator, ARC Grant
Chair, Division of Audiology and Ass’t Professor, Mayo Clinic College of Medicine Science
Landscape of Implantable Devices: An Overview
René Gifford, PhD, ARC 2024 Chairperson
Fred H. Bess Chair in Audiology; Professor, Hearing and Speech Sciences; Director, Implantables, Hearing Enhancement, & Amplification Research (I HEAR) Laboratory; Vanderbilt University Medical Center
Current Status of Bone Conduction Hearing Implants
Hillary Snapp, AuD, PhD
Chief of Audiology and Associate Professor
University of Miami Ear Institute
Program Description:
This course will provide an in-depth review of the latest advancements and current applications of bone conduction hearing devices . It provides a scientific framework for best practices in the provision of bone conduction implants, ensuring clinicians have the evidence-based knowledge required to make informed decisions. Areas of focus include principles of bone conduction, candidacy for bone conduction devices, prognostic factors, and assessment methods. The course will cover the clinical and technical considerations involved in bone conduction stimulation alongside the latest advancements in implantable technologies.
Learning Objectives:
-Identify different types of bone conduction implants and their applications
-Discuss prognostic factors influencing patient outcomes
-Understand the principles of bone conduction stimulation in managing patients with hearing loss
Hearing Health: Our Role in Risk Prevention of Cognitive Decline
Regina Presley, AuD, Director of Audiology, Presbyterian Board of Governors Cochlear Implant Center of Excellence at GBMC
Program Description:
Over 20 years ago researchers began forecasting the prevalence of the impact of dementia on society. Since that time, the estimation of individuals with dementia continues to rise encouraging researchers to explore insights to combat this global crisis. The WHO and the CDC continue to provide guidance regarding the top factors that influence reducing the risk of dementia or slowing its decline. This presentation has been designed to help us all have a better foundation regarding stages of dementia. We will discuss what we know to date about the relationship between hearing loss and cognitive function. We will explore how this impacts patient management and recommendations. Most importantly, we will examine ways to improve patient care as it relates to brain health.
Learning Objectives:
-Identify stages of cognitive decline.
-List risk factors and comorbidities important to comprehensive patient counseling.
-Examine how cognitive screening results and case history can impact patient management audiologically, rehabilitatively, and medically.
Genetic Evaluation and Counseling for Pediatric Cochlear Implant Patients
A. Elliot Shearer, MD, PhD, FACS, Pediatric Otolaryngologist, Boston Children’s Hospital; Assistant Professor, Harvard Medical School
Shelby Redfield, MS, CGC, Genetic Counselor and Clinical Research Coordinator, Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital
Program Description:
Genetic evaluation is integral for pediatric cochlear implant candidates as it provides critical information to families including: (1) evaluation for syndromic forms of hearing loss, (2) empowerment over their diagnosis of hearing loss, and (3) determines whether patients are candidates for clinical trials for gene therapy. In this presentation, we will describe an algorithm for clinical evaluation for pediatric hearing loss patients that includes genetic testing. We will emphasize the impact a genetic diagnosis has on clinical care. And finally, we will provide examples of how we counsel families who are receiving genetic diagnoses. At the end of the presentation, attendees will better understand how an understanding of the genetic cause of hearing loss is key to patient-centered care for pediatric cochlear implant candidates.
Learning Objectives:
To describe the recommended clinical evaluation for pediatric cochlear implant candidates.
To detail ways in which a genetic diagnosis is impactful to patients and their families.
To provide an overview of how to counsel pediatric patients who are receiving a genetic diagnosis, particularly in the context of gene therapy clinical trials.
Panel Discussion of Speakers and Program Committee
PM Sessions
Welcome and Cochlear Implant Overview
Michelle Hughes, PhD, ARC 2024 Program Committee
Professor and Director of the Cochlear Implant Research Lab, University of Nebraska, Lincoln
Hearing and Robotic-assisted CI Surgery
Marlan Hansen, MD, Professor of Neurosurgery, University of Iowa
Binaural Auditory Development and Implications for Determining Bilateral CI and Bimodal Candidacy: From auditory neuroscience to audiology
Polonenko, AuD, PhD, Assistant Professor in the Department of Speech-Language-Hearing Sciences, University of Minnesota
Program Description:
Cochlear implantation criteria have expanded to include infants and children who have residual hearing by giving a hearing aid (or normal hearing in the extreme case) in one ear and a cochlear implant in the other ear, called bimodal hearing. This talk will explore the underlying neural changes that occur with asymmetric hearing during development and how those changes and their trajectory influence outcomes of cochlear implantation. A particular focus will be on how these developmental changes and outcomes inform clinical decisions about whether to give, or keep, bimodal hearing and when to recommend bilateral cochlear implants to children with some residual hearing, with the ultimate goal of maximizing binaural auditory development and spoken language acquisition.
Learning Objectives:
-Describe some neuroplastic changes during development that impact cochlear implantation (CI) outcomes.
-Identify some factors influencing the choice for bimodal versus bilateral CI candidacy.
-Explain how timing and type of hearing influence outcomes with bimodal vs bilateral CI.
Totally Implantable Cochlear Implants: Where we came from, where we are, and where we’re going
Heidi Nakajima, MD, PhD, Gudrun Larsen Eliasen and Nels Kristian Eliasen Associate Professor of Otolaryngology–Head and Neck Surgery, Harvard Medical School; Investigator, Eaton-Peabody Laboratories, Mass Eye and Ear
Program Description:
A totally-implantable cochlear implant (TICI) has the potential to offer significant advantages over a conventional cochlear implant (CI) with external hardware. Obstacles to internalizing all hardware for a TICI, such as power consumption, battery life, charging, and miniaturization have been removed through recent technical advances. However, to enable widespread adoption of a TICI, an implantable microphone having performance on par with that of conventional external microphones is still needed. Although TICIs are not currently available on the market, several clinical studies have been performed or are underway. A short overview of the various types will be described.
For our design, we considered some of the natural benefits of our normal ears. A microphone that senses middle-ear motion benefits from the external ear’s acoustic pressure enhancement and from sound localization cues that improve hearing in the face of challenging environmental noise. Unlike external microphones, an implantable microphone would pick up less noise from wind, hair, or head-coverings, and would be visually discrete.
We have developed a prototype implantable microphone with the goal of enabling TICI that takes advantage of the outer-ear acoustic benefits. This microphone, called the umbo-mic (UMic), senses the motion of the umbo (the distal tip of the manubrium) within the middle ear cavity. Due to its novel design and fabrication, the UMic’s performance rivals that of a conventional external cochlear implant microphone in terms of sensitivity, bandwidth, linearity, dynamic range, signal-to-noise ratio, and ability to reject and shield from electrical noise (such as cochlear implant signals). The UMic was developed through iterations of analytical modeling, finite-element analysis, bench testing and implanted testing in human cadaveric ears. Its exceptional performance derives from its architecture: a triangular cantilever sensor comprised of two layers of piezoelectric polymer polyvinylidene fluoride (PVDF) providing a differential output to. This sensor, composed of fully biocompatible materials, connects to a custom low-noise low-power differential amplifier.
Learning Objectives:
-What are the limitations that have prevented totally implantable microphones from being generally available to patients?
-What are some of the designs of implantable microphones and their benefits and limitations?
-What are some of the goals and design considerations that went into the umbo-mic (UMic)?
Panel Discussion of Afternoon Speakers and Program Committee
Future Priorities
Camille Dunn-Johnson, PhD, ARC 2024 Program Committee
Assistant Professor and Director of the Cochlear Implant Program, University of Iowa